Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom.
Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
JAMA Neurol. 2021 Sep 1;78(9):1057-1063. doi: 10.1001/jamaneurol.2021.2403.
Neurodegenerative disease mortality is higher among former professional soccer players than general population controls. However, the factors contributing to increased neurodegenerative disease mortality in this population remain uncertain.
To investigate the association of field position, professional career length, and playing era with risk of neurodegenerative disease among male former professional soccer players.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used population-based health record linkage in Scotland to evaluate risk among 7676 male former professional soccer players born between January 1, 1900, and January 1, 1977, and 23 028 general population control individuals matched by year of birth, sex, and area socioeconomic status providing 1 812 722 person-years of follow-up. Scottish Morbidity Record and death certification data were available from January 1, 1981, to December 31, 2016, and prescribing data were available from January 1, 2009, to December 31, 2016. Database interrogation was performed on December 10, 2018, and data were analyzed between April 2020 and May 2021.
Participation in men's soccer at a professional level.
Outcomes were obtained by individual-level record linkage to national electronic records of mental health and general hospital inpatient and day-case admissions as well as prescribing information and death certification. Risk of neurodegenerative disease was evaluated between former professional soccer players and matched general population control individuals.
In this cohort study of 30 704 male individuals, 386 of 7676 former soccer players (5.0%) and 366 of 23 028 matched population control individuals (1.6%) were identified with a neurodegenerative disease diagnosis (hazard ratio [HR], 3.66; 95% CI, 2.88-4.65; P < .001). Compared with the risk among general population control individuals, risk of neurodegenerative disease was highest for defenders (HR, 4.98; 95% CI, 3.18-7.79; P < .001) and lowest for goalkeepers (HR, 1.83; 95% CI, 0.93-3.60; P = .08). Regarding career length, risk was highest among former soccer players with professional career lengths longer than 15 years (HR, 5.20; 95% CI, 3.17-8.51; P < .001). Regarding playing era, risk remained similar for all players born between 1910 and 1969.
The differences in risk of neurodegenerative disease observed in this cohort study imply increased risk with exposure to factors more often associated with nongoalkeeper positions, with no evidence this association has changed over the era studied. While investigations to confirm specific factors contributing to increased risk of neurodegenerative disease among professional soccer players are required, strategies directed toward reducing head impact exposure may be advisable in the meantime.
与普通人群对照相比，神经退行性疾病的死亡率在退役职业足球运动员中更高。然而，导致该人群神经退行性疾病死亡率增加的因素仍不确定。
研究场上位置、职业生涯长度和比赛时代与男性前职业足球运动员神经退行性疾病风险之间的关联。
设计、设置和参与者：这项基于队列的研究使用苏格兰基于人群的健康记录链接来评估 1900 年 1 月 1 日至 1977 年 1 月 1 日之间出生的 7676 名男性前职业足球运动员和与之匹配的 23028 名普通人群对照个体的风险，这些对照个体通过出生年份、性别和地区社会经济地位匹配，提供了 1812722 人年的随访。从 1981 年 1 月 1 日至 2016 年 12 月 31 日，可获得苏格兰发病率记录和死亡证明数据，从 2009 年 1 月 1 日至 2016 年 12 月 31 日，可获得处方数据。数据库查询于 2018 年 12 月 10 日进行，数据分析于 2020 年 4 月至 2021 年 5 月进行。
参加男子足球职业比赛。
通过个体层面的记录链接，从国家心理健康电子记录、综合医院住院和日间病例入院以及处方信息和死亡证明中获得结果。评估前职业足球运动员和匹配的普通人群对照个体的神经退行性疾病风险。
在这项涉及 30704 名男性的队列研究中，7676 名前足球运动员中有 386 名（5.0%）和 23028 名匹配的普通人群对照个体中有 366 名（1.6%）被诊断出患有神经退行性疾病（风险比[HR]，3.66；95%置信区间[CI]，2.88-4.65；P<0.001）。与普通人群对照个体的风险相比，防守球员的神经退行性疾病风险最高（HR，4.98；95%CI，3.18-7.79；P<0.001），守门员的风险最低（HR，1.83；95%CI，0.93-3.60；P=0.08）。关于职业生涯长度，职业生涯长度超过 15 年的前足球运动员的风险最高（HR，5.20；95%CI，3.17-8.51；P<0.001）。关于比赛时代，所有 1910 年至 1969 年出生的球员的风险仍然相似。
本队列研究中观察到的神经退行性疾病风险差异表明，与守门员位置相关的因素暴露风险增加，而没有证据表明这种关联在研究期间发生了变化。虽然需要进一步调查以确认导致职业足球运动员神经退行性疾病风险增加的具体因素，但同时减少头部撞击暴露的策略可能是明智的。
