Football’s InfluencE on Lifelong health and Dementia risk: Late Outcomes and NeuroradioloGy (FIELD: LONG)
BACKGROUND: The Football Association/ Professional Footballer’s Association funded project, Football’s InfluencE on Lifelong health and Dementia risk (FIELD), has proven a remarkably successful initiative. At commencement of FIELD, risk of neurodegenerative disease in former professional footballers was unknown, wider health outcomes were incompletely understood and the pathology of dementia in this population was speculative. The specific aims of FIELD were designed to address these knowledge gaps using robust epidemiological methodologies to leverage unique, comprehensive datasets of former Scottish professional footballers linked national electronic health records and through pursuit of autopsy brain donation and research evaluations.
In the short lifetime of the FIELD study, insights into these principal questions have been delivered via multiple, high-impact original research reports published or in progress to publication. In summary, FIELD has provided first robust understanding that, compared to matched population controls, former professional footballers show:
- higher neurodegenerative disease risk
- lower mortality from cardiac disease and some cancers
- lower risk of common mental health disorders
- no difference in suicide
- novel findings in brain pathology of former footballers with dementia
However, as FIELD has progressed it is clear that the richness of the professional footballer cohort and linked health records’ dataset is such that many more insights into health in this population are possible. Further, given the outputs of FIELD it is clear that a longitudinal surveillance project to track changes in health in former footballers over time would be informative, for instance from adjustments to game technology or changes in medical management in football. Finally, the research autopsy studies supported by FIELD suggest a possible structural change in the brain that might prove a specific marker of neurodegeneration in former footballers.
Aims of FIELD: LONG
To this end, the specific aims of FIELD: Late Outcomes and NeuroradioloGy (FIELD:LONG) are to:
Aim 1: extend the current dataset to players born up to 31/12/1990 and the data capture to end 2020.
Aim 2: generate pilot longitudinal surveillance data on the FIELD cohort.
Aim 3: continue with a deeper interrogation of neurodegenerative and wider health outcomes using the rich FIELD dataset.
Aim 4: pursue a putative diagnostic imaging marker of neurodegenerative disease in former footballers using already available diagnostic images.