Rugby players more than twice as likely to develop dementia

By Mark Waghorn via SWNS

International rugby union players are more than twice as likely to develop dementia, according to new research on Scottish players.

Neurodegenerative illnesses double compared to the general population - with cases of motor neuron disease rising fifteenfold and Parkinson's tripling.

Risk varies by condition. Strategies to cut the number of head impacts and injuries in all sports are needed - including in training, say scientists.

The findings are based on 412 former Scotland internationals aged at least 30 by the end of 2020.

They echo previous studies of ex-professional footballers and American football players.

The men were matched for age, gender and socioeconomic status with 1,236 members of the public.

Lead author Dr. William Stewart, of the University of Glasgow, said: "Notably, in contrast to data from the NFL (National Football League) and soccer, our cohort of rugby players largely comprises amateur athletes, although participating at an elite, international level.

"In this respect, it is the first demonstration that high neurodegenerative disease risk is not a phenomenon exclusive to professional athletes."

Rugby authorities have taken steps to improve the detection of concussion injuries and to reduce the risks during match play.

Dr. Stewart said: "However, head impact exposures and concussion risk are not isolated to match play. As such, measures to reduce exposures in training might also be considered a priority

“In addition to these primary prevention measures, interventions targeted towards risk mitigation among former rugby players with already accumulated head impact exposures might also be considered, including the development of specialist brain health clinics."

He added: "These data add to our understanding of the association between contact sports and lifelong health outcomes, specifically risk of adverse brain health outcomes."

England World Cup winner Steve Thompson - who was diagnosed with early onset dementia - has admitted his illustrious career "wasn't worth it" because he'd "rather not be such a burden on his family."

The researchers tracked the health and survival of both groups for an average of 32 years.

They used national electronic health record data on hospital admissions, prescription drugs and the most common causes of death among Scottish men - circulatory system disease, respiratory disease and cancer.

Traumatic brain injury is a major risk factor for neurodegenerative disease. It is thought to account for three percent of all dementia cases.

In recent years post mortem studies of brain tissue have uncovered evidence of neurological disease uniquely associated with a previous history of traumatic brain injury or repetitive head impact exposure.

It is termed CTE-NC (chronic traumatic encephalopathy neuropathologic change) in former professional athletes from sports such as football, rugby union and American football.

During the monitoring period, 121 (29%) of the ex-rugby players and 381 (31%) of the others died.

The former group reached an average age of nearly 79 - compared with just over 76 in the latter.

They also had lower mortality rates from any cause up until 70 - after which they levelled up.

No differences in cause of, or age at, death were observed for the most common primary causes of death.

But the chance of being diagnosed with a neurodegenerative disease was more than twice as high among the rugby stars - 47 (11.5%) compared to 67 (5.5%).

The risk of dementia or Parkinson's diagnosis was just over twice or three times as high, respectively. Motor neuron disease was 15 times as common.

Leeds Rhinos and Great Britain rugby league legend Rob Burrows and former Premier League striker Marcus Stewart are among the ex-sportsmen with the illness.

Additional analysis showed players' positions in the team - whether they were forwards or backs - had no bearing on neurodegenerative disease risk.

The researchers acknowledge that 37% of former international rugby players who might have been eligible for inclusion had to be excluded in the absence of matched health records - and it focused only on men.

Nor was information available on total career length or history of head impact and traumatic brain injury or on other potential risk factors for dementia.

But the study was relatively large and long-term. Similar trends have been identified in other sports including professional football and American football, say the researchers.

Dr. Stewart said: "There remains a need for further research exploring the relationship between contact sports and risk of neurodegenerative disease.

“In the meantime, strategies to reduce exposure to head impacts and head injuries across all sports should continue to be developed and promoted, while measures to mitigate risk of adverse brain health in former athletes should be considered."

Children under the age of 12 in England, Scotland and Northern Ireland are now banned from heading footballs during practice or training.

The rule has been backed by former England player Ryan Mason. He was forced to retire after fracturing his skull during a Premier League game.

One recent study found footballers are three and a half times more likely to die of dementia.

In a trailer for BBC Two documentary, Head On: Rugby, Dementia and Me, which airs on Wednesday, 44-year-old Thompson reveals he can't remember winning the Webb Ellis Cup in 2003.

The former hooker was diagnosed with the degenerative condition, which has been linked to repetitive trauma to the brain, in 2020.

He is one of nearly 200 former players diagnosed with a brain disease suing World Rugby, the Rugby Football Union and Welsh Rugby Union.

The study is in The Journal of Neurology Neurosurgery & Psychiatry.