Dementia risk in footballers related to player position and career length

A major study has found the risk of dementia in former professional footballers is related to what position they played in and the length of their career.

The University of Glasgow is leading the FIELD research into long term health outcomes associated with the sport and has already concluded former professional footballers are three-and-a-half times more likely to die due to neurodegenerative disease.

The study is the largest to date in any sport. Led by Professor Willie Stewart, the researchers looked at health records data for around 8,000 Scottish former professional footballers and 23,000 matched general population controls and explored whether risk of neurodegenerative disease varied by player position, length of career or playing era.

The results show that, for goalkeepers, neurodegenerative disease risk was similar general population levels. For outfield players, it was almost 4 times higher than expected and varied by player position with risk highest among defenders, at around 5-fold higher than expected.

The new findings also show that neurodegenerative disease diagnoses increased with increasing career length, ranging from an approximately doubling of risk in those with shortest careers, to around a 5-fold increase in those with the longest careers.

Prof Willie Stewart said: “We have already established that former professional footballers are at a much greater risk of death from dementia and other neurodegenerative disorders than expected. These latest data from FIELD take that observation further and suggest this risk reflects cumulative exposure to factors associated with outfield positions.”

In parallel work led by Prof Stewart, a specific pathology linked to brain injury exposure, known as chronic traumatic encephalopathy (CTE), has been described in a high proportion of the brains of former contact sport athletes, including former amateur and professional footballers.

Prof Stewart added: “The evidence is clear that the standout risk factor for neurodegenerative disease in football is exposure to head injury and head impacts.

“As such, a precautionary principle approach should be adopted to reduce, if not eliminate exposure to unnecessary head impacts and better manage head injuries in football and other sports.”

Charlotte Cowie, FA Chief Medical Officer, said: “The FIELD study team, funded by ourselves and the PFA, have continued to produce insightful data that has enabled us to make changes in the game. We welcome these new findings.”

PFA Chief Executive, Maheta Molango, said: “The PFA would like to thank the FIELD study team. The welfare of our players, past, present and future is at the forefront of everything we do and this data will inform us how best to protect them and improve our services.”