Russell Emma R, Lyall Donald M, Mackay Daniel F, Cronin Kirstie, Stewart Katy, MacLean John A, Pell Jill P, Stewart William
School of Psychology & Neuroscience, University of Glasgow, Glasgow, United Kingdom.
School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom.
JAMA Netw Open. 2024 Dec 2;7(12):e2449742. doi: 10.1001/jamanetworkopen.2024.49742.
Elite-level contact sport participation is associated with increased dementia risk, which may be attributable to sport-related traumatic brain injury and repetitive head impact exposure. However, the contribution of wider, potentially modifiable dementia risk factors remains uncertain.
To explore the association of potentially modifiable dementia risk factors with dementia risk among former professional soccer players.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used electronic health record linkage to national electronic datasets of general and mental health hospital inpatient and day-case admissions, prescribing information, and death certification in Scotland for male former professional soccer players born between January 1, 1900, and December 31, 1990, who were aged 30 years or older on December 31, 2020, and general population control individuals matched by sex, year of birth, and area socioeconomic status. Database interrogation was performed on November 30, 2021, and data were analyzed between January 16, 2023, and July 8, 2024.
History of smoking, depression, alcohol-related disorders, diabetes, hypertension, hearing loss, and obesity coded within electronic health records.
Prevalence of dementia risk factors and their association with incident dementia diagnoses were evaluated and compared between former soccer players and matched controls.
The final cohort consisted of 11 984 male former professional soccer players and 35 952 matched controls. Over a median 21 years (IQR, 7-34 years) of follow-up from study entry at age 30 years or older, providing a total of 1 039 848 years of follow-up, 434 former soccer players (3.62%) and 453 matched population controls (1.26%) were identified with a dementia diagnosis (hazard ratio [HR], 3.02; 95% CI, 2.54-3.58; P < .001). Overall, rates of general health and lifestyle dementia risk factors were similar or lower among former soccer players compared with matched controls (eg, diabetes: 4.26% vs 6.35%). Dementia risk associated with these factors among soccer players was similar to or lower than among controls (eg, hypertension: HR, 4.62 [95% CI, 3.69-5.78] vs 6.96 [95% CI, 5.64-8.59]).
This cohort study found no evidence that high dementia risk among former professional soccer players was associated with potentially modifiable general health and lifestyle dementia risk factors. These data support continuation of measures directed toward reducing exposure to repetitive head impacts and traumatic brain injury in sport.
参加精英级别的接触性运动与痴呆症风险增加有关，这可能归因于与运动相关的创伤性脑损伤和反复头部撞击暴露。然而，更广泛的、可能可改变的痴呆症风险因素的作用仍不确定。
探讨前职业足球运动员中潜在可改变的痴呆症风险因素与痴呆症风险之间的关联。
设计、设置和参与者：这项回顾性队列研究利用电子健康记录与苏格兰普通和精神健康医院住院及日间病例入院、处方信息和死亡证明的国家电子数据集进行关联，研究对象为1900年1月1日至1990年12月31日出生、在2020年12月31日年龄30岁及以上的男性前职业足球运动员，以及按性别、出生年份和地区社会经济地位匹配的普通人群对照个体。2021年11月30日进行数据库查询，2023年1月16日至2024年7月8日进行数据分析。
电子健康记录中编码的吸烟史、抑郁症、酒精相关疾病、糖尿病、高血压、听力损失和肥胖症。
评估并比较前足球运动员和匹配对照组中痴呆症风险因素的患病率及其与痴呆症诊断事件的关联。
最终队列包括11984名男性前职业足球运动员和35952名匹配对照组。从30岁及以上的研究入组开始，中位随访21年（四分位间距，7 - 34年），共提供1039848人年的随访，434名前足球运动员（3.62%）和453名匹配的人群对照组（1.26%）被诊断患有痴呆症（风险比[HR]，3.02；95%置信区间，2.54 - 3.58；P <.001）总体而言，与匹配对照组相比，前足球运动员中一般健康和生活方式痴呆症风险因素的发生率相似或更低（例如，糖尿病：4.26%对6.35%）。足球运动员中与这些因素相关的痴呆症风险与对照组相似或更低（例如，高血压：HR，4.62[95%置信区间，3.69 - 5.78]对6.96[95%置信区间，5.64 - 8.59]）。
这项队列研究没有发现证据表明前职业足球运动员中高痴呆症风险与潜在可改变的一般健康和生活方式痴呆症风险因素有关。这些数据支持继续采取措施，以减少运动中反复头部撞击和创伤性脑损伤的暴露。
