Mortality from neurodegenerative disease may be higher among former professional soccer players

1. In this retrospective cohort study, mortality from neurodegenerative disease was higher among former professional soccer players than the control group. Mortality related to ischemic heart disease and lung cancer was lower.

2. Former professional soccer players were prescribed dementia-related medications more frequently than the control group.

Evidence Rating Level: 2 (Good)

Study Rundown: Attention has been raised about the risks of neurodegenerative diseases among athletes in contact sports, especially soccer since it is popular worldwide. While the neurocognitive consequences of contact sports are uncertain, the overall health benefits of physical activity, like reduction in cardiovascular disease, have been established. A retrospective cohort study was conducted to compare mortality from neurodegenerative disease among former soccer players with than among controls. Causes of death were obtained from death certificates and data on dementia-related medications were collected. Overall mortality rate was lower among former soccer players up to the age of 70 years and was higher thereafter as compared to controls. Mortality from neurodegenerative disease was higher in former soccer players, while mortality from ischemic heart disease and lung cancer was lower. Median age of death was a few years higher in former soccer players as compared to controls. In addition, medications for dementia were more common among former soccer players than controls. Given that this study only included prescribing outcomes from 2009 onwards, only contained data on males, and was a retrospective study, more research needs to be done to confirm mortality rates, causes, and the use of dementia-related medications among soccer players.

Click to read the study in NEJM

Relevant Reading: Mortality Among Professional American-Style Football Players and Professional American Baseball Players

In-Depth [retrospective cohort]: A retrospective cohort study was performed to determine mortality causes and rates among male Scottish professional soccer players. All males born before January 1977 were eligible for the study and included data up to December 2016. Data on the primary and contributory causes of death were obtained from death certificates and data on medications were obtained from the Prescribing Information System from 2009 onward. The overall mortality rate was lower among soccer players than the control groups (15.4% vs. 16.5%; hazards ratio, 0.87; 95% CI, 0.80 to 0.93; P<0.001). Mortality from neurodegenerative disease as the primary cause of death was higher among soccer players than the controls (1.7% vs. 0.5%; hazards ratio 4.10; 95% CI, 2.88 to 5.83; P<0.001), but did not differ significantly between goalkeepers and outfield players. Prescriptions for dementia-related medications were more common among former soccer players than controls (odds ratio, 4.90; 95% CI, 3.81 to 6.31; P<0.001), but less common among goal-keepers than outfield players. Of note the median age of death was 67.9 years among soccer players and 64.7 years among the controls. Mortality rates resulting from ischemia heart disease and lung cancer were lower among soccer players. Mortality rates resulting from stroke and cerebrovascular disease and age at death from neurodegenerative disease did not differ significantly between the two groups.

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