Research published recently has shown professional football players are more than three and a half times more likely to die of dementia. This study comes after a push from the family of former England footballer Jeff Astle, who died in 2002 aged 59 from what was later diagnosed as a form of dementia called Chronic Traumatic Encephalopathy (CTE). These finding are particularly shocking, as CTE has been diagnosed in individuals who played high-contact sports such NFL and rugby, as well as professional boxers, but now the risks of low-contact sports such as football are coming to light.

CTE is thought to be caused be repeated blows to the head, causing traumatic brain injury which leads to symptoms such as personality and mood changes, depression and intellectual impairment. While CTE had been previously described in professional boxers, it came to prominence when in 2002 Dr Bennet Omalu investigated the death of former NFL player Mike Webster, who had suffered with cognitive decline, anger issues and depression before his death. When his brain was investigated at autopsy, large tangles of ‘Tau’ protein were found, similar to the plaques seen in the brain in Alzheimer’s disease.

In the years that followed, Omalu found the same ‘Tau’ tangles in the brains of multiple former NFL players, including Terry Long who died by suicide aged 45, and was found to have signs of CTE in his brain after only 8 seasons in the NFL. Since then, studies have found shockingly high levels of CTE in over 200 professional NFL players, but also individuals who had played the sport at only high school or college level.  When these findings were presented to the commissioner of the NFL in 2007, they were dismissed, and it took almost 10 years for the NFL to officially acknowledge a connection between the sport and CTE. Since then, evidence of CTE has been found in wrestlers and professional rugby and ice hockey players, amongst others.

The recent study confirming the increased risk of dementia in ex-professional footballers such as Jeff Astle shows it is not just contact-sports where the risk of head-injuries lies. Leather footballs such as those Astle played with were extremely heavy and would have caused a significant impact force on the head when ‘headed’, but the lighter footballs used today have the ability to move much faster and may still lead to traumatic injury to the brain.

Head injury in sport is a complex issue. Removing all aspects of contact is just not possible whilst maintaining the integrity of many games and enjoyment for fans. As a fan of rugby and NFL myself, I am conflicted as I watch sports I love and flinch at every hard hit, knowing the consequences of such actions. Players need to be made more aware of the risks of the sports they play, not only that a concussion may cause pain and injury, but could lead to serious life-changing neurological conditions. CTE can currently only be confirmed post-mortem, but as scientists work to develop a test for the condition in live subjects, it is an issue which will continue to plague the sporting world. 

Emma Dalby

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