Former footballers are three-and-a-half times more likely to die from neurodegenerative disease than the general population, according to a new study.
The report, released on Monday and commissioned by the Football Association and the Professional Footballers’ Association, assessed the medical records of 7676 men who played professional football in Scotland between 1900 and 1976.
Their records were matched against more than 23,000 individuals from the general population, with the study led by consultant neuropathologist Dr Willie Stewart of Glasgow University.
His findings report that the “risk ranged from a five-fold increase in Alzheimer’s disease, through an approximately four-fold increase in motor neurone disease, to a two-fold Parkinson’s disease in former professional footballers compared to population controls”.
Although footballers had higher risk of death from neurodegenerative disease, they were less likely to die of other common diseases, such as heart disease and some cancers, including lung cancer.
The study – titled ‘Football’s Influence on Lifelong Health and Dementia Risk’ or FIELD for short – found that deaths in ex-footballers were lower than expected up to age 70, and higher than expected over that age.
Dr Stewart said in a statement: “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.
“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.”
Rod Petrie, Scottish FA President: “We welcome the findings of this important study – the most comprehensive one ever commissioned into neurodegenerative disease in former professional footballers anywhere in the world.
“It is important to outline that this is only the start in truly understanding the relationship. Further research is needed to determine what exactly causes the increased rates of dementia and while this will naturally involve the wider scientific community it is important that world football takes a lead on this to ensure the appropriate action to such a complex matter.”
Ian Maxwell, Scottish FA Chief Executive: “As someone who played senior football for almost 20 years I profoundly understand the importance of this research and, equally, how football responds to it.
“The game has changed immeasurably during the timeline examined by the researchers and we need to understand what exactly causes the increased rates of dementia: whether through concussion or concussion management, heading of the football, style of play, design and composition of footballs, or other factors. None the less, we must be cognisant of the findings and look where possible to reduce any risk.
“While the research is based purely on the professional game and will be discussed at the Professional Game Board, through the Non-professional Game Board we will also consider any implications for the grassroots game, notwithstanding the report states that its observations cannot be applied directly to the recreational game.
“We are also fortunate to have world-class procedures in Scotland that have been adopted across Europe but in light of these findings we must remain responsive.”
Dr John MacLean, Scottish FA Medical Consultant and co-author of the research: “It is important to point out that the FIELD study has also confirmed the benefits of physical activity on other aspects of lifestyle, particularly the reduction in heart disease and some cancers.
“Scottish football has in many ways taken a lead on the subject of head injury and trauma in sport. We are fortunate to have among the best health data anywhere in the world, for which the Scottish Government should rightly be acknowledged.
“Scotland was also the first country in the world to produce concussion guidelines: a joint venture by the Scottish FA, Scottish Rugby, sportscotland and the Scottish Government.
“We also have one of the best medical education programmes in sport, including the Advanced Pitchcare course, designed for doctors and physiotherapists working in football to deal with issues such as sudden cardiac arrest, major trauma and concussion on the pitch, and its immediate and long term management. This course has been recognised by UEFA as their only accepted course, with the Scottish tutors teaching to all 55 National Associations over the last 10 years.”
FA chairman Greg Clarke said: “The whole game must recognise that this is only the start of our understanding and there are many questions that still need to be answered.
“It is important that the global football family now unites to find the answers and provide a greater understanding of this complex issue. The FA is committed to doing all it can to make that happen.”
PFA chief executive Gordon Taylor said it was “incumbent on football globally to come together to address this issue in a comprehensive and united manner”.
He added: “Research must continue to answer more specific questions about what needs to be done to identify and reduce risk factors.”
It is not clear from the study what the exact causes of the increased rates of dementia are. The FA said in a statement: “The study does not determine whether the cause is due to concussions suffered by the group of professional footballers, or concussion management, or heading of the football, or style of play, or the design and composition of footballs over the years, or personal lifestyle, or some other factor.”
The governing body said the study’s findings had been reviewed by an independent Medical and Football Advisory Group, which recommended re-issuing the current FA concussion guidelines and best-practice advice for coaching heading and called for further steps to improve head injury management, like supporting UEFA’s proposals to introduce concussion substitutes.
The group said more research was needed and there was “not enough evidence at this stage to make other changes to the way the modern-day game is played”.
The FA said it was not important to try and establish “whether or not the results from this historic group of former professional footballers relates, in any way, to the modern-day professional footballer”.
It said it had written to Fifa and Uefa to offer its full support on future research in this area as well as share the findings of the study with them.