A recent study conducted by researchers at Boston University has uncovered significant discrepancies in the cognitive impairment ratings of NFL players diagnosed with advanced chronic traumatic encephalopathy (CTE) posthumously. The findings, published in JAMA Network Open, reveal that even players who exhibited cognitive impairment during their lives did not qualify for financial compensation under the NFL Concussion Settlement.
The study focused on 33 former NFL players who were diagnosed with CTE following their deaths. These individuals had previously completed the baseline assessment program (BAP) outlined in the 2014 settlement, which was established to resolve a lengthy class-action lawsuit against the league. This research is noted as the largest of its kind to investigate the correlation between cognitive testing results during life and CTE pathology confirmed after death.
Among the participants, seven were found to have advanced stages of CTE (Stage 3 or 4). Notably, six of these seven players displayed measurable cognitive impairments during their lives. However, all seven received the lowest possible impairment rating (Level 0) according to the BAP's evaluation system, as documented by the families of the players involved.
Michael Alosco, PhD, co-director of clinical research at the Boston University CTE Center, emphasized the implications of these findings, stating, "The BAP's diagnostic criteria might miss cases of cognitive impairment that are objectively measurable and associated with confirmed CTE pathology. This has important implications for former players seeking diagnosis and potential compensation through the NFL Concussion Settlement." His comments highlight the potential shortcomings of the current assessment methods used to evaluate cognitive health in former players.
The average age of participants at the time of testing was 63 years, with an average age of death at 65. The study identified memory issues as the most prevalent cognitive impairment, affecting 63% of the participants. Other common impairments included executive function difficulties, which impacted 52% of the players, and language problems, affecting 41%.
Anna Aaronson, the lead author of the study and a PhD student at the Boston University CTE Center, remarked on the significance of the research, stating, "This is the largest study of its kind to directly link the amount of CTE pathology found at autopsy with objective cognitive testing during life. These findings provide an important roadmap for recognizing CTE in living patients." This statement underscores the need for improved diagnostic criteria that can better identify cognitive impairments in former players.
As of August 31, 2026, the NFL Concussion Settlement has disbursed approximately $1.7 billion in compensation to affected players, but the findings from this study raise questions about the adequacy of the current evaluation processes and their impact on players seeking support.
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