From Our 2012 Archives
NFL Players at Higher Risk of Brain Diseases
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NFL Players May Have Higher Risk of Dying From Diseases That Damage Brain Cells
By Denise Mann
Reviewed by Louise Chang, MD
Sept. 5, 2012 -- Former National Football League (NFL) players may have a higher risk of dying from diseases that damage brain cells.
Research has raised red flags about the health risks associated with cumulative blows to the head. Now a new study finds that pro football players are four times more likely to die with Alzheimer's or Lou Gehrig's disease (amyotrophic lateral sclerosis or ALS), compared to the general population.
The study looked at nearly 3,500 football players with five or more years in the NFL, playing from 1959-1988. There were a total of 334 deaths, including seven with Alzheimer's and seven with ALS listed on their death certificates.
The new findings appear in the journal Neurology.
Are Repeated Mild Concussions Causing the Risk?
At greatest risk were NFL players who held "speed" positions, such as quarterback, running back, halfback, fullback, and tight end. These players were three times more likely to die from a brain-related disease than their teammates who played non-speed positions, such as defensive and offensive lineman.
Still, there's a lot of information the study can't provide. For example, researchers did not have information on head injuries or concussions sustained by the players or knowledge about any other risks for these diseases.
The study also did not look at why football players may be at higher risk for dying from these brain diseases. The theory is that repeated blows to the head may start a process that results in one or more brain-damaging disorders in some people.
Past research has linked concussions to chronic traumatic encephalopathy (CTE), a disorder that has symptoms similar to those of ALS, Alzheimer's, or Parkinson's disease. But it is not yet known if CTE develops independently or is the beginning signs of these diseases.
"There are probably other factors involved, such as other environmental exposures or genetic factors, but we are in the very early stages of knowing how those may be involved," says researcher Everett Lehman, of the CDC's National Institute for Occupational Safety and Health in Cincinnati.
Prevent and Identify Concussions in Athletes
"Our results may not be generalizable to shorter-term professional players or to college or high school players," Lehman says. NFL players included in the study may have been exposed to more football risk factors than those who had only played high school or college football.
Still, Lehman says, "while we are waiting to see if concussion is one of the causes of [long-term brain damage], we may want to go ahead and take steps to reduce, manage, and effectively treat concussions."
Over the last few years, the NFL has implemented rule changes aimed at reducing concussions, Lehman says. These include moving kickoffs forward to the 35 yard line and increasing penalties for certain blows to the head and neck.
And today the NFL announced it is donating $30 million to the Foundation for the National Institutes of Health to help set up a Sports Health and Research Program that will look into topics such as CTE, concussion, and Alzheimer's.
The new study gives some numbers to the problem, says Jagan Pillai, MD, PhD, of the Center for Brain Health at the Cleveland Clinic. "It is definitely an important study."
"This is very alarming," says Patrick Lyden, MD, of Cedars-Sinai Medical Center in Los Angeles. Still many questions remain. "Is it the head trauma or something else about athletes that are behind these numbers?" he asks. "To prove causation, we have to have some high-quality basic science."
It has long been thought that Lou Gehrig developed ALS from blows to his head during his athletic career, Lyden says.
Gayatri Devi, MD, a neurologist at Lenox Hill Hospital in New York, says playing football simply is not good for the brain. "Repeated head injury over long periods of time clearly causes serious brain damage, and this is becoming more apparent as we are living longer."
Recent news reports have also focused on rates of depression and suicide seen among some pro athletes. "Depression and mood changes can be a harbinger of Alzheimer's disease down the road, so there may be a link," she says.
"We need to protect our brains and be more careful when playing games that involve head injuries," Devi says." We come with hard heads for a reason."
SOURCES: Lehman, E. Neurology, 2012. Patrick Lyden, MD, chairman, department of neurology, Cedars-Sinai Medical Center, Los Angeles. Jagan Pillai, MD, Center for Brain Health, Cleveland Clinic, Ohio. Everett Lehman National Institute for Occupational Safety and Health, Cincinnati Ohio. Gayatri Devi MD, neurologist, Lenox Hill Hospital, New York City. National Institutes of Health.