Are footballers more at risk of developing dementia?

Dr Michael Grey, of UEA’s School of Health Sciences, has a list of expertise matched in length only by the number of universities at which he has conducted his research, ranging from Aalborg and Copenhagen in Denmark, to Jyvaskyla in Finland, and Birmingham, before joining UEA in 2017.

His field of expertise dips its toes in non-invasive electrophysiology, transcranial magnetic stimulation and neuroimaging techniques, but his interest in the impact of mild traumatic brain injuries (concussions) has led him most recently to the football pitch.

Dr Grey leads a research team investigating the link between mild tissue damage obtained from heading the ball in football with the onset of dementia.

The study follows in the wake of research carried out by the Glasgow Group, released in October of last year, that matched ex-professional Scottish footballers against a sample group of people the same age and socio-economic background to see if there were different patterns of brain degeneration.

“What they found was that there was a three and a half times increased rate of neuro-degeneration compared with the control group,” Dr Grey says.

“And if you look specifically at something like dementia then, depending on the type of dementia, it varied. It’s still about three and a half but Alzheimer’s disease specifically was a five times greater risk… if you played professional football compared with if you didn’t.

“So that right there says there’s a link. Now the question is what do we do about it, and that’s where my study comes in.”

The new study focuses on learning exactly what goes on inside the heads of ex-footballers and what shape their decline takes.

As Dr Grey explains: “Everybody declines. Now, the question is, what’s the rate of decline? Ideally we decline at a slow rate until we get really, really old and then we decline really quickly and we die. That’s the ideal case.

“Of course, it’s not that way with most of us. You know, there’s a shallow decline but it’s steepness of that decline that’s important. And our question with the footballers is really: is the decline in footballers different on average than the decline that we would see normally.

“So, that means is the rate of the decline steeper and/or is the onset of that decline earlier?”

But he remains clear that he has no expectations regarding the results of the study.

“The hypothesis is that there will be a steeper decline and the onset will be earlier than the general population, but that’s the hypothesis that we’re testing.

“Now that’s a scientific construct. That doesn’t mean I necessarily believe this will be the case. That’s how we do science: we make a hypothesis and we test the hypothesis. We then either accept the null hypothesis or we reject it.

“I have no expectations.”

In its current setup, the study’s focus remains within the Norfolk region. It deals with a group of 50 ex-professional footballers, and matches them against samples taken from an online survey of the Norfolk population, with researchers harvesting results every six months.

However, the aim is to complete the regional study by January 2021 at the latest, and then expand the investigation first nationally, and then internationally.

“Down the road it’s going to be hundreds of footballers and thousands of control people,” Dr Grey says.

While there is little, as of yet, revolutionary about the investigation, an aspect that he is excited by is the inclusion of women.

“The women angle to this story, I think, is really, really important because the vast majority of studies in this area look at men. Nobody looks at women,” he explains.

But supposing the research proves the hypothesis, and it becomes accepted that football headers lead to brain degeneration earlier or more rapidly than normal, what would the result be? Dr Grey asserts that his study is not aiming to make any rule alterations to the game of football.

“This study is about… looking after the people that are still alive,” he says. “In our group of people we’ll see some people who are not performing quite as well as they should be, and it will allow us to signpost them to get a proper clinical diagnosis and, if needed, then treatment.”

Nevertheless, he explains that the damage caused by minor head traumas like headers is widely accepted, and he believes investigation should lead to a reduction in the number of headers per game, both professionally and in practice, especially with young children playing.

“Everybody in this industry knows what we need to do. It’s no secret. We need to stop kids from heading balls at a very young age,” he says.

“We’re not getting rid of heading from the game, nobody’s suggesting that at the minute.

“We’re suggesting that we look at what do we do with kids and bringing them up to a stage where they could be heading balls. Once we get to sort of teenagers and adults then what we need to be doing is, I think, is really minimising the contact time, minimising exposure during practices and spending a little bit more time practicing keeping the ball on the ground.”

He points to plummeting incidences of heading per game in recent years as a promising trend. With more and more studies being conducted into the effects of sub-concussive injuries, it may be that the game is taking notice.


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Jamie Hose

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May 2022
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