Centers for Disease Control and Prevention, The National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies, Cincinnati, OH, USA.
Neurology. 2012 Nov 6;79(19):1970-4. doi: 10.1212/WNL.0b013e31826daf50. Epub 2012 Sep 5.
To analyze neurodegenerative causes of death, specifically Alzheimer disease (AD), Parkinson disease, and amyotrophic lateral sclerosis (ALS), among a cohort of professional football players.
This was a cohort mortality study of 3,439 National Football League players with at least 5 pension-credited playing seasons from 1959 to 1988. Vital status was ascertained through 2007. For analysis purposes, players were placed into 2 strata based on characteristics of position played: nonspeed players (linemen) and speed players (all other positions except punter/kicker). External comparisons with the US population used standardized mortality ratios (SMRs); internal comparisons between speed and nonspeed player positions used standardized rate ratios (SRRs).
Overall player mortality compared with that of the US population was reduced (SMR 0.53, 95% confidence interval [CI] 0.48-0.59). Neurodegenerative mortality was increased using both underlying cause of death rate files (SMR 2.83, 95% CI 1.36-5.21) and multiple cause of death (MCOD) rate files (SMR 3.26, 95% CI 1.90-5.22). Of the neurodegenerative causes, results were elevated (using MCOD rates) for both ALS (SMR 4.31, 95% CI 1.73-8.87) and AD (SMR 3.86, 95% CI 1.55-7.95). In internal analysis (using MCOD rates), higher neurodegenerative mortality was observed among players in speed positions compared with players in nonspeed positions (SRR 3.29, 95% CI 0.92-11.7).
The neurodegenerative mortality of this cohort is 3 times higher than that of the general US population; that for 2 of the major neurodegenerative subcategories, AD and ALS, is 4 times higher. These results are consistent with recent studies that suggest an increased risk of neurodegenerative disease among football players.
分析神经退行性疾病（阿尔茨海默病[AD]、帕金森病和肌萎缩性侧索硬化症[ALS]）在职业足球运动员队列中的死亡原因。
这是一项对 1959 年至 1988 年期间至少有 5 个养老金赛季的 3439 名美国国家橄榄球联盟球员的队列死亡率研究。通过 2007 年确定了生存状况。为了分析目的，根据所扮演位置的特点，将球员分为 2 个层次：非速度球员（线卫）和速度球员（除踢球手/弃踢手之外的所有位置）。与美国人口相比，使用标准化死亡率比（SMR）；速度与非速度球员位置之间的内部比较使用标准化率比（SRR）。
与美国人口相比，总体球员死亡率降低（SMR0.53，95%置信区间[CI]0.48-0.59）。使用根本死因死亡率文件（SMR2.83，95%CI1.36-5.21）和多种死因（MCOD）死亡率文件（SMR3.26，95%CI1.90-5.22），神经退行性死亡率均升高。在神经退行性疾病中，使用 MCOD 率，肌萎缩性侧索硬化症（SMR4.31，95%CI1.73-8.87）和阿尔茨海默病（SMR3.86，95%CI1.55-7.95）的结果均升高。在内部分析（使用 MCOD 率）中，与非速度球员相比，速度球员的神经退行性死亡率更高（SRR3.29，95%CI0.92-11.7）。
该队列的神经退行性死亡率比美国一般人群高 3 倍；2 种主要神经退行性疾病亚类（AD 和 ALS）的死亡率高 4 倍。这些结果与最近的研究一致，即足球运动员患神经退行性疾病的风险增加。
