Cognitive Disorders Among Incoming College Football Athletes: Legal and Medical Implications of Undisclosed Inclusion in Concussion Research

Concussion research in the United States commonly relies on collegiate athletes as study subjects. Such research recognizes learning disabilities and attention deficit disorders (LD/ADHD) as co-morbidities that should be addressed in concussion research and management. This forensic study has three objectives: 1) to investigate the prevalence of such diagnoses and examine neuropsychological test results among incoming college football players at a major US university 2) to examine how LD/ADHD diagnoses were addressed in concussion research that included such athletes, and 3) to address the implication of these results for ongoing concussion litigation. This study observed LD/ADHD rates among football athletes exceeding 50% in multiple cohort-years, a degree of magnitude greater than the rate among general college student populations. Neuropsychological testing revealed scores among some incoming freshman college football players consistent with those of severe traumatic brain injury (TBI) patients. Evidence of cognitive impairment among incoming college football players raises concern over the potential effects of cumulative exposure to head trauma and the increased risk associated with continued participation in collision sports. We discuss the implications of our findings for concussion litigation and research ethics.