Ten thousand steps and more. From publication to publication, the suspicion has been confirmed: professional footballers are more exposed than the general population to neurodegenerative diseases, and in particular to Alzheimer’s disease. But the results of work carried out in different countries remain difficult to interpret. And many questions remain. How big is the risk? What is the role of concussions, heading game, but also other factors? And finally, what prevention should be put in place?
A new study conducted in Swedenpublished on March 16 in the journal The Lancet Public Health, brings some elements to this complex and sensitive issue. Peter Ueda (Karolinska Institute, Stockholm) and colleagues have included 6,007 male footballers – including 510 goalkeepers – having played, between 1924 and 2019, at least one match in the equivalent of the Swedish first division. As Sweden has many registers of statistical and medical data on its population, the researchers were able to identify the neurodegenerative diseases occurring in the cohort, each of the players being compared with ten controls.
During the follow-up period – until the end of 2020 – 537 professional players (8.9%) were diagnosed with a neurodegenerative pathology, compared to 6.2% of control subjects, i.e. a relative risk of 1.46. The excess risk concerns above all Alzheimer’s disease and other dementia syndromes (relative risk of 1.62), and was not found among goalkeepers. Furthermore, overall mortality was found to be lower in athletes than in the general population.
These findings are partly in line with those of other teams that have studied the mortality of professional footballers, particularly in Scotland and in France. In the Scottish study, published in 2019 in The New England Journal of Medicine, the association was particularly strong with Alzheimer’s disease (risk multiplied by five). An excess risk was also observed for Parkinson’s disease (which is not the case in the Swedish cohort).
Strengthen prevention
In the followingmath of the publication, the Scottish Football Federation had, as a precaution, announced measures to limit the game of heading in children, then, more recently, in adults. The Union of European Football Associations (UEFA) has listed directives for heading in youth football.
However, beware of amalgams, warns Emmanuel Orhant, medical director at the French Football Federation (FFF) and first author of the French study: “An excess of neurodegenerative diseases has been found in professional football, but there are no studies showing a link among amateurs. » The FFF doctor also underlines the evolution of the technical characteristics of the ball and menstruation in recent decades, which reduces the risk of head impacts and concussions.
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