JAMA Neurology: In a football game, which athletes are more likely to suffer from neurodegenerative diseases?

It is estimated that 50 million people worldwide suffer from dementia, and the annual loss to the global economy is approximately US$1 trillion
.

Therefore, identifying potentially modifiable factors related to the risk of dementia and other neurodegenerative diseases is essential to provide opportunities for intervention that may reduce the burden of disease

Compared with the general population, Former professional contact sports are believed to have a higher mortality rate from dementia and a range of other neurodegenerative diseases, including motor neuron disease and Parkinson's disease
.

Autopsy studies of these populations often report the existence of specific neurodegenerative pathologies associated with traumatic brain injury (TBI), called chronic traumatic encephalopathy (CTE) neuropathological changes

Former professional contact sports are believed to have a higher mortality rate from dementia and a range of other neurodegenerative diseases, including motor neuron disease and Parkinson’s disease

However, it is still uncertain whether the risk of neurodegenerative disease in former athletes is related to TBI and repeated head impact exposure or other unidentified factors
.

The relationship between TBI in sports and advanced neurodegenerative diseases was first recognized in the description of the so-called "punch-drunk syndrome" of former boxers in the early 20th century.
The understanding of CTE neuropathological changes in autopsy studies of non-boxers and other people exposed to TBI has brought this issue to widespread attention
.

To date, almost all people who describe neuropathological changes in CTE have a history of TBI or repetitive head impact
.

Although the neuropathological changes of CTE are a frequently occurring pathological phenomenon, the neurodegenerative diseases and diagnosis in these populations are not limited to CTE

diagnosis

Demographic data also provide evidence of an increased risk of neurodegeneration among former athletes
.

Specifically, among former professional football players and former professional football players of the National Football League (professional US football players), the death rate from neurodegenerative diseases is reported to be higher than expected

These studies reflect the experience of post-mortem observations and recorded a higher risk of neurodegenerative diseases in a series of diagnoses
.

Therefore, although the overall neurodegenerative disease death rate of former professional football players is approximately 3.

Football is played in more than 200 countries and has more than 2.

5 billion active participants.

In this way, Emma R.
Russell of the University of Glasgow and others hypothesized that the neurodegenerative disease risk of former professional football players may vary depending on the position on the field and the length of their career.
There is no position on the field (ie non-goalkeeper) and career.
The risk of length increase is higher
.

In order to reflect the changes in game technology and medical services during the study period, it is also assumed that the risk of neurodegenerative diseases may change due to the year of the game
.

In order to resolve these assumptions, they consulted the National Electronic Health Record and explored the relationship between the position of the Scottish male former professional football player, the length of his career, and the age of the game, and the risk of neurodegenerative diseases

They assessed the risk of 7,676 male former professional football players and 23,028 general population controls who were born between January 1, 1900 and January 1, 1977, according to their year of birth, gender, and regional socioeconomic The status was matched, and 1,812,722 person-years of follow-up were provided
.

Scotland’s morbidity record and death certificate data can be from January 1, 1981 to December 31, 2016, and the prescription data can be from January 1, 2009 to December 31, 2016
.

Main clinical outcome: The results are obtained by linking individual-level records with the electronic records of inpatient and day wards of mental health and general hospitals across the country, as well as prescription information and death certificates
.

They assessed the risk of neurodegenerative diseases between former professional football players and matched general population controls
.

In this cohort study of 30,704 male individuals, 386 (5.

0%) of 7,676 ex-football players and 366 (1.
6%) of 23,028 matched population control individuals were identified as having neurodegenerative diseases Diagnosis (hazard ratio [HR], 3.
66; 95% CI, 2.
88-4.
65; P<0.
001)
.

They found that defenders had the highest risk of neurodegenerative disease ( HR, 4.
98; 95% CI, 3.
18-7.
79; P <.
001), and goalkeepers had the lowest risk (HR , 1.
83; 95% CI, 0.
93-3.
60; P = .
08)
.

Compared with the risk of general population controls, defenders had the highest risk of neurodegenerative disease (goalkeepers had the lowest (HR, 1.
83; 95% CI, 0.
93-3.
60; P = .
08)
.

Former football players who have a professional career longer than 15 years have the highest risk (HR, 5.
20; 95% CI, 3.
17-8.
51; P <.
001)
.

The risks for all players born between 1910 and 1969 remain similar
.

The important significance of this research lies in the discovery: The risk of neurodegenerative diseases is highly correlated with non-goalkeeper positions
.
Although investigation is needed to further confirm the specific factors that increase the risk of neurodegenerative diseases in professional football players, strategies to reduce head impact exposure may be desirable
.

Risk of neurodegenerative diseases, highly correlated with non-goalkeeper positions

 

Original Source:
Russell ER, Mackay DF, Stewart K, MacLean JA, Pell JP, Stewart W.
Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players.
JAMA Neurol.
Published online August 2, 2021.
doi:10.
1001/jamaneurol.
2021.
2403

Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players.
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