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Athletes’ Age, Sex, and Years of Education Moderate the Acute Neuropsychological Impact of Sports-Related Concussion: A Meta-analysis

Published online by Cambridge University Press:  04 February 2013

Brooke K. Dougan*
School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
Mark S. Horswill
School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
Gina M. Geffen
School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
Correspondence and reprint requests to: Brooke Dougan, School of Psychology, University of Queensland, St Lucia, Brisbane, QLD 4072 Australia. E-mail:


The objective of this study is to determine which pre-existing athlete characteristics, if any, are associated with greater deficits in functioning following sports-related concussion, after controlling for factors previously shown to moderate this effect (e.g., time since injury). Ninety-one independent samples of concussion were included in a fixed+systematic effects meta-analysis (n = 3,801 concussed athletes; 5,631 controls). Moderating variables were assessed using analogue-to-ANOVA and meta-regression analyses. Post-injury assessments first conducted 1–10 days following sports-related concussion revealed significant neuropsychological dysfunction, postural instability and post-concussion symptom reporting (d = −0.54, −1.10, and −1.14, respectively). During this interval, females (d = −0.87), adolescent athletes competing in high school competitions (d = −0.60), and those with 10 years of education (d = −1.32) demonstrated larger post-concussion neuropsychological deficits than males (d = −0.42), adults (d = −0.25), athletes competing at other levels of competition (d = −0.43 to −0.41), or those with 16 years of education (d = −0.15), respectively. However, these sub-groups’ differential impairment/recovery beyond 10 days could not be reliably quantified from available literature. Pre-existing athlete characteristics, particularly age, sex and education, were demonstrated to be significant modifiers of neuropsychological outcomes within 10 days of a sports-related concussion. Implications for return-to-play decision-making and future research directions are discussed. (JINS, 2013, 19, 1–17).

Research Articles
Copyright © The International Neuropsychological Society 2013 

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References References marked with an asterisk (*) indicate papers included in the meta-analysis.

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