Lower cognitive performance of older football players possessing apolipoprotein E epsilon4.

OBJECTIVE: To determine whether the cognitive status of professional football players varies as a function of age and apolipoprotein E (APOE) genotype. METHODS: Fifty-three active players underwent APOE and neuropsychological assessments. Players were grouped according to age (proxy indicator of high/low exposure to contact) and the presence/absence of at least one copy of the epsilon4 allele. Outcome measures were overall cognitive performance and scores in cognitive domains. RESULTS: As a group, older players possessing APOE epsilon4 exhibited significantly lower cognitive test scores than did all other players studied, including non-epsilon4-possessing players and younger epsilon4-carriers. Measures of general cognitive functioning, information-processing speed and accuracy, and attention were related to poorer performance among the epsilon4-carrying players. In an analysis of variance model, the interaction between APOE genotype and age was significant (P = 0.004). As determined using linear regression, age accounted for 34% of the variance in the memory index among APOE epsilon4-possessing players but did not contribute significantly to variance among the non-epsilon4-possessing players. Older APOE epsilon4-carriers were significantly overrepresented among players whose scores indicated possible cognitive impairment, with the criterion of performing two or more standard deviations below the general normal values in a summary index of general cognitive functioning. CONCLUSION: Older professional football players who possessed the APOE epsilon4 allele scored lower on cognitive tests than did players without this allele or less experienced players of any genotype. The cognitive status of professional athletes with repeated exposure to head trauma may therefore be influenced by age, inherited factors such as APOE genotype, and cumulative exposure to contact.

Hormones and cognition: current concepts and issues in neuropsychology.

This article provides an extensive and comprehensive review of the effects of hormones on cognition. Studies detailing specific neurocognitive functions affected by variation in hormone levels across the life span are presented. Dysregulation of hormone levels is considered from models of both normal and diseased functioning. Patterns of cognitive dysfunction are described for a range of syndromes involving the neuroendocrine system, and evidence of specific neurophysiological mechanisms that can account for these findings is outlined. This review includes discussion of treatment outcomes and the permanency of endocrine-related cognitive dysfunction. The authors present a set of guidelines for clinical neuropsychologists to use for assessment of patients with neuroendocrine system dysfunction. Clinical and methodological issues in research and treatment settings are discussed.

Neuropsychology of sports-related head injury: Dementia Pugilistica to Post Concussion Syndrome.

This article reviews the existing literature in the following areas of sports neuropsychology: Dementia Pugilistica, concussion and Post Concussion Syndrome, Second Impact Syndrome, and the emerging role of the sports neuropsychologist regarding return to play decisions. Dementia Pugilistica is discussed as a condition that exists along a continuum: Although many boxers will develop mild neurocognitive deficits, it is not yet known what percent of these mild presentations will progress to diagnosable Dementia Pugilistica. Factors contributing to both increased and reduced risk are detailed. The role of neuropsychological assessment in research and clinical management is reviewed. Existing studies of concussion incurred during contact sports provide evidence of an important role for neuropsychology in assessment and management of mild head injuries. Issues in clinical assessment of concussion are reviewed. The importance of grading of concussions, monitoring of postconcussive symptom resolution, and the use of neuropsychological test results in return to play decisions is detailed. The Second Impact Syndrome is discussed with regard to return to play decisions. Recommendations are proposed for research and for clinical application of findings in sports neuropsychology.

Identity status and empathic response patterns: a multidimensional investigation.

This study examined the multidimensional empathic response patterns of late adolescent undergraduate students according to their identity status. Subjects were 153 undergraduates at seven New York City area colleges. Subjects completed self-report measures of empathic response style and identity development. Empathic concern showed a statistically significant positive linear relationship with the identity status hierarchy. Cognitive empathy had a statistically significant positive relationship, and empathic distress had a statistically significant negative relationship with identity exploration. Findings are discussed in the context of developmental and social-cognitive models of identity status.