High school football and late-life risk of neurodegenerative syndromes

Pieter H.H. Janssen, Jay Mandrekar, PhD, Michelle M. Mielke, PhD, J. Eric Ahlskog, PhD, MD, Bradley F. Boeve, MD, Keith Josephs, MD, Rodolfo Savica.  High School Football and Late-Life Risk of Neurodegenerative Syndromes, 1956-1970. Mayo Clinic Proceedings.  In press.

Abstract

Objective

To assess whether athletes who played American varsity high school football between 1956 and 1970 have an increased risk of neurodegenerative diseases later in life.

Patients and Methods

We identified all male varsity football players between 1956 and 1970 in the public high schools of Rochester, Minnesota, and non–football-playing male varsity swimmers, wrestlers, and basketball players. Using the medical records linkage system of the Rochester Epidemiology Project, we ascertained the incidence of late-life neurodegenerative diseases: dementia, parkinsonism, and amyotrophic lateral sclerosis. We also recorded medical record–documented head trauma during high school years.

Results

We identified 296 varsity football players and 190 athletes engaging in other sports. Football players had an increased risk of medically documented head trauma, especially if they played football for more than 1 year. Compared with nonfootball athletes, football players did not have an increased risk of neurodegenerative disease overall or of the individual conditions of dementia, parkinsonism, and amyotrophic lateral sclerosis.

Conclusion

In this community-based study, varsity high school football players from 1956 to 1970 did not have an increased risk of neurodegenerative diseases compared with athletes engaged in other varsity sports. This was from an era when there was a generally nihilistic view of concussion dangers, less protective equipment, and no prohibition of spearing (head-first tackling). However, the size and strength of players from previous eras may not be comparable with that of current high school athletes.