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Former professional footballers more likely to have dementia: Study

A new study has found that former professional footballers are 3.5 times more likely to die from neurodegenerative diseases, such as Alzheimer’s.

The University of Glasgow FIELD research is the largest study of the incidence of neurodegenerative disease in any sport. It looked at the causes of death of 7,676 former Scottish male professional football players who were born between 1900 and 1976 against those of more than 23,000 matched individuals from the general population.

Results showed that footballers had a five-fold increased risk of having Alzheimer’s, four-fold increase in motor neurone disease and a two-fold increase in Parkinson’s when compared to the control population.

“An important aspect of this work has been the ability to look across a range of health outcomes in former professional footballers. This allows us to build a more complete picture of health in this population,” said lead researcher, consultant neuropathologist Dr Willie Stewart.

“Our data show that while former footballers had higher dementia rates, they had lower rates of death due to other major diseases. As such, whilst every effort must be made to identify the factors contributing to the increased risk of neurodegenerative disease to allow this risk to be reduced, there are also wider potential health benefits of playing football to be considered.”

The work was funded, in part, by the Football Association (FA) and the Professional Footballers’ Association (PFA). Former players have often associated the heading of old-style heavy footballs to instances of dementia, and although this study does not explicitly make this link, the families of former footballers feel that some answers are being found.

In 2002 a British coroner recorded the cause of death for former footballer, Jeff Astle, as “industrial disease” partly caused by heading heavy footballs during his career.

His daughter Dawn Astle told The Guardian that: “My overall feeling is that I am staggered even though my own research and instinct was always that there was a serious problem.”

“There will be no celebrations. We knew dad could not be the only one. We just wanted that question answered. We just wanted to see that football cared enough to find out the scale of the problem, to do the right thing and be there for these people when they need them most. Whatever they do next, it must be across all parts of the game. And these players who have suffered dementia must not be a statistic – they must never be forgotten.”

Gordon Taylor, PFA chief executive, said: “These findings are a matter of considerable importance to our members. We are grateful to Dr Willie Stewart and his team for their work.

“The PFA co-funded FIELD, alongside the FA. It is now incumbent on football globally to come together to address this issue in a comprehensive and united manner. Research must continue to answer more specific questions about what needs to be done to identify and reduce risk factors.”

The science around the relationship between contact to the head and subsequent neurological disorders in other sports is growing, if not contentious.

Originally recognised in boxers and known as ‘punch drunk syndrome’ or dementia pugilistica, CTE (Chronic traumatic encephalopathy) is a neurodegenerative disease caused by repeated head injuries and it is associated with the development of dementia.

The issue has gained more media attention due to the prevalence and high profile cases of CTE identified in former NFL players, including the high profile case of Aaron Hernandez who had the most severe case of CTE ever found in a person under 46. Hernandez committed suicide in prison after being found guilty of murder. The 27-year old’s brain was then examined and was found to be significantly damaged at the frontal lobe, which impacts a person’s ability to make decisions and moderate behaviour, among other areas.

Here in Australia, several former NRL and AFL players have come forward to tell stories of their struggles with life due to repeated knocks and concussions sustained whilst playing. Earlier this year the first official diagnosis of former NRL players was made by researchers at the university of Sydney.

Lead author, clinical associate professor Michael Buckland told Aged Care Insite that: “This is a very powerful study. It’s something that’s been needed to be done for a while. There have been similar, smaller studies with ex-NFL players, which have basically come to the same conclusion. The fact that it’s such a large cohort, and it’s such a statistically robust finding very much prove the link between, at least, professional soccer players and increased risk of neurodegenerative diseases.”

One issue when trying to prove the instance of CTE, is that it can only be accurately diagnosed post-mortem. However, the FIELD study did look at the difference between soccer position likely to head the ball and not – like goalkeepers. These findings, Buckland asserts, do suggest that repeated heading leads to a higher risk.

“They took another angle and they went through the prescribing data, who was prescribed dementia medicines, which is another way of looking at does this person have dementia. In fact, then there was actually a statistically significant difference between goalkeepers and everyone else with dementia medicine,” he said.

Buckland says that the study shows what could be achieved if various sports codes join forces with scientists, and that research like this could have wider implications for the study of dementia.

“This is definitely a blueprint of what we should be doing. I would definitely call on the NRL and the AFL to work with the players’ associations and with the independent scientists and doctors to do something similar here,” he said.

“Everyone focuses on, ‘Oh, the codes,’ and, ‘They’re going to ruin the game,’ and, ‘There’s going to be litigation.’ Well, maybe that has to happen. Why isn’t everyone really excited? After a hundred years and hundreds of billions of dollars of research into Alzheimer’s disease, we’ve still got nothing. We’ve got no treatments.

“Suddenly we actually have an insight into, ‘Hang on a second. Is there something here with head injury?’ With simple modifications we may be able to really impact on dementia in later life. It could be the simplest behavioural modification to significantly impact on disease.”

Symptoms of CTE include memory loss, confusin, personality changes (including depression and suicidal thoughts), erratic behaviour (including aggression), problems paying attention and organising thoughts, difficulty with balance and motor skills.

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One comment

  1. This study’s reflective method and surprising questions around benefits vs costs of a dangerous sport are vital to we males, players and the public, and professionally tantalising for we male focussed health professionals. Their thoughtful findings and questions beg adequate priority public funding of further informed and reflective research.

    Given that males consume up to about 75% of the ‘developed’ world’s health care dollar (read risk taking and extreme costs of acute Services – Ambos, Police, Suicide, Homicide, Fire, Crash, Retrieval, ED, OT, ICU, Surg, Med, Ortho, Burns, Disability, Coronial, Social, Industrial, Legal, Regulatory, ad nauseum), such particularly efficient use of resources could arguably be triaged for emergency funding via careful miniscule diversions of existing unfairly giant and sloppily used buckets of male health funding.

    Grist for the mill at least …

    Adrian.

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