Espahbodi, S., Hogervorst, E., Macnab, T.-M.P. et al. (12 more authors) (2023) Heading frequency and risk of cognitive impairment in retired male professional soccer players. JAMA Network Open, 6 (7). e2323822. ISSN 2574-3805
Abstract
Importance
Although professional soccer players appear to be at higher risk of neurodegenerative disease, the reason remains unknown.
Objective
To examine whether heading frequency is associated with risk of cognitive impairment in retired professional soccer players.
Design, Setting, and Participants
A UK nationwide cross-sectional study was conducted between August 15, 2020, and December 31, 2021, in 459 retired male professional soccer players older than 45 years and registered with the Professional Footballers’ Association or a League Club Players’ Association.
Exposure
Data on heading frequency in 3 bands—0 to 5, 6 to 15, and more than 15 times per match or training session and other soccer-specific risk factors, such as player position and concussion—were collected through a self-reported questionnaire.
Main Outcomes and Measures
Cognitive impairment was defined using the Telephone Interview for Cognitive Status-modified as scores of less than or equal to 21. Hopkins Verbal Learning Test, verbal fluency, and independent activities of daily living were also assessed. Test Your Memory and physician-diagnosed dementia/Alzheimer disease were self-reported via the questionnaire. Adjusted odds ratios (AORs) with 95% CIs were calculated.
Results
Of 468 retired male professional soccer players who completed questionnaires (mean [SD] age, 63.68 [10.48]; body mass index, 27.22 [2.89]), 459 reported heading frequency: 114 headed 0 to 5 times, 185 headed 6 to 15 times, 160 headed more than 15 times per match, and 125 headed 0 to 5 times, 174 headed 6 to 15 times, and 160 headed more than 15 times per training session during their careers. The prevalence of cognitive impairment was 9.78% (0-5 times), 14.78% (6-15 times), and 15.20% (>15 times) per match (P = .51). Compared with players reporting 0 to 5 headers per match, the AORs were 2.71 (95% CI, 0.89-8.25) for players reporting 6 to 15 headers per match and 3.53 (95% CI, 1.13-11.04) for players reporting more than 15 headers per match (P = .03 for trend). Corresponding AORs for heading frequency per training session were 2.38 (95% CI, 0.82-6.95) for those reporting 6 to 15, and 3.40 (95% CI, 1.13-10.23) for those reporting more than 15 in comparison with those who reported 0 to 5 (P = .03 for trend). Concussion involving memory loss was also associated with a greater risk of cognitive impairment (AOR, 3.16; 95% CI, 1.08-9.22). Similar results were observed with other cognitive tests and self-reported physician-diagnosed dementia/Alzheimer disease.
Conclusions and Relevance
The findings of this study suggest that repetitive heading during a professional soccer career is associated with an increased risk of cognitive impairment in later life. Further study is needed to establish the upper threshold for heading frequency to mitigate this risk.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 Espahbodi S et al. JAMA Network Open. This is an open access article distributed under the terms of the CC-BY License. https://creativecommons.org/licenses/by/4.0/ |
Keywords: | Humans; Male; Middle Aged; Soccer; Alzheimer Disease; Neurodegenerative Diseases; Cross-Sectional Studies; Activities of Daily Living; Brain Concussion; Cognitive Dysfunction |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 29 Nov 2023 11:06 |
Last Modified: | 29 Nov 2023 11:06 |
Status: | Published |
Publisher: | American Medical Association (AMA) |
Refereed: | Yes |
Identification Number: | 10.1001/jamanetworkopen.2023.23822 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:205592 |
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