Football Dementia Risk Linked to Playing Position and Career Length

Peter Russell

August 02, 2021

The risk of mortality from neurodegenerative disease is known to be higher in professional footballers compared with the rest of the population. A new study has found that this risk increases with years of play and varies by field position.

Former players in outfielder positions had higher risks across a range of neurodegenerative diseases. Their risk was higher than that of both matched controls and goalkeepers, and increased with career length. However, the risk to goalkeepers was not significantly heightened when compared with non-players, researchers said.

The findings come as new rules are set to be introduced in the sport to curb the number of times players are expected to head the ball.

Risk Linked to Pitch Time and Playing Position

Research by the University of Glasgow was based on data from 7676 male former professional football players from Scotland born between January 1900 and January 1977. Their health outcomes were matched against 23,028 people of similar age and background in the general population.

The study, in JAMA Neurology, found that 5% of the professional players had a neurodegenerative disease diagnosis compared with only 1.6% in the general population.

When it came to individual risk among footballers, results varied according to playing position.

The hazard was higher across all outfield positions and highest in defenders, and lowest for goalkeepers. Defenders had an approximately fivefold  increase in risk of neurodegenerative disease compared with the matched general population control individuals, the researchers found.

A significant risk factor was the length of time spent in the professional sport, with death from neurodegenerative disease increasing with each year.

Era of playing career did not seem to impact on the results, with the risk of neurodegenerative disease similar for players born between 1910 and 1969.

'Sensible' Further Guidance

Commenting for the Science Media Centre, Dr Susan Kohlhaas, director of research at Alzheimer's Research UK, said the study was "another piece of a large and largely unfinished jigsaw when it comes to understanding dementia risk", but there was "more to do in order to fully understand what is causing increased dementia risk in outfield players".

She said: "This study did not look at all aspect of players' lives on or off the pitch to determine what may be behind the increased risk.

"Existing results from this research team have shown that former professional footballers may also get several health benefits of playing the game and therefore it’s important to understand both the benefits and risks of playing professional sport as it relates to dementia.

“Football is close to the hearts of so many of us, and it’s right that authorities and footballing bodies take sensible steps to mitigate the risk of injury to ensure players can enjoy the game safely at all levels. It is good news that further guidance on heading will be introduced into the English game from next season, with all professional, amateur, and grassroots clubs involved."

The new guidance, specifically focused on training sessions, recommends a maximum of 10 higher-force 'headers' to be allowed in any training week.

The guidelines will apply to clubs in the Premier League, English Football League (EFL), Barclays Women's Super League, FA Women’s Championship, the National League System, the Women’s Football Pyramid Tiers 3 and below, all grassroots football, and across the England national teams.

Recent media coverage highlighted the deaths of several former top-flight England footballers, including Jeff Astle, Jack Charlton, and Nobby Stiles, who had all been diagnosed with dementia.

Jama Neurology, published 2 August 2021. doi:10.1001/jamaneurol.2021.2403

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