OVERVIEW: BEGINNING THE FIELD STUDY
In the past decade there has been growing concern around the potential increased risk of dementia through participation in contact sports.
In part, this has been driven by the recognition of a specific form of a degenerative brain disease linked to traumatic brain injury (TBI), known as chronic traumatic encephalopathy (CTE), in athletes from a wide range of contact sport. However, despite this increased attention, there remains a remarkable lack of evidence regarding late health outcomes in former athletes, including risk of dementia and related diseases.
It was this pressing need for better understanding of the influence of contact sports on lifelong health and wellbeing, including risk of neurodegenerative disease, that encouraged us to begin the FIELD study.
We have brought together a multidisciplinary collaboration of researchers and experts in traumatic brain injury, public health, and sport to direct studies investigating a wide range of physical and mental health outcomes in former soccer players, including neurodegenerative disease.
Former professional soccer players were identified from records of pre/post war Scottish league players. These players were then matched to individuals from the general population, matched on sex (all male), year of birth, and socioeconomic status (calculated using the Scottish Index of Multiple Deprivation) – providing us with a comparison group. All individuals were anonymised to researchers.
Health records such as death certification, hospital admissions, and prescription information were collected for both former players, and their general population comparison group. Analyses were then performed to assess whether former players were at greater risk of a number of health outcomes of interest.
You may have seen the recent media focus in relation to dementia in football. We’ve seen some high profile cases, such as individuals from the World Cup winning England squad of 1966, which has raised public awareness of this issue. There has also been a report by the Digital, Culture, Media and Sport Committee highlighting the issue of concussion and neurodegenerative disease risk in contact sport athletes, and the potentially devastating outcomes of such. The FIELD study (Football’s InfluencE on Lifelong health and Dementia risk) was set up as the first large study into lifelong health outcomes, including dementia, in former professional football players. This study was the first of its kind, and produced some extremely important results
To understand some of the key findings of the study, and what this means for the future of soccer, you can read our summary of results below, as well as clicking the buttons to see overviews of each of our individual FIELD papers.
OVERALL: SUMMARY OF RESULTS
The risk of neurodegenerative disease in former professional soccer players was previously unknown. Following the results of the FIELD study, we now have a more complete picture of lifelong health and dementia in soccer, greater than that of any other contact sport. Thus far, results from the FIELD study provide evidence of increased neurodegenerative disease in former professional soccer players, with risk shown to be greatest for outfield players – specifically defenders, and those with longer career lengths. There were many health benefits also associated with a career in professional level soccer – lower risk of ischaemic heart disease, and respiratory cancer mortality, were seen in former players, as well as a lower risk of common mental health disorders, namely; anxiety and stress, depression, alcohol use, drug use, and bipolar and mood disorders.
IN CONTEXT: WHAT THESE FINDINGS MEAN,
AND GOING FORWARD
Following initial results of this study, the Football Associations of Scotland, England, and Northern Ireland, acted to restrict heading in youth soccer as a precautionary measure, amid concerns of the long-term consequences of heading to brain health. Following on from the knowledge we now have regarding neurodegenerative risk in former professional soccer players, adjustments to the wider game of soccer are needed, including further heading restrictions and guidelines, and improved concussion education, and concussion protocols put in place. Further research is also required in order to gain a greater understanding of the underlying risk factors that contribute to this elevated neurodegenerative disease risk in this population, as well as within other populations – such as female soccer players, and other contact sport athletes.
Whilst it’s a priority to ensure safety of current and future soccer players, there are still many ways to reduce the consequences of poor neurological outcome in former players who have already had exposure to repetitive head impacts throughout their sporting career. Programmes such as Prevent Dementia have been set up, with the aim of evaluating biomarkers to provide a greater understanding of dementia risk factors (Ritchie and Ritchie, 2012). By following guidance produced by studies such as Prevent Dementia, and guidance available by Brain Health Scotland, brain health can still be optimised in retired athletes. Reducing intake of alcohol, and avoidance of smoking, continuing to learn new skills and keeping the brain active, following a healthy lifestyle including eating a balanced diet and undertaking regular activity, are just some of the ways to optimise brain health, and can act to reduce risk of neurodegenerative disease in mid-life (BrainHealthScotland, accessed June 2021).
We are indebted to those who kindly donated their brain to make this research possible. If you or anyone you know is interested in registering for brain donation, you can find more info here, you can sign up here, or you can contact us if you have any questions.
EXPLAINED: FIELD PUBLICATIONS
Click the buttons to see summaries of each paper’s findings
FIELD: PROTOCOL PAPERS
If you have any questions about our research, or want to find out more about our other projects, click the button below or contact us! We’d love to hear from you.