Neurodegenerative causes of death among retired National Football League players
Neurodegenerative causes of death among retired National Football League players
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DOI：
10.1212/wnl.0b013e31826daf50
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发表时间：
2012-11-01
期刊：
影响因子：
9.9
通讯作者：
Gersic, Christine M.
中科院分区：
文献类型：
--
作者：
Lehman, Everett J.;Hein, Misty J.;Gersic, Christine M.
目的：分析职业橄榄球运动员队列中神经退行性死亡原因，特别是阿尔茨海默病 (AD)、帕金森病和肌萎缩侧索硬化症 (ALS)。方法：这是一项队列死亡率研究，对象为 3,439 名国家橄榄球联盟球员，这些球员在 1959 年至 1988 年间至少有过 5 个养老金计入的赛季。截至 2007 年，生命状况已确定。出于分析目的，将球员分为 2 个阶层根据所踢位置的特征：非速度球员（巡线员）和速度球员（除了踢球手/踢球手之外的所有其他位置）。使用标准化死亡率（SMR）与美国人口进行外部比较；使用标准化比率 (SRR) 对速度和非速度球员位置进行内部比较。结果：与美国人口相比，总体球员死亡率有所降低（SMR 0.53，95% 置信区间 [CI] 0.48-0.59）。使用根本原因死亡率文件（SMR 2.83，95% CI 1.36-5.21）和多重原因死亡（MCOD）率文件（SMR 3.26，95% CI 1.90-5.22），神经退行性死亡率增加。在神经退行性原因中，ALS（SMR 4.31，95% CI 1.73-8.87）和 AD（SMR 3.86，95% CI 1.55-7.95）的结果均升高（使用 MCOD 率）。在内部分析（使用 MCOD 率）中，与非速度位置的玩家相比，速度位置的玩家观察到更高的神经退行性死亡率（SRR 3.29，95% CI 0.92-11.7）。结论：该队列的神经退行性死亡率是美国普通人群的 3 倍；对于两个主要的神经退行性亚类（AD 和 ALS）来说，这个数字要高出 4 倍。这些结果与最近的研究一致，该研究表明足球运动员患神经退行性疾病的风险增加。神经病学（R）2012；79：1970-1974
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. Neurology (R) 2012;79:1970-1974