The Impact and Influence of Sports Related Concussion and Cardiovascular Risk Factors on Brain and Heart Health across an Ageing Population
Citation:
Joyce, Oisín Cormac James, The Impact and Influence of Sports Related Concussion and Cardiovascular Risk Factors on Brain and Heart Health across an Ageing Population, Trinity College Dublin, School of Medicine, Physiology, 2023Download Item:
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Abstract:
This study focused on the relationship between perceptual performance, brain health, and cardiovascular (CV) profiles in both recreational athletes and non-athletes, bridging the gap between sensory integration, cognitive function, and physical well-being. The study's primary aim was to explore brain health in young and middle-aged recreational athletes in diverse contact and non-contact sports via a neuropsychological measure of multisensory integration (MSI) known as the Sound-Induced Flash Illusion (SIFI) task. This task may be of use as an objective diagnostic test of sports-related concussion, thus history of concussion in all subjects was recorded. Additionally, the impact of exercise on SIFI performance and the test's reliability and overall level of agreement were examined since, if the test is to be of diagnostic use in a sports setting, performance must be resistant to exercise and the test must be robust and reliable across multiple testing sessions. Finally, the link between older community-level athletes' CV health profile and cognition in midlife was investigated alongside a systematic review of the literature investigating the influence of midlife CV risk factors on cognition across multiple domains.
Our results show that healthy young adults (aged 18-30) with or without a history of concussion showed comparable perceptual accuracy in the SIFI task across illusory conditions. While females exhibited greater susceptibility to the illusion, factors like sex and concussion history did not account for perceptual performance variance. Contact sports participants demonstrated heightened MSI, possibly due to training in open skill sports, but overall sporting cohort did not significantly affect perceptual differences. A follow-up study confirmed sex-based and sports-specific disparities in perceptual performance with open skill sport participants excelling in larger temporal asynchrony conditions, and a subgroup exhibiting a nuanced learning effect linked to cumulative SIFI exposure. The influence of moderate and high-intensity exercise on SIFI performance was negligible, supporting the hypothesis that the test may be of use in sport settings. Remarkably, the SIFI displayed strong reliability across multiple testing sessions, further supporting its utility in concussion diagnosis and prognosis.
A series of systematic reviews highlighted the complex relationship between midlife CV risk factors (hypertension, diabetes, cholesterol) and cognitive function, underscoring the need for targeted interventions at particular life stages in order to protect brain health in older age. Findings varied across different cognitive domains; notably, impairments in memory, executive function, and global cognition were correlated with poorer CV health. Longitudinal studies predominantly affirmed an adverse link between midlife CV risk factors, specifically hypertension and type 2 diabetes (T2DM), and cognitive decline in later life. In contrast, the relationship with cholesterol was less clear, with some studies indicating positive associations while others identified negative links with cholesterol, high-density lipoproteins, low density lipoproteins, and triglycerides.
A study of SIFI performance, markers of CV health and history of concussion in middle-aged subjects with a history of recreational sporting activity revealed sex differences in BMI and health measures, with sporting engagement influencing blood pressure (BP) and mental health outcomes. A notable distinction emerged in sports participation; females engaged exclusively in non-contact sports, whereas males participated in both sporting types. Lifetime sporting involvement showed a positive correlation with systolic BP and depression, but conversely showed a negative correlation with overall physical activity and mental health metrics. Markedly, no significant correlation emerged between cognitive functioning and sports experience. Sex differences in global cognition were not significant, although females displayed an average score below the clinical cut-off, suggesting a potential increased risk of mild cognitive impairment. Susceptibility patterns to SIFI illusory conditions among older community athletes at midlife resembled those in our study of younger subjects, revealing high, moderate, and low performers. While sex did not significantly predict perceptual accuracy, males exhibited reduced susceptibility to the SIFI. Intriguingly, those who had participated in non-contact sports consistently outperformed contact sports across all SOA conditions, and despite differing outcomes from those in young participants, no significant distinctions emerged between open skill and closed skill sports.
Results included in this thesis have broad implications for athletes, coaches, healthcare professionals, policymakers, and the general public. As well as providing evidence to support the potential use of a simple but robust test of MSI in the diagnosis of concussion and monitoring of recovery, it also adds to our knowledge of the influence of CV wellbeing on brain health and function in middle age and later life. Future research should investigate the physiological mechanisms underlying the age-, sex-, disease- and exercise-related influences on cognitive function that we have observed and work towards development of tailored interventions to promote healthy aging for athletes and non-athletes alike. Ultimately, this research advances our understanding of the intricate relationships between cognitive function, brain health, and cardiovascular well-being, urging proactive measures to ensure the well-being of both athletes and the wider population.
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APPROVED
Author: Joyce, Oisín Cormac James
Advisor:
Kelly, ÁinePublisher:
Trinity College Dublin. School of Medicine. Discipline of PhysiologyType of material:
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