Elite male footballers are more likely to develop dementia than the general population, according to a Swedish study published today.
In their observational study, researchers at the Karolinska Institutet found they were 1.5 times more likely to develop a neurogenerative disease later in life.
This compares to a previous study in Scotland that suggested footballers were 3.5 times more likely to develop neurodegenerative disease.
Writing in the latest edition of The Lancet Public Health, the researchers say among the 6,007 male footballers they followed, who played in the Swedish top division, 9% (537) were diagnosed with neurodegenerative disease, compared to 6% (3,485 out of 56,168) population controls.
Dr Peter Ueda, assistant professor at Karolinska Institutet, said: “While the risk increase in our study is slightly smaller than in the previous study from Scotland, it confirms that elite footballers have a greater risk of neurogenerative disease later in life.
“As there are growing calls from within the sport for greater measures to protect brain health, our study adds to the limited evidence-base and can be used to guide decisions on how to manage these risks.”
The study examined Sweden’s national health registers to look for records of neurodegenerative disease in 6,007 male football players who had played in the Swedish top division from 1924 to 2019.
The team compared players’ risk of neurodegenerative disease with population controls and the analysis broke down the risk for different neurogenerative conditions, including Alzheimer’s and other dementias, motor neuron disease (MND), and Parkinson’s disease. It also compared the risks between outfield players and goalkeepers.
Overall, football players had a 1.5 times increased risk of neurogenerative disease compared to controls.
Football players had a 1.6 increased risk of Alzheimer’s disease and other dementias compared to controls – with 8% (491 out of 6,007) of footballers being diagnosed with the condition compared to 5% (2889 out of 56,168) of controls.
The team also found outfield players had a 1.4 times higher risk of neurogenerative disease compared to goalkeepers.
No significant risk increase was observed for football players for motor neuron disease, which includes ALS. The risk of Parkinson’s disease was lower among football players.
Despite the findings, the authors caution that although 9% of football players and 6% of controls were diagnosed with neurodegenerative disease during their study, most participants were still alive at the end of data collection, so the lifetime risk of developing neurodegenerative disease for both groups are likely to be higher.
Dr Ueda said: “Importantly, our findings suggest that goalkeepers don’t have the same increased risk of neurodegenerative disease as outfield players. Goalkeepers rarely head the ball, unlike outfield players, but are exposed to similar environments and lifestyles during their football careers and perhaps also after retirement.
“It has been hypothesised that repetitive mild head trauma sustained through heading the ball is the reason football players are at increased risk, and it could be that the difference in neurodegenerative disease risk between these two types of players supports this theory.”
Björn Pasternak, senior researcher at Karolinska Institutet, added: “The lower overall mortality we observed among footballers indicates that their overall health was better than the general population, likely because of maintaining good physical fitness from frequently playing football.
“Physical activity is associated with a lower risk of dementia, so it could be hypothesised that the potential risks from head impacts are being somewhat offset by having good physical fitness. Good physical fitness may also be the reason behind the lower risk of Parkinson’s disease.”
Ueda P, Pasternak B, Lim C-E et al. Neurodegenerative disease among male elite football (soccer) players in Sweden: a cohort study. Lancet 17 March 2023.
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