1 in 3 former NFL players believe they have CTE, according to a new Harvard study

Beginning in 2017, nearly 2,000 former NFL players participated in a study that sought to explore sensitive, personal terrain: determining how many believed that they had developed a neurodegenerative disease from playing football, and were also experiencing suicidal thoughts.

That research, conducted by Harvard University’s Football Players Health Study, and published Monday in the medical journal JAMA Neurology, found that 34% of the players felt certain that they had Chronic Traumatic Encephalopathy, which can only be diagnosed after a person has died.

The average age of ex-players who believed that they had CTE was 54. The study found that 25% of those players also reported having suicidal thoughts in the previous two weeks.

Data that researchers collected showed that many of those same retired athletes suffered from other health problems, including sleep apnea, depression, low testosterone, and high blood pressure — maladies that could cause cognitive difficulties that players might mistakenly attribute to CTE.

“All of these guys who have cognitive issues may have CTE. But they also have these conditions that are treatable,” said Rachel Grashow, the study’s lead author, and the director of epidemiological research initiatives for the Harvard Football Players Health Study.

“People don’t realize, if you have sleep apnea, you’re depriving your brain of oxygen a couple of times a night. If you have low testosterone, that could be impacting your ability to maintain a clear focus.”

Earlier this month, an Inquirer investigation, The Final Penalty, examined the toll that concussions and sub-concussive hits have taken on members of the 1980 Eagles, the first team in franchise history to appear in a Super Bowl.

The newspaper spoke with a dozen of that team’s 22 starters, and with relatives of two who have died, and found that 12 of the 14 developed a range of cognitive issues after retirement — from memory loss and depression, to personality changes and movement disorders.

Researchers at Boston University’s Chronic Traumatic Encephalopathy Center, which has examined the brains of former athletes since 2008, determined that three 1980 Eagles had CTE: former center Guy Morriss, former linebacker Frank LeMaster, and former punter Max Runager.

(All told, 376 former players have so far donated their brains to Boston University, which found CTE in 345 specimens, or nearly 92%.)

The NFL long denied a connection between football and neurodegenerative diseases, but has, in recent years, changed its stance, and acknowledged a link.

The league did not immediately reply to a request for comment Monday.

Former players who participated in the Harvard study — which was funded in large part by the NFL players union — reported that they began playing football, on average, when they were 11 years old.

Many of those athletes made their NFL debut in 1980, when an average player’s salary was $78,657; their careers lasted little more than six years.

The Football Players Health Study sent invitations to more than 15,000 retired players in 2015, and 4,180 provided baseline information about their demographics, health, and playing history. By 2019, nearly half of them — 1,980 — answered a second survey about perception of CTE and self harm.

Among players who felt that they had CTE, 37% percent were former offensive or defensive linemen, positions that experience collisions on nearly every play of an NFL game. (“I compare it to boxing,” former Eagles left tackle Stan Walters recently told The Inquirer. “A thousand jabs, instead of one knockout punch.”)

Nearly 20% of players who believed that they had CTE also acknowledged having used performance-enhancing drugs, some of which have been linked to depression.

“There are so many different ways to treat depression,” Grashow said.

She said she hoped the study’s findings would help “move the needle” on health literacy among former players, and motivate some to investigate underlying medical issues.

“They want to be proactive, but it’s hard to be proactive when the national conversation is so CTE-focused,” Grashow said. “They’re worried that they have a progressive illness, and there’s nothing that they can do about it.”

In 2011, more than 80 former players sued the NFL in California and Pennsylvania, accusing the league’s leaders of minimizing the risks of repeated brain injuries. The NFL denied those claims. The number of plaintiffs climbed into the thousands, and the cases were consolidated in Philadelphia federal court.

Three years later, the former players and the league settled the case. The NFL admitted no wrongdoing, but agreed to fund a program that would pay retired players between $25,000 and $5 million if they had neurocognitive impairment, Alzheimer’s disease, Parkinson’s disease, or amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease).

The NFL settlement program has paid out more than $1.3 billion. Among the 20,572 former players who are eligible — those who retired before July 7, 2014 — just 4,057 have submitted claims. Only 1,802 players, or 44%, have actually been paid.

The specter of brain injuries continues to cast a shadow over the league.

On Sept. 12, during a Thursday Night Football matchup between the Miami Dolphins and Buffalo Bills, Dolphins quarterback Tua Tagovailoa suffered the third concussion of his NFL career.

Tagovailoa, 26, collided with Bills safety Damar Hamlin, then slammed the back of his head against the playing field. Tagovailoa’s right arm jutted out awkwardly in a “fencing response,” a reaction observed in victims of traumatic brain injuries. (The Dolphins placed Tagovailoa on injured reserve, meaning he would miss at least four games.)

On Sunday afternoon, Eagles right tackle Lane Johnson suffered a concussion during the first quarter of the team’s game against the New Orleans Saints.

It was at least the fourth diagnosed concussion of Johnson’s career. Reporters observed Johnson, 34, vomiting on the sideline, and he was removed from the game.

Later in the game, during the fourth quarter, Eagles wide receiver DeVonta Smith hauled in a short pass, and was corralled by two Saints defenders.

A third Saint, defensive tackle Khristian Boyd, then struck Smith with such force that the slender wide receiver’s helmet was knocked off his head.

Smith, 25, initially lay motionless on the field, and trainers rushed to his side. He, too, had suffered a concussion, and was removed.

“He’s recovering,” Eagles coach Nick Sirianni said of Smith on Monday, “continuing to recover.”