Concussion is a growing concern among health professionals in the United States. Most research to date has focused on sport-related concussion, although it is known that a substantial number of concussions occur outside of participation in sport. A new study aimed to determine the prevalence of concussion among undergraduate athletes and nonathletes. Researchers determined that although the incidence of concussion was similar among men and women, the rate of non-sport-related concussion was higher than that of sport-related concussion, according to data published in JAMA.
The researchers used data spanning 3 academic years for nonathlete students and 2 academic years for varsity athletes attending a large public US university. Diagnoses of concussion were made either by a concussion team at the student health care center for the general population or by the sports medicine department of the school for varsity athletes. All students were evaluated for neurological status, postural stability, and oculomotor and vestibular domains. The cause of the injury was also indicated for each case. These were characterized as either sport-related or non-sport-related (falls, hits to head, motor vehicle crashes, etc.). Concussion incidence was measured in terms of incidence per 10,000 students and incidence per 1000 person-months (the number of months students were on campus multiplied by undergraduate enrollment).
Of 954 students who were diagnosed with concussions, 52.6% were men and 47.4% were women. The majority (78.5%) were white. Nearly half of the students reported a previous concussion, with many reporting multiple previous concussions. Most common causes were falls (37.7%) and sport-related (35.6%). Among varsity athletes, there were 32 sport-related concussions among women and 9 among men during the first year of the study. The following year, there were 10 concussions among male athletes and 19 among female athletes.
The incidence of non-sport-related concussion was almost double that of sport-related concussion during the study period. This included data for varsity athletes. The majority of non-sport-related concussions occurred in the month of August, whereas sport-related concussion rates varied throughout the academic year. This incidence is more than 2-fold higher than the concussion incidence for the general population reported by the World Health Organization in 2004, demonstrating that the undergraduate population is at an increased risk for concussion. Specifically, women had higher rates of concussion than men, and there were higher rates of non-sport-related concussions than those related to sports.
The study was limited by the facts that not all students who have concussions will seek care and students who do seek care may not do so at a student health center. Varsity athletes are especially less likely to report symptoms, which places the likely rates of concussion among undergraduates higher than those reported in the study. Additionally, the population included in the study is not necessarily representative of the entire student body or the student body at other US colleges and universities.
Breck J, Bohr A, Poddar S, McQueen MB, Casault T. Characteristics and incidence of concussion among a US collegiate undergraduate population. JAMA Netw Open. 2019;2(12):e1917626. doi: 10.1001/jamanetworkopen.2019.17626.