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Abstract
Objective: To analyze neurodegenerative causes of death, specifically Alzheimer disease (AD), Parkinson disease, and amyotrophic lateral sclerosis (ALS), among a cohort of professional football players.
Methods: This was a cohort mortality study of 3,439 National Football League players with at least 5 pension-credited playing seasons from 1959 to 1988. Vital status was ascertained through 2007. For analysis purposes, players were placed into 2 strata based on characteristics of position played: nonspeed players (linemen) and speed players (all other positions except punter/kicker). External comparisons with the US population used standardized mortality ratios (SMRs); internal comparisons between speed and nonspeed player positions used standardized rate ratios (SRRs).
Results: Overall player mortality compared with that of the US population was reduced (SMR 0.53, 95% confidence interval [CI] 0.48−0.59). Neurodegenerative mortality was increased using both underlying cause of death rate files (SMR 2.83, 95% CI 1.36−5.21) and multiple cause of death (MCOD) rate files (SMR 3.26, 95% CI 1.90−5.22). Of the neurodegenerative causes, results were elevated (using MCOD rates) for both ALS (SMR 4.31, 95% CI 1.73−8.87) and AD (SMR 3.86, 95% CI 1.55−7.95). In internal analysis (using MCOD rates), higher neurodegenerative mortality was observed among players in speed positions compared with players in nonspeed positions (SRR 3.29, 95% CI 0.92−11.7).
Conclusions: The neurodegenerative mortality of this cohort is 3 times higher than that of the general US population; that for 2 of the major neurodegenerative subcategories, AD and ALS, is 4 times higher. These results are consistent with recent studies that suggest an increased risk of neurodegenerative disease among football players.
GLOSSARY
- AD=
- Alzheimer disease;
- ALS=
- amyotrophic lateral sclerosis;
- CI=
- confidence interval;
- CTE=
- chronic traumatic encephalopathy;
- ICD=
- International Classification of Diseases;
- MCOD=
- multiple cause of death;
- NDI=
- National Death Index;
- NFL=
- National Football League;
- NIOSH=
- National Institute for Occupational Safety and Health;
- PD=
- Parkinson disease;
- SMR=
- standardized mortality ratio;
- SSR=
- standardized rate ratio
Footnotes
Study funding: Supported by the Intramural Research Program of the National Institute for Occupational Safety and Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health. The sponsor reviewed and approved final submission but did not have a role in design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation of the manuscript.
- Received April 24, 2012.
- Accepted July 9, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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