Elevated Neurodegenerative Disease Risk in Rugby Players

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The risk varies by condition: up to 15 times higher for motor neurone disease.

Strategies needed to reduce head impact/injury risk in all sports, researchers say

The risk of neurodegenerative disease among former Scottish international rugby union players is more than double that of the general population, according to research published online in the Journal of Neurology Neurosurgery & Psychiatry .

The risk varies by condition, from just over twice as high for dementia to 15 times as high for motor neurone disease, the findings show, prompting researchers to call for strategies to reduce risks of impact on the condition. head and traumatic brain injury worldwide. all sports, even in training.

Traumatic brain injury is a major risk factor for neurodegenerative disease and is thought to account for 3% of all dementia cases.

In recent years, postmortem studies of brain tissue have uncovered evidence of neurological disease associated only with a prior history of traumatic brain injury or repetitive exposure to head impacts, termed chronic traumatic encephalopathy neuropathological change (CTE-NC). in former professional athletes in sports, including American football, soccer and rugby.

And in this study, researchers wanted to find out whether the risk of neurodegenerative disease could also be higher among former rugby players than among the general population.

They included 412 former Scottish international male rugby players (from an initial total of 654), for whom complete health and field position data was available, and who were at least 30 years old at the end of 2020.

Players were matched by age, sex and socioeconomic status with 1,236 members of the public.

National electronic health record data on hospital admissions, prescribed medications and the most common causes of death among Scottish men: diseases of the circulatory system; respiratory disease; and cancer—were used to track the health and survival of both groups for an average of 32 years starting at age 30.

During the follow-up period, 121 (29%) of the former rugby players and 381 (31%) of the comparison group died. The former rugby players were older when they died, reaching an average of almost 79 years old compared to just over 76 in the comparison group.

And former rugby players had lower rates of death from any cause until they were 70, after which there was no difference between the two groups.

There were no differences in cause or age of death between former rugby players and the comparison group for the most common primary causes of death for Scottish men.

But the likelihood of being diagnosed with a neurodegenerative disease was more than twice as high among former rugby players (47; 11.5%) as among the comparison group (67; 5.5%), although the risks varied by condition.

The risk of a dementia diagnosis was slightly more than double, while that of Parkinson’s disease was three times higher and that of motor neurone disease/amyotrophic lateral sclerosis 15 times higher. Further analysis showed that the field position (forward or backward) of former rugby players did not influence the risk of neurodegenerative diseases.

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

There was also no information available on total length of rugby career or history of head impact and traumatic brain injury or other potential risk factors for dementia.

But the study was relatively large and long-term, and the findings echo previous studies of former professional soccer players and former American soccer players, the researchers say.

“Notably, in contrast to the NFL [National Football League] and soccer data, our cohort of rugby players is largely made up of amateur athletes, although they participate at an elite international level. In this sense, it is the first demonstration that the high risk of neurodegenerative diseases is not an exclusive phenomenon of professional athletes,” they point out.

Rugby authorities have taken steps to improve the detection of concussion injuries and reduce risks during matches, researchers say.

“However, head impact exposures and concussion risk are not isolated to gaming. As such, measures to reduce training exposures could also be considered a priority.

“In addition to these primary prevention measures, interventions aimed at risk mitigation among former rugby players with already accumulated head impact exposures could also be considered, including the development of specialized brain health clinics,” they suggest.

And they conclude: “These data add to our understanding of the association between contact sports and lifetime health outcomes, specifically the risk of adverse brain health outcomes.

“There remains a need for more research exploring the relationship between contact sports and the risk of neurodegenerative diseases.

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