Study reveals cumulative CTE risk in ice hockey players: years of play linked to increased odds

By Sneha Bansal. This article was initially published in the 1/9/25 edition of our Concussion Update newsletter; please consider subscribing.

A recent study published in JAMA Network Open provides compelling evidence that the risk of developing chronic traumatic encephalopathy (CTE) increases cumulatively with each year of ice hockey play, similar to findings observed in American football and rugby league players. The research found that for each additional year of ice hockey played, the odds of having CTE increased by 34%, with a corresponding increase in the severity of the condition.

Dr. Jesse Mez, primary author of the study and co-director of clinical research at the CTE Center at Boston University, emphasized the importance of these findings in an article in Healio, stating, "This is the first study to clearly establish a dose-response relationship between years of ice hockey play and chronic traumatic encephalopathy."

The study examined the brains of 77 deceased male ice hockey players from various levels of play, ranging from youth to professional, with a median age of 51 years. The researchers adjusted for modifying factors, including age at death, other contact sports played, age of first hockey exposure, concussion count, and hockey position. 

While the study provides valuable insights, the sample size was small, especially for players participating in lower levels of play. Moreover, the sample consisted exclusively of White males, limiting the generalizability of the findings to more diverse populations and female hockey players. 

Additionally, the researchers acknowledged that career duration is an imperfect proxy for repetitive head impact exposure. In this article published by MedPage Today, Dr. Mez theorized, "Ice hockey players skate quickly, and checking leads to impacts with other players, the ice, boards, and glass. We think years of play is a proxy for these impacts that are harder to measure directly, but are likely what are leading to the disease."

In conclusion, this study highlights the need for continued research into the long-term effects of ice hockey play on brain health and underscores the importance of implementing strategies to reduce the risk of CTE in hockey players at all levels. These findings provide crucial information for players, families, and clinicians to make informed decisions about participation in ice hockey and to better manage the health of former players.