How Many NFL Players Have CTE?

late night bites with friends already hard to beat that first too hot bite of fries you couldn't wait for followed by ice cold pepsi now that hits different suddenly the energy kicks back in the night goes longer and the laughs don't stop because pepsi brings out more flavor more fun and more of the moment food deserves pepsi grab a pepsi zero sugar today it's wednesday august 25th is it a dream job or a waking nightmare we start here a new study suggests there are way more nfl players getting traumatic brain injuries than we thought it's almost certainly above that 25 this is reverberated across the sporting landscape the study author is here to answer questions canada aims to hit the u.s where it hurts that means a 50 counter tariff on steel and metal and aluminum goods president trump himself now says this could become a problem and i will always love you doesn't begin to cover it you know i think that any two americans could have a conversation about how much they love dolly parton america says goodbye to perhaps its most beloved modern icon from abc news this is start here i'm brad milkey you we are at the height of the nfl preseason and it is still by far america's favorite sport warm-up games are sold out regular season games are about to be played not just across america but around the globe we want to continue to play around the world and become a global sport australia was always on our map melbourne rio de janeiro paris mexico city this league is determined to make it the world's game and yet for years now the nfl continues to be haunted by three different letters cte cte cte do you think there is a link between football and degenerative brain disorders like cte well certainly dr mckee's research shows that a number of retired nfl players are diagnosed with cte so they're the answer to that question is certainly yes cte it's short for chronic traumatic encephalopathy a condition that people can get from a repeated blows to the head and despite the money that nfl players can make these symptoms are things you wouldn't wish upon your worst enemy let alone the countless amateur players who take these hits for nothing we're talking about memory loss depression minds going blank during routine tasks we're not talking about aging alzheimer's patients here we're talking about elite athletes now in their 40s who can't remember their children's names who wake up screaming had he known he wouldn't have felt so ashamed or alone no one should have to die in a room by himself multiple times in recent years former nfl players have shot themselves to death by aiming the gun at their heart their family said they did so so their brains could be studied some players say they would never let their own children play football others say get over it football is a violent sport we know what we're doing most parents though are not interested in debates between nfl stars they just want to know straight up if my kid plays football what is the likelihood they will suffer for the rest of their lives well yesterday researchers published a study in the british medical journal making a startling claim that between the years 2016 and 2021 of all the former nfl players who died those years one in four of them had cte let's start the day with dr daniel danish var he's the chief of brain injury rehabilitation at harvard medical school he's the co-director of the sports concussion program at mass general brigham and he's the chief of brain injury rehabilitation at harvard medical school and he was the lead author of this study that has shaken the sports landscape overnight dr danish var thanks for being with us can you give us a real world sense of how bad cte can get like what are the symptoms well when we're thinking about the average person first off it's helpful to think about how commonly cte is occurring in the general population and it's less than one percent of people in community brain banks that develop this disease process now in terms of what the disease looks like people with cte tend to have problems with thinking and memory they tend to have problems with behavioral dysregulation meaning uh that they sometimes fly off the handle in ways that they otherwise previously wouldn't this is a change in their personality they sometimes have changes in their mood including new depression or anxiety these are things that we commonly see and what we also found in this study is that over 60 percent of the people with cte in this study they had impairment in their thinking and memory so severe that they couldn't take care of their activities a daily living what i mean by that is they couldn't feed themselves they couldn't groom themselves they couldn't take care of themselves we call that dementia well which brings us to your study right because i assume the goal here was to figure out like what percentage of nfl players get cte but you can't really diagnose it till after they die right and after people donate their brains to science which i imagine becomes difficult right so how did you approach this yeah you're exactly right one of the problems is that we can't diagnose cte until someone passes away and so many of the analyses trying to figure out how frequently cte occurs have been looking at brain donation registries but people are more likely to donate their brains if they think that they have concerns about themselves or their loved ones have concerns about them oh so you're like oh well five out of ten of these brains have cte but that doesn't tell us about the wider universe exactly the sample is a group that is necessarily biased because they're preferentially going to have the people who are most impaired be the donors and so what we did in this study was something a little different we said let's take the entire boundaries of what's possible in terms of the rate of cte and what i mean with that is let's look at everybody who died during the study window and use that as our denominator and then let's take into account just the cases that donated to use that to determine the ranges and so what we said is on the bottom end that 25 number that's based on the assumption that every single person who did not donate their brain to our center that they had completely clean brains that's assuming that the 16 of people who had dementia so severe that it was written up on their death certificate that their brains were clean that's assuming that the people who were diagnosed with cte by other brain banks that their brains were clean wait so you're saying we have so many brains that clearly have cte of players that died already in our possession that 25 of all nfl deaths in this few year time span that that would be the low number of players that had it that's the low number and then at the high end what we said is let's say that the only brains without cte were the ones that we observed with our own eyes as well and that's the high number of 98 percent the real number is somewhere between that 25 percent and 98 percent but it's almost certainly above that 25 percent if the low number in your estimation is 25 percent and the high number is basically almost every nfl player what does that say at this point about the dangers of tackle football at this like if your kid is playing football is there a sense of how dangerous it truly is long term yeah so when we're thinking about kids the although this study was just looking at professional athletes these professional athletes didn't just get their exposure to head impacts from the professional level we've had 40 different rule changes that are all designed on making the game safer they got their exposure at college they got their exposure in high school and in many cases in youth as well and all of those cumulative g-force added up to increase their risk of having problems later in life and so that's where we need to target our interventions to reduce that cumulative g-force that these individuals are experiencing what kind of interventions i know there have been advancements in helmets and there are sort of policies of sometimes even in pre-season right now you see these players with these huge kind of extra big padded helmets i mean is any of that making a difference yeah i mean the uh the best you know technology might say decrease the force by 10 of an impact compared to another technology and so when on average you're talking about a 30 g impact for an average collision you're now talking about that making that impact a 27 g impact uh-huh realistically you're much better taking that 30 g impact and making it a zero g impact by eliminating the unnecessary hit altogether right and by that i mean you know for example at the nfl level they have less than one contact practice per week and if that change were propagated at the collegiate high school and youth level we know that over 70 percent of head impacts occur at those levels so you can effectively without changing one minute of game time you can make a difference in the game time eliminate the majority of head impacts oh that's interesting because i was going to say like the nfl has issued a statement saying we continuously strive to make the game of football safer including by implementing strategies to reduce concussions and head impacts it sounds like you're saying like yeah the nfl has actually made policy shifts based on this phenomenon and yet you still might see a high school or college team be like no we play tough we play tackle every single day yeah we have not seen the changes that the nfl has made down to those lower levels of play and if they did our athletes would be a whole lot safer bottom line though doctor i mean do you is there a place for tackle football in a country that values health or would would doctors at this center send their kids to play you know high school football i played football in high school myself And I learned about leadership, about discipline, about teamwork from playing sports. There are ways to make our sports safer for our kids. And for example, as an example of that, my six-year-old is playing flag football this fall. And so there are ways we can teach those really important skills without exposing people unnecessarily to head impact. I probably wouldn't even let my kids play tackle football until they're about 14, 15 years old. But the reality of the game is it's aggressive, it's violent. We have linked concussion with CTE in our minds for so long. But we're increasingly realizing that it's not a concussion or two or even a dozen concussions that's driving someone's risk of CTE. What's causing CTE is the accumulation of thousands or tens of thousands of head impacts. Add it up over years or decades. That's what's driving the risk. That's troublesome because we have all these protocols for concussions now. But if you're still getting damage, even if the doctor on field is like, no, I don't think you got a concussion this time, there's still damage perhaps. Yeah, the concussion protocols are important at preventing concussion. But we also need to meet them with CTE prevention protocols that are specific to this type of process later in life. Really useful. Dr. Daniel Danishvar. From Harvard and Mass General. Also a member of BU's renowned CTE Center. Thank you so much. Thank you very much for having me. Appreciate it. Next up on Start Here, the U.S. is taxing Canadian cars. Well, what if Canada taxes all the stuff that goes into them? Pedal to the metal after the break. This show is sponsored by Trust and Will. Let's talk about something that no one really wants to talk about. What happens when you pass? Unfortunately, it happens to all of us. As you get older, as your family and assets become more complex, it can be stressful to think about organizing your wishes to keep your family protected after you're gone. But Trust and Will is here for you. Trust and Will offers affordable attorney-designed estate plans that you can create online in as little as 30 minutes. On their easy-to-use website, you can document your wishes for guardianship of children and pets, distribution of assets, and health care planning. When you're ready, you can share access with trusted contacts to ensure your will gets carried out. That's my issue. I have something all in a draft of an email somewhere that nobody has the password to. All documents are state-specific and tailored to your needs. And their bank-level encryption and secure sharing features ensure your documents stay protected and accessible. Trust and Will. Affordable estate plans. Priceless peace of mind. Go to trustandwill.com slash start and get 20% off. That's trustandwill.com slash start to get your 20% off. Trustandwill.com slash start. Today, I want to tell you about a new product. I want to tell you about an exciting new deal from our friends at Cozy Earth. Take a moment and think back to the best night of sleep you ever had. Did it feel like you might never sleep that well again? Well, good news. You can give yourself an amazing night of sleep every night by upgrading your bedding to Cozy Earth. Cozy Earth offers luxury bedding at an incredible price. Their ultra-soft temperature-regulating sheets, coverlets, and duvet covers are the perfect companion for a night of uninterrupted relaxation. Their sheets come in all different colors and stripes, so there's something for everyone, whether you're doing a big fall. You can even get a small refresh for your master bedroom or updating a guest room in time for the holidays. And as comfy as they are on day one, they actually only get better from there because they are designed to get softer with every wash. Best of all, with our limited-time deal, the already great prices are even better. You can get 50% off a wide assortment of bedding options by going to our unique link. That's right, 50% off. But hurry, this deal is only for a very limited time. Get yourself the bedding of your dreams. Right now, go to abcsecretsavings.com. Start here for 50% off the best bedding you will ever sleep on. That's abcsecretsavings.com. Start here. You can't spell tariff without TIFF. And right now, this back and forth between the U.S. and Canada has gone from a TIFF to a fight to an all-out trade war. Remember, Canada said it would not negotiate any further on what it called unreasonable trade demands from the U.S. The U.S. instituted tariffs. Canada said they would respond. The U.S. preemptively said they'd add even more tariffs. Well, yesterday, Canada unveiled a list of what they are about to tax as items from the U.S. enter their country. ABC's White House correspondent Karen Travers is at the West Wing right now. Karen, what is Canada planning on doing here? Canada is going to put in place tariffs effective September 8th. And Brad, they're not messing around. I mean, they were really strong in their response yesterday. It is fundamental for Canada to stand up and to say, no thanks. We're not going to do that. We have never done that. They're fining. The U.S. finance minister said, we stood up for our workers. We stood up for our businesses. We stood up for Canada. I think what Canadians can see this morning is that we stand united. So starting on September 8th, there will be tariffs of 15, 25 and 50 percent on American products that go across the border imported into Canada. And what they're doing is essentially trying to match the U.S. tariffs applied to similar goods. They said it wasn't a perfect product for product match. But really going out. They're going after exactly what the Trump administration was targeting. So that means a 50 percent counter tariff on steel and aluminum goods that had previously been hit with a 25 percent tariff. They're also going to have a tariff on furniture, apparel, clothing, also going after things like motorcycles and some food and dairy products. One thing that's also notable here is that you saw some Canadian political officials say that they're not ruling out going after red states. Republican states here in the U.S. with these retaliatory measures. Oh, to hurt Trump. To really hurt Trump. That they want to make sure that the U.S. economy is impacted in a way that sends a message to him. We heard that from Doug Ford, the premier of Ontario. I just want to remind the American people, we didn't start this economic war against us. And I'm not too sure why the president decided to do this. That's really striking to see that this is beyond just the war of words. They're actually taking action. Well, Karen, I can imagine any of our listeners being like, what do I buy from Canada? Like besides maple syrup or something like motorcycles, I don't get motorcycles from Canada. And yet enough people do. You'd imagine where if those cost 50 percent more, clearly those like nobody's going to import those. Right. If it's that expensive. And so that means there's just fewer motorcycles overall. And therefore, you'd imagine the price on motorcycles in general in the U.S. would just go up. Right. Are there other products that like the U.S. really does rely on, though, where that could become a huge problem? Yeah. So, you know, the. The president on Monday tried to brush all of this off. He said on social media, we don't need Canada. They need us. Canada is the U.S. second largest export trade partner after Mexico. So we do a lot of trade with Canada. You know, we do need them. Yes, they need us, but we need them because of how much we do with them. And it was striking to hear that the president, hours after he had posted it on social media, acknowledged at a political event on Monday. Well, the U.S. Does need Canada. We need aluminum in this country. We don't have it. We get it all from Canada for the most part. And we need it badly. So there was this recognition that, you know, there is a reliance on Canada for something like that. Well, that aluminum is exactly what Canada said yesterday was now going to face a 50 percent counter tariff. So the president can try to brush that off. But the reality is, is it's a very coordinated, complex, critical relationship with the neighbors to the north. There's also the potential of this not just backing down, but escalating. The president earlier this week had said that he might ramp things up and he threatened more tariffs, 50 percent on Canadian cars, 50 percent on auto parts from Canada. But these wouldn't go into effect until January 1st. The White House hasn't explained why there would be that delay on this, but that would be also a very complicating thing because of how cars are made. In. The U.S., Canada and Mexico, a lot of things go back and forth across the border multiple times. So putting a tariff on the car parts could really make for a complicating situation. I also just note, Brad, that yesterday the president said he deals with a lot of countries around the world, but he called Canada, quote, the most difficult and unreasonable. Yeah, that was wild to me that you're effectively saying under your breath like you're worse than the North Koreans. You're worse than the Russians. Like, unbelievable. All right. Karen Travers there at the White House. Thank you so much. Thanks, Brad. OK, one more quick break. When we come back, she was more than the girl two doors down. There were more colors in her coat than you could imagine. One last thing is next. Food tastes better because Pepsi brings out more flavor, more fun and more of the moment. Food deserves Pepsi. Grab a Pepsi zero sugar today. Do you hear that? That sound, right? That means that summer's officially here. It means that grown adults just sprint into the street for a frozen dessert shaped like a cartoon. But this summer, Mint Mobile has a better treat. Every plan, including unlimited, is fifteen dollars a month. And unlike ice cream, it won't drip down your wrist or look nothing like the picture. Does anyone have any cash? Give it a try. Mint Mobile. Upfront payment of $45 for three months. for six months or $180 for a 12-month plan required. $15 per month equivalent to taxes and fees extra. New customer offer for initial plan term only greater than 50 gigabytes may slow when network is busy. See terms. And one last thing. I've always heard don't meet your heroes, unless they'd say you meet Dolly Parton. Well, yesterday, America lost one of its most likable heroes in its history. What do you want on your tombstone? On my tombstone? I didn't write these. I think tombstone, pepperoni, Dolly Parton, the legendary country singer, songwriter and entertainer, died at the age of 80. She had been hospitalized recently, so perhaps not a surprise. But while people knew in their heads this was a possibility, that didn't make it any easier on the heart. I think that any two Americans could have a conversation about how much they love Dolly Parton. This is ABC's entertainment contributor Chris Connolly, who's interviewed Dolly before, and like everyone, seemed to have an endearing story about her. He said one time he was interviewing everyone in a movie cast along with her. And afterwards I looked at all the room service menus for all the wonderful actors in them and, you know, absolutely, you know, just like I did, it was salad, salad, salad, salad, salad. I had a salad that day. I looked at Dolly Parton's burger well done with fries. Dolly was a person of the people always. This was just a slice of the life that delighted so many people, starting back in the 1940s in the smoky mountains of Tennessee. Dolly was born one of 12 children cramped into a one-room cabin, but they were fluent in music from the start. They'd crowd around the radio listening to broadcast from the Grand Ole Opry. And from the start, Dolly was special. Dolly, you said that you had these goals. Sometimes you said that your life is a fairy tale. Well, I want to be a star. I would like to be a superstar. She started composing songs before she could read. Her mom would write down the lyrics for her. By 13, she was making trips to the Grand Ole Opry herself, now as a performer. Eventually, she moved to Nashville and met her husband at the Wishy-Washy Laundromat. She described it to R. Robin Roberts just a few years ago. The very day I go down to the laundromat, this good-looking man just drives by and he says something like, "Well, why are you going to get sunburned out here?" And I say something stupid like, "Well, what's it to you?" We start talking and two years later we married. Perhaps it was that support system that gave her the confidence to do what she did next. Because, you see, in the music world it's easy to get pigeonholed as a duet actor, a cute frilly girl, or as just the songwriter. Dolly Parton bet on herself. It's a famous story that Elvis Presley wanted to record, "I Will Always Love You." But when Colonel Tom Parker said he wanted to do that, he said that he would need to take a big chunk of Dolly Parton's publishing on the song. And Dolly said no. Dolly turned down what was probably millions of dollars in her pocket to be able to hold on to her song. And as we can see, it turned out to be the right decision. And this is where we start seeing the central duality of Dolly's career. Even in her upbeat material, she's having a fun time, she seems like the happy-go-lucky girl, but her songs are expertly crafted. That is the work of a savant who has also seen some stuff. Even in the most rhinestones, with the most glammed-up thing, you knew that was a real beating heart underneath. And from her songwriting, which is steeped in the music of her Tennessee background, like "Coat of Many Colors" and "Jolene." "Jolene, Jolene, Jolene, Jolene. I'm begging of you, please don't take my man." To the huge pop hits that she had, songs like "Isle of Islands in the Stream," the duet that she did with Kenny Rogers that was written by the Bee Gees' Barry Gibb, to of course the anthem to end all working women's anthems, "Nine to Five." "Tumble out of bed and I stumble to the kitchen, pour myself a cup of ambition and yawn and stretch and try to come to life." From a holler, you know, writing a song that's perfectly pitched to office life in 1980. "Work like me on the job from nine to five. Working nine to five, what a way to make a living." And work she did. She appeared on television. She starred in movies. She was somehow at home on Hollywood talk shows, all the while knowing she would field questions about her physical proportions. "I always say that I weighed a hundred and plenty. I'm just saying now that I've lost the plenty." And again, this is the genius of Dolly Parton. She had this way of inviting jokes and laughter while also reminding us that she was letting the joke happen. She remained the smartest person in the room as she expanded her empire to an iconic theme park named Dollywood. "Good morning everybody and welcome to Dollywood." "But were there some people that were saying, 'Girl, you crazy?'" "Yes, my lawyers and my accountants and a lot of the people that I was working with at the time thought I was making a big mistake, but it was such a burning idea in my gut and in my heart, and I knew it was right because I live by my gut." And in ways like this, she managed to work her way into every American's consciousness. Southern conservatives would thank her for showcasing Tennessee. Drag queens would thank her for being supportive of the queer community. And in the last 24 hours, we have seen statements of gratitude from everyone, from country artists, to rock legends, from GLAAD to U.S. Senators and Presidents. President Trump has ordered flags flown at half staff for a week. Perhaps my favorite tribute, though, was from the estate of Dr. Seuss, which calls her a literary icon. It's a reminder that for all of her work in music, from being portrayed as the ditzy blonde, from being raised barefoot in the mountains by a man who could not read or write, Dolly Parton might be best known by some for books. "I really appreciated the Imagination Library as a tribute to my daddy. He was the smartest man I've ever known, but I knew in my heart his inability to read probably kept him from seeing all his dreams come true." To date, Dolly Parton's Imagination Library has put more than 300 million books into the hands of those who might not otherwise get them. She did it without being asked, without talking down to anyone, and while giving respect to everyone. She had hope for the American Dream, even when it still fades for so many. It's why she's still here today. She said one of her favorite songs she's ever written was this one. "I can see the light of a clear blue morning. I can see the light of a brand new day." If anything can bring us all together, it can be Dolly and our treasuring her memory in whichever incarnation we choose to honor. It's why on this morning, from coast to coast, Americans are realizing that if this one woman can inspire so much passion in all of us, we must not be so different, you and I. It's also like a reminder, we do have this national culture. Like, didn't matter if you were from Tennessee or Oregon or Maine, everyone seemed to be able to connect with that sound of hers. What a legend. More on all these stories on ABC News Live. I'm Brad Milkey. See you tomorrow. What I'd like for people to say about me 100 years from now is, "Boy, she looks great for her age." This episode is brought to you by Progressive Insurance. Do you ever think about switching insurance companies to see if you could save some cash? Progressive makes it easy to see if you could save when you bundle your home and auto policies. Try it at Progressive.com. Progressive Casualty Insurance Company and affiliates. Potential savings will vary. Not available in all states. This episode is brought to you by Progressive Insurance. Not available in all states.