The New England Journal of Medicine has published the report that The FA and PFA commissioned into health, dementia and football.
The independent FIELD study is led by Dr Willie Stewart with Glasgow University and the Hampden Sports Clinic. This study had the unique possibility of comparing the recently digitised NHS Scotland databases with a full database of ex-professional footballers in Scotland. This study was the first of its kind anywhere in the World and had only been made possible in the last couple of years due to the availability of these two unique datasets.
It looked at the medical records of over 7,500 ex-professional Scottish male footballers born between 1900 and 1976 and socio-demographically matched the players with over 23,000 members of the public. 1,180 of the ex-professional footballers had passed away.
The medical results of those who died showed that in this cohort of players:
- Former professional footballers on average lived three and a quarter years longer than the general population
- Ex-players were less likely to die of nearly all major diseases such as heart disease or cancer
- 11% of the death certificates of the ex-players that has passed away declared that they had died from dementia, compared to around 3% for the socio-demographically matched sample
- From statistical analysis, the study showed that in this cohort of Scottish ex-professional male players, the ex-footballers were around 3.5 times more likely to die of dementia than the matched sample
- The ex-professional footballers dying of dementia died at approximately the same age as the general population, meaning footballers did not die earlier of dementia
- There was no evidence of ex-professional footballer getting dementia earlier in their life
- There are no findings for grassroots players - some of whom would have appeared in the matched sample - or female footballers.
This is a hugely important piece of work for football. The study shows the overall significant benefits that playing football had for these ex-players’ health, allowing them to avoid some of the traditional killers of their era and live longer than the general public. However, these players were more likely to have died of dementia when they passed away.
As the population ages and people live for longer, Dementia has become one of the most important health and care issues facing the world. In England it is estimated that around 676,000 people have dementia. In the whole of the UK, the number of people with dementia is estimated at 850,000. The number of people with dementia are predicted to rise by up to 35% by 2025 and 146% by 2050. Dementia mainly affects older people, and after the age of 65, the likelihood of developing dementia roughly doubles every five years. Both men and women in the UK over the age of 80 are more likely to die of dementia than anything else.
The FA has set up an independently chaired Medical & Football Advisory Group which has reviewed the findings of the study ahead of publication. It recommended that The FA re-issues both the current FA Concussion Guidelines and best-practice advice for coaching heading, while also asking football to consider further steps to improve head injury management, for example by supporting UEFA’s proposals to introduce concussion substitutes. The Group also concluded that more research is needed into why players had been affected, but that there is not enough evidence at this stage to make other changes to the way the modern-day game is played.
The FA is committed to finding out why these footballers were more likely to get dementia. The data for example does not show yet if there was a difference for players playing in different decades, whether concussion, heading, the old leather ball, different playing styles or other factors were causal.
The FA has convened a Research Taskforce which will now look at these questions and recommend next steps to a football taskforce which includes the Premier League, EFL and PFA.
More details of the report and FAQs can be found on The FA’s website.
IMPORTANT - SCHOOLS FOOTBALL
- The FA believe that it is important to make evidence-based decisions on whether or not heading should be banned in youth football. As it stands, there is no evidence to suggest that heading should be banned in youth football. Heading is significantly less common in children’s games.
- The FA have recommended that heading practice follows best practice guidelines and that children only practice heading in proportion to the very infrequent number of times the ball is actually headed in youth games.