Chronic traumatic encephalopathy (CTE) is a progressive neurodegeneration associated with repetitive head trauma.
American football players may be at an increased risk of long-term neurological conditions, particularly CTE, according to the study.
Researchers from Boston University in the US examined the brains of 202 deceased former football players to determine neuropathological features of CTE through laboratory examinations.
They analysed the clinical symptoms of CTE by talking to players' next of kin to collect detailed histories including on head trauma, athletic participation and military service.
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The 177 players included three of 14 high school players (21 per cent), 48 of 53 college players (91 per cent), nine of 14 semiprofessional players (64 per cent), seven of eight Canadian Football League players (88 per cent), and 110 of 111 NFL players (99 per cent), researchers said.
Neuropathological severity of CTE was distributed across the highest level of play, with all three former high school players having mild pathology and the majority of former college (56 per cent), semiprofessional (56 per cent), and professional (86 per cent) players having severe pathology.
Among 84 participants with severe CTE pathology, 89 per cent had behavioural or mood symptoms or both, 95 per cent had cognitive symptoms, and 85 per cent had signs of dementia.
"In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football," researchers said.
The study was published in The Journal of the American Medical Association.