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Neurodegenerative Disease and Association Football (NDAF): Systematic Review and Meta-Analysis

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  • Nathan E. Howarth

    (Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
    NIHR Biomedical Research Centre (BRC), University of Exeter, Exeter EX1 2LU, UK
    Concussion Legacy Foundation, Boston, MA 02115, USA)

  • Chen Ji

    (Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK)

  • John Batten

    (Faculty of Health and Wellbeing, University of Winchester, Winchester SO22 4NR, UK)

  • Alan J. Pearce

    (Swinburne Neuroimaging Facility, School of Health Science, Swinburne University, Melbourne 3122, Australia)

  • Helen Dawes

    (NIHR Biomedical Research Centre (BRC), University of Exeter, Exeter EX1 2LU, UK)

  • Adam J. White

    (Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
    NIHR Biomedical Research Centre (BRC), University of Exeter, Exeter EX1 2LU, UK
    Professional Footballers Association, London EC3M 8AA, UK)

  • Gabriele DeLuca

    (NIHR Biomedical Research Centre (BRC), University of Oxford, Oxford OX3 9DU, UK)

  • Samantha Bureau

    (Concussion Legacy Foundation, Boston, MA 02115, USA)

  • Christopher J. Nowinski

    (Concussion Legacy Foundation, Boston, MA 02115, USA)

  • Michelle A. Miller

    (Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK)

Abstract

There is increasing concern that head injuries in Association Football (or soccer) may lead to adverse health outcomes. The aim of this study was to determine whether head impacts or injuries are associated with an increased risk of neurodegenerative disease. We performed a systematic search using PubMed, Embase, and Ovid (up to April 2025). Studies included investigated neurodegenerative diseases in football in comparison to control athletic and general populations. Data were extracted according to PRISMA guidelines. Studies with an odds ratio (OR) were included in the meta-analysis. A total of ten studies were included in this review, of which nine were suitable for meta-analysis from eight cohorts. The risk for developing any neurodegeneration was 1.69 OR (95%CI 1.11 to 2.59; p = 0.01); for Dementia, it was 2.16 OR (95%CI 1.60 to 2.93; p < 0.01; for Motor Neurone Disease (MND), it was 1.39 OR (95%CI 0.67 to 2.53; p = 0.21); for Parkinson’s Disease (PD), it was 1.14 OR (95%CI 0.55 to 2.89; p = 0.79). Heterogeneity was reduced following the removal of two studies and the revised risk scores for any neurodegenerative disease; Dementia increased, with that for MND reaching significance, 1.81 OR (95%CI 1.22 to 2.30; p = 0.01), but there remained no association with PD. Evidence suggests that professional football significantly increases the odds of neurodegenerative disease.

Suggested Citation

  • Nathan E. Howarth & Chen Ji & John Batten & Alan J. Pearce & Helen Dawes & Adam J. White & Gabriele DeLuca & Samantha Bureau & Christopher J. Nowinski & Michelle A. Miller, 2025. "Neurodegenerative Disease and Association Football (NDAF): Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 22(5), pages 1-14, May.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:5:p:806-:d:1660834
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    1. Tommaso Filippini & Maria Fiore & Marina Tesauro & Carlotta Malagoli & Michela Consonni & Federica Violi & Elisa Arcolin & Laura Iacuzio & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study," IJERPH, MDPI, vol. 17(3), pages 1-17, January.
    2. Giorgia Adani & Tommaso Filippini & Caterina Garuti & Marcella Malavolti & Giulia Vinceti & Giovanna Zamboni & Manuela Tondelli & Chiara Galli & Manuela Costa & Marco Vinceti & Annalisa Chiari, 2020. "Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy," IJERPH, MDPI, vol. 17(21), pages 1-18, October.
    3. Tommaso Filippini & Marina Tesauro & Maria Fiore & Carlotta Malagoli & Michela Consonni & Federica Violi & Laura Iacuzio & Elisa Arcolin & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study," IJERPH, MDPI, vol. 17(8), pages 1-13, April.
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