Scat5 Cognitive Screening Performance By Athlete Sex: Implications For Clinical Interpretation

Abstract Objective To examine sex differences in performance on SCAT-5 Cognitive Screening indices. Method A multisport baseline sample was composed of 727 uninjured Division I collegiate athletes (52% female) who were administered the SCAT5 before the 2017–2018 seasons. Repeat baseline testing was completed by 273 uninjured athletes (48% female) at 1 year (days M = 352.56;SD = 56.03) who were then included in the repeated measure analyses. SCAT5 Cognitive Screening indices included the SAC Total, Immediate Recall, and Delayed Recall, at both baseline testing sessions. Results A 3-factor mixed repeated measure MANOVA (SCAT5 Cognitive Index x baseline administration x sex) was completed. Significant between-subject differences were noted across SCAT5 measures and baselines by sex (F(1, 271) = 26.38,p < .001,partialη2 = 0.09). Significant practice effects on all SCAT5 indices between Baseline administrations were observed for all athletes (F(1,271) = 103.68,p < .001,partialη2 = 0.28) and a small but significant interaction was noted where females demonstrated slightly larger practice effects than males (F(1,271) = 6.24,p = .015,partialη2 = 0.02). Descriptive statistics for SCAT Total highlight these findings: males (M = 34.10,SD = 5.10) and females (M = 36.05,SD = 4.66) at Baseline 1; males (M = 36.07,SD = 4.59) and females (M = 38.90,SD = 4.79) at Baseline 2. Conclusions Significant differences on the SCAT5 Cognitive Screening between male and female athletes were evident, with the females generally outperforming their male counterparts (medium effect). Substantial practice effects were noted for all athletes (large effect), with slightly larger practice effects noted for female athletes relative to males (small effect). These findings support the use of sex-specific SCAT5 normative data for interpretation, which may be of increased importance if using reliable change methodology requiring multiple administrations.