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Several modifiable lifestyle factors have been linked to cognitive ability and the risk of developing Alzheimer’s disease and related dementias (ADRD). Health coaching (HC) is an intervention that addresses lifestyle factors associated with cognition. The effectiveness of an HC protocol was evaluated and compared with a health education (HE) intervention, representing the current standard of care, in a sample of 216 adults between the ages of 45 and 75 years who were at-risk for developing ADRD. Outcomes examined were global cognition, neuropsychological cognition, and Alzheimer’s risk. HC participants received personalized coaching from a health coach focusing on nutrition, physical activity, sleep, stress, social engagement, and cognitive activity. HE participants received biweekly education materials focusing on the same modifiable lifestyle factors addressed by HC. Participants were assessed at baseline and again 4 months later. Self-reported global cognition scores improved only in the HC group (16.18 to 15.52, p = .03) and neuropsychological cognitive ability improved in the HE group (104.48 to 108.76, p p > .05), self-reported global cognition demonstrated an even larger mean improvement in the HC group (16.20 to 15.41, p = .01), and the HC group saw an improvement in ADRD protective risk score (− 10.39 to − 11.45, p = .007). These results indicate that HC and HE can both improve cognition, but HC may be more effective and may yield increased protection against ADRD risk.

No single variable has been identified as the sole factor for predicting an individuals’ declining health status. In order to predict mental or physical decline in older adults, researchers have designed tasks that include both a physical and mental or cognitive demand known as dual task (DT). The purpose of implementing dual task is to assess the possible changes in accuracy when a second task gets compounded with a given single task. Our study consists of males and females aged from 45 to 75 years who have risk factors for dementia. Each subject was randomly assigned to either a health coaching (HC), or health education (HE) control group. The HC group received coaching to address the lifestyle areas known to be linked to AD risk, such as diet, exercise, sleep, stress, cognitive training, and social interaction. Blood markers of each individual have been assessed to determine carrier status of Apolipoprotein E 4 (APOE4) due to the correlation between the allele and increased risk of Alzheimer’s. To be included in the study, the participants must have at least 2 positive risk factors for AD as determined by the Australian National University-Alzheimer Disease Risk Index (ANU-ADRI). Among non-APOE carriers, a 2x3 (group x time) mixed ANOVA revealed a significant interaction effect wherein the HC group improved DTC score more than the HE group from time 1 to time 3, F (2, 362) =1.253, P=0.017. No significant interaction was noted for APOE carriers.

ObjectiveTo examine the association between estimated age at first exposure (eAFE) to American football and clinical measures throughout recovery following concussion.MethodsParticipants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association (NCAA)–Department of Defense Concussion Assessment, Research and Education Consortium. There were 294 NCAA American football players (age 19 ± 1 years) evaluated 24–48 hours following concussion with valid baseline data and 327 (age 19 ± 1 years) evaluated at the time they were asymptomatic with valid baseline data. Participants sustained a medically diagnosed concussion between baseline testing and postconcussion assessments. Outcome measures included the number of days until asymptomatic, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores, Balance Error Scoring System (BESS) total score, and Brief Symptom Inventory 18 (BSI-18) subscores. The eAFE was defined as participant's age at the time of assessment minus self-reported number of years playing football.ResultsIn unadjusted regression models, younger eAFE was associated with lower (worse) ImPACT Visual Motor Speed (R2 = 0.031, p = 0.012) at 24–48 hours following injury and lower (better) BSI-18 Somatization subscores (R2 = 0.014, p = 0.038) when the athletes were asymptomatic. The effect sizes were very small. The eAFE was not associated with the number of days until asymptomatic, other ImPACT composite scores, BESS total score, or other BSI-18 subscores.ConclusionEarlier eAFE to American football was not associated with longer symptom recovery, worse balance, worse cognitive performance, or greater psychological distress following concussion. In these NCAA football players, longer duration of exposure to football during childhood and adolescence appears to be unrelated to clinical recovery following concussion.

OBJECTIVES: To test whether 1) concussed athletes demonstrate slower tandem gait times compared to controls and 2) concussed female athletes display greater post-injury deficits than males. DESIGN: Prospective longitudinal METHOD: Fifty concussed collegiate student-athletes (32% female, age= 20.18±1.27 years) completed tandem gait tests during pre-season (Time 1) and acutely (

Context Postconcussion deficits in neurocognitive performance and postural control may persist at the time of return to sport participation. How these deficits, if present, affect athletic performance is largely unknown, with prior studies showing mixed results. Objective To evaluate postconcussion National Hockey League player performance using advanced hockey metrics over short- (5 games), medium- (10 games), and long-term (remainder of the season) seasonal performance. Design Retrospective cohort study. Patients or Other Participants National Hockey League players who sustained a sport-related concussion (SRC; n = 93) and returned during the same season and players (n = 51) who missed time for non–injury-related reasons. Main Outcome Measure(s) Six performance metrics were used: (1) points per 60 minutes, (2) Corsi percentage, (3) personal Fenwick shooting percentage, (4) scoring chances per 60 minutes, (5) penalty difference, and (6) PDO (not an acronym but sometimes referred to as SVSP% [save percentage shooting percentage]). Performance was compared using 2 (group) × 2 (time) repeated-measures analyses of variance for 3 time windows: (1) ±5 games, (2) ±10 games, and (3) the remainder of the season postconcussion. Alpha values were set at a conservative .01 to account for the lack of independence among dependent variables. Results No significant interactions were present for any of the 6 dependent variables at any of the 3 time windows. Overall, none of the secondary variables differed. Conclusions Using advanced, sport-specific metrics, we found that National Hockey League players did not display worse seasonal performance during 3 postinjury time frames after they sustained an SRC. Whereas laboratory studies have identified lingering neurologic deficits after concussion, our results suggest that these deficits, if present, either do not translate to worse athletic performance or were not captured by these 44 metrics. Further, prospective efforts are needed to accurately quantify performance after SRC among professional hockey players.

ObjectivesTo determine the effect of heading a soccer ball on serum neurofilament light (NF-L) protein, plasma tau protein and symptom metrics including total number of symptoms reported and symptom severity scores on the Standardized Concussion Assessment Tool— 3rd edition (SCAT3).MethodsEleven male collegiate soccer players were recruited to take part in three experimental conditions including heading, sham and control conditions. Participants were required to perform 40 headers in 20 min in the heading condition, and control 40 soccer balls directed at them with their hands, chest or thigh in the sham condition. No ball contact was made during the control condition. Blood sampling and SCAT3 symptom assessments were completed prior to and 1 hour following conditions. A subset of participants returned 3 weeks following the heading condition for blood sampling.ResultsNF-L was elevated at 1 hour (p=0.004) and 1 month (p=0.04) following the heading condition, and at 1 hour (p=0.02) following the control condition. Tau levels remained unchanged following all conditions. The total number of symptoms (TS) and symptom severity (SS) scores from the SCAT3 were both elevated following the heading condition (p=0.01 and p=0.03, respectively). Both TS and SS decreased following sham (p=0.04 and p=0.04) and control conditions (p=0.04 and p=0.04).ConclusionAn acute bout of soccer heading is associated with increased NF-L concentrations at 1 hour and 1 month following the session and can lead to symptoms commonly reported following sport-related concussion.

ObjectiveTo examine sex differences in TG performance among collegiate student-athletes acutely post-concussion relative to pre-injury performance.BackgroundPostural control impairments are common following concussion and traditionally assessed using the Balance Error Scoring System (BESS). Tandem gait (TG) has successfully identified impairments in postural control acutely post-concussion that were undetected by the BESS; thus, TG may be a more robust postural control assessment following concussion. While sex differences in BESS performance after concussion have been explored, there is no literature regarding sex differences in post-concussion TG.Design/MethodsForty-eight concussed collegiate student-athletes (30 females) and twenty-five healthy controls (13 females) completed TG tests during pre-season and again acutely post-concussion. Participants walked heel-to-toe down a 3-meter line, turned, and returned as quickly as possible, completing four single-task (ST) and dual-task (DT) TG trials. During DT trials, they simultaneously answered mini-mental style questions. The best ST and DT times were recorded. A 2 × 2 (group*sex) ANOVA was used to examine TG change between pre-injury and post-injury tests (positive value = slower/worsening; negative value = faster/improving).ResultsThe change in TG time from pre-injury to post-injury was significantly higher for the concussion group relative to the control group during both ST (Concussion: 1.6 ± 2.6 seconds, Controls: −1.1 ± 0.8 seconds, p < 0.001) and DT (Concussion: 2.0 ± 3.8 seconds, Controls: −0.9 ± 1.7 seconds, p < 0.001) TG. There were no significant interactions (ST: p = 0.17, DT: p = 0.23) or main effects for sex (ST: p = 0.63, DT: p = 0.91).ConclusionsThere were no sex-specific differences in TG performance acutely post-concussion. However, all concussed participants, regardless of sex, performed significantly worse on TG than male and female controls after injury relative to baseline, while controls did not demonstrate such a change. These results suggest that TG can appropriately identify postural control impairments following concussion; however, there do not appear to be differences in performance between males and females.

ObjectiveTo examine the association between concussions and lower extremity musculoskeletal injury (LE-MSI) rates in Reserve Officer Training Corps (ROTC) cadets.BackgroundConcussions have been associated with an increased risk for LE-MSI among high school, collegiate, and professional athletes as well as U.S. Army Soldiers. However, there is a paucity evidence on this relationship among U.S. Army ROTC cadets, future U.S. Army Officers, and a group similar to student-athletes in regards to physical activity levels.Design/MethodsA modified reliable injury questionnaire (ICC = 0.92) was used to identify the total number of reported concussions, intentionally unreported concussions, and potentially unrecognized concussions (e.g., memory loss not diagnosed as a concussion) as well as LE-MSI (e.g., muscle strains, ACL rupture) a cadet had suffered. A chi-square analysis was performed to identify the association between concussion and LE-MSI and any concussive injury and LE-MSI.Results47 cadets (19.9 ± 1.3 years) were recruited from one Army ROTC program. There was not a significant association between reported concussions and LE-MSI (Χ(1) = 3.122, p = 0.077). There was not a significant association between any concussive injury (reported, unreported, or potentially unrecognized) and LE-MSI (Χ(1) = 3.590, p = 0.058). The reported concussion history was 38.3% (18/47), any concussive history was 46.8% (22/47), and 68.1% (32/47) reported history of LE-MSI.ConclusionsPreliminary results showed that there was no statistically significant association between concussion and LE-MSI among ROTC cadets at this university. Future research is warranted on a larger cohort of cadets to determine if this relationship exists since cadets will soon commission, potentially risking injury while serving on active duty, causing limited duty days, reduced Department of Defense readiness, and increased healthcare costs. Cadets showed a high incidence of concussion and LE-MSK injury, and future research should target reducing these injuries among ROTC cadets prior to commissioning.