Background and Objectives: Some retired professional athletes report physical, cognitive, and emotional symptoms in their daily life. We examined the presence of symptoms in retired professional collision sports athletes and matched control participants.
Methods: 86 former Australian professional rugby league players and 36 community-based controls with no history of collision sport participation or neurotrauma completed the Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ) based on their symptom presentation during the 24 hours prior to testing. Each symptom was dichotomized (absent vs. present at any severity level). The total number of symptoms endorsed on the RPCSQ score was compared across groups using a Mann-Whitney U-Test because the data were non-normally distributed. Chi-squared analyses were used to compare the prevalence of individual symptom reporting between groups. 
Results: The retired athletes and control participants were group-matched on age (retired players: M=52.7, SD=13.3, range 30-89; controls: M=51.9, SD=14.8, range=31-82, U=1,489.5, p=.74) and education (retired players: M=11.8, SD=2.6, controls: M=12.8, SD=2.69, U=1,269.5, p=.11). The retired athletes reported a median of 12 prior concussions (IQR=6-30). Their most recent concussion was, on average, 20 years prior to testing. Out of 16 possible symptoms, retired players endorsed currently experiencing more symptoms compared to controls (retired players: M=6.76, SD=3.91, Md=7; controls: M=4.05, SD=3.55, Md=3; U=901.5, p<.001, d=0.73). Compared to controls, a significantly greater portion of the retired players noted some degree of depressed mood (44.7% vs 16.7%), feeling frustrated/impatient (67.1% vs. 41.7%), forgetfulness (71.8% vs. 44.4%), poor concentration (68.2% vs. 30.6%), taking longer to think (63.5% vs. 25.0%) and restlessness (50.6% vs. 27.8%, all ps<.05). A similar portion of both groups reported headaches (players=41.2% vs. controls=33.3%), irritability (players=56.5% vs. controls=41.7%), fatigue (player=52.9% vs. controls=50.0%), and sleep problems (players=54.1% vs. controls=47.2%; all ps>.05).
Conclusions: Symptom endorsement was very common in both groups. On average, retired professional athletes reported experiencing a greater number of current symptoms compared to control participants. The etiology of these symptoms is unclear, and could be related to a variety of biopsychosocial factors like neurodevelopment, physical health diagnoses, mental health problems, substance abuse, and a history of repetitive neurotrauma.

Current concussion-like symptom reporting among former professional rugby league players