Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players.
Association of Field Position and Career Length With Risk of Neurodegenerative Disease in Male Former Professional Soccer Players.
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DOI：
10.1001/jamaneurol.2021.2403
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发表时间：
2021-09-01
期刊：
影响因子：
29
通讯作者：
Stewart W
中科院分区：
文献类型：
--
作者：
Russell ER;Mackay DF;Stewart K;MacLean JA;Pell JP;Stewart W
在男性前职业足球运动员中，球场位置、职业生涯长度和比赛时间与神经退行性疾病风险之间有什么联系？在这项队列研究中，7676名苏格兰男性前职业足球运动员和23028名一般人群对照个体按性别，出生年份和地区社会经济地位进行匹配，前足球运动员的神经退行性疾病风险因场地位置和职业生涯长度而异，但在参与时代相似。在这项研究中，职业生涯较长的前职业足球运动员和非守门员位置的人患神经退行性疾病的风险较高，这表明应仔细研究与非守门员位置相关的因素以减轻风险;同时，减少头部撞击暴露的策略可能是明智的，以减少这一人群的负面结果。这项队列研究调查了苏格兰男性前职业足球运动员的场地位置，职业生涯长度和比赛年龄与神经退行性疾病风险的关系。前职业足球运动员的神经退行性疾病死亡率高于一般人群对照。然而，导致该人群神经退行性疾病死亡率增加的因素仍不确定。探讨男性前职业足球运动员的场地位置、职业生涯长度和比赛年限与神经退行性疾病风险的关系。这项队列研究使用苏格兰基于人群的健康记录联系来评估1900年1月1日至1977年1月1日出生的7676名男性前职业足球运动员和23028名一般人群对照个体的风险，这些对照个体按出生年份、性别和地区社会经济状况进行匹配，提供了1812722人-年的随访。苏格兰死亡记录和死亡证明数据可从1981年1月1日至2016年12月31日获得，处方数据可从2009年1月1日至2016年12月31日获得。2018年12月10日进行了数据库询问，并在2020年4月至2021年5月期间分析了数据。参加职业男子足球比赛。通过个人水平的记录与国家精神卫生和综合医院住院和日间病例入院的电子记录以及处方信息和死亡证明的联系获得结果。在前职业足球运动员和匹配的一般人群对照个体之间评估神经退行性疾病的风险。在这项针对30704名男性的队列研究中，7676名前足球运动员中有386人（5.0%）和23028名匹配的人群对照个体中有366人（1.6%）被诊断患有神经退行性疾病（风险比[HR]，3.66; 95%CI，2.88-4.65; P < .001）。与普通人群对照组相比，后卫的神经退行性疾病风险最高（HR，4.98; 95% CI，3.18-7.79; P <0.001），守门员最低（HR，1.83; 95% CI，0.93-3.60; P = 0.08）。在职业生涯长度方面，职业生涯长度超过15年的前足球运动员的风险最高（HR，5.20; 95%CI，3.17-8.51; P < .001）。在年龄方面，1910年至1969年出生的所有球员的风险保持相似。在这项队列研究中观察到的神经退行性疾病风险的差异意味着暴露于更常与非守门员位置相关的因素的风险增加，没有证据表明这种关联在研究的时代发生了变化。虽然需要进行调查以确认导致职业足球运动员神经退行性疾病风险增加的特定因素，但同时可能建议采取减少头部撞击暴露的策略。
What is the association of field position, career length, and playing era with risk of neurodegenerative disease in male former professional soccer players? In this cohort study of 7676 Scottish male former professional soccer players and 23 028 general population control individuals matched by sex, year of birth, and area socioeconomic status, risk of neurodegenerative disease among former soccer players varied by field position and career length but was similar across era of participation. In this study, risk of neurodegenerative disease was higher among former professional soccer players with longer careers and among those in nongoalkeeper positions, indicating that factors associated with nongoalkeeper positions should be scrutinized to mitigate risk; meanwhile, strategies to reduce head impact exposure may be advisable to reduce negative outcomes in this population. This cohort study investigates the association of field position, professional career length, and playing era with risk of neurodegenerative disease among Scottish male former professional soccer players. Neurodegenerative disease mortality is higher among former professional soccer players than general population controls. However, the factors contributing to increased neurodegenerative disease mortality in this population remain uncertain. To investigate the association of field position, professional career length, and playing era with risk of neurodegenerative disease among male former professional soccer players. This cohort study used population-based health record linkage in Scotland to evaluate risk among 7676 male former professional soccer players born between January 1, 1900, and January 1, 1977, and 23 028 general population control individuals matched by year of birth, sex, and area socioeconomic status providing 1 812 722 person-years of follow-up. Scottish Morbidity Record and death certification data were available from January 1, 1981, to December 31, 2016, and prescribing data were available from January 1, 2009, to December 31, 2016. Database interrogation was performed on December 10, 2018, and data were analyzed between April 2020 and May 2021. Participation in men’s soccer at a professional level. Outcomes were obtained by individual-level record linkage to national electronic records of mental health and general hospital inpatient and day-case admissions as well as prescribing information and death certification. Risk of neurodegenerative disease was evaluated between former professional soccer players and matched general population control individuals. In this cohort study of 30 704 male individuals, 386 of 7676 former soccer players (5.0%) and 366 of 23 028 matched population control individuals (1.6%) were identified with a neurodegenerative disease diagnosis (hazard ratio [HR], 3.66; 95% CI, 2.88-4.65; P < .001). Compared with the risk among general population control individuals, risk of neurodegenerative disease was highest for defenders (HR, 4.98; 95% CI, 3.18-7.79; P < .001) and lowest for goalkeepers (HR, 1.83; 95% CI, 0.93-3.60; P = .08). Regarding career length, risk was highest among former soccer players with professional career lengths longer than 15 years (HR, 5.20; 95% CI, 3.17-8.51; P < .001). Regarding playing era, risk remained similar for all players born between 1910 and 1969. The differences in risk of neurodegenerative disease observed in this cohort study imply increased risk with exposure to factors more often associated with nongoalkeeper positions, with no evidence this association has changed over the era studied. While investigations to confirm specific factors contributing to increased risk of neurodegenerative disease among professional soccer players are required, strategies directed toward reducing head impact exposure may be advisable in the meantime.
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