Sport associated dementia

Stewart, William

doi:10.1136/bmj.n168

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…43 In addition to these primary prevention measures, interventions targeted towards risk mitigation among former rugby players with already accumulated head impact exposures might also be considered, including the development of specialist brain health clinics. 44 A strength of our study is the inclusion of a relatively large number of former rugby players and, importantly, a matched general population comparison group, with outcomes derived from comprehensive electronic health records. As such, potential biases were minimised.…”

Section: Figurementioning

confidence: 99%

Neurodegenerative disease risk among former international rugby union players

Russell

Mackay

Lyall

et al. 2022

J Neurol Neurosurg Psychiatry

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BackgroundAutopsy studies of former contact sports athletes, including soccer and rugby players, frequently report chronic traumatic encephalopathy, a neurodegenerative pathology associated with traumatic brain injury. Nevertheless, little is known about the risk of neurodegenerative disease in these populations. We hypothesised that neurodegenerative disease risk would be higher among former elite rugby union players than the general population.MethodsWe conducted a retrospective cohort study accessing national electronic records on death certification, hospital admissions and dispensed prescriptions for a cohort of 412 male Scottish former international rugby union players and 1236 members of the general population, matched to former players by age, sex and area socioeconomic status. Mortality and incident neurodegenerative disease diagnoses among former rugby players were then compared with the matched comparison group.ResultsOver a median 32 years follow-up from study entry at age 30 years, 121 (29.4%) former rugby players and 381 (30.8%) of the matched comparison group died. All-cause mortality was lower among former rugby players until 70 years of age with no difference thereafter. During follow-up, 47 (11.4%) former rugby players and 67 (5.4%) of the comparison group were diagnosed with incident neurodegenerative disease (HR 2.67, 95% CI 1.67 to 4.27, p<0.001).ConclusionsThis study adds to our understanding of the association between contact sports participation and the risk of neurodegenerative disease. While further research exploring this interaction is required, in the meantime strategies to reduce exposure to head impacts and head injuries in sport should be promoted.

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Section: Figurementioning

confidence: 99%

Neurodegenerative disease risk among former international rugby union players

Russell

Mackay

Lyall

et al. 2022

J Neurol Neurosurg Psychiatry

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“…Formally established in 2015, CTE is a tauopathy defined by its distinct irregular spatial pattern of abnormal tau accumulation in neurons and astroglia around small blood vessels at the base of sulci of the cortex [ 7 ]. Specific mechanisms, including the progressive nature of CTE and additional factors contributing to the pathological development, remain largely unestablished [ 6 , 8 ]. Kriegel and colleagues [ 9 ] proposed the axonal and microvascular injuries which lead to persistent neuroinflammation and metabolic disruption that are sustained due to mTBI may trigger another ‘pathological cascade’ that leads to the development of CTE in at-risk individuals.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, no treatment has been validated by clinical trials to be used for the management of CTE [ 5 ]. Experts have suggested looking at other similar neurodegenerative conditions [ 6 ]. Tau targeting therapies intended to modify disease progression in tau pathologies are still under investigation, with symptomatic management remaining the primary intervention strategy for tauopathies.…”

Section: Introductionmentioning

confidence: 99%

The effects of active rehabilitation on symptoms associated with tau pathology: An umbrella review. Implications for chronic traumatic encephalopathy symptom management

et al. 2022

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Objective This review sought to address an evidence gap and lay a foundation for future Chronic Traumatic Encephalopathy (CTE) management studies by evaluating and appraising the literature which reports the effect that active rehabilitation has on other tauopathies, a group of conditions with hyperphosphorylation and aggregation of tau protein that can lead to neurodegeneration. Design Umbrella review. Data source Meta-analyses and systematic reviews were identified using CINAHL, Medline, Cochrane, Web of Science, PubMed, and SPORTDiscus. Eligibility Systematic review or meta-analyses that examine the effect active rehabilitation has on outcome measures of symptoms associated with CTE. Studies with men and women diagnosed with Alzheimer’s disease, Parkinson’s disease, Lewy Body dementia, Frontotemporal degeneration/dementia or Corticobasal degeneration. All types of active rehabilitation were included. Control group was usual care, no intervention, or light-intensity physical activity. Results Twelve reviews were included. A large pooled standardized mean difference (SMD) was observed for balance (SMD = 0.88, P<0.001) and motor function (SMD = 0.83, P<0.001). A moderate pooled SMD was observed for cognitive function (SMD = 0.66, P<0.116). A small pooled SMD was observed for mobility (SMD = 0.45, P = 0.002). A trivial pooled SMD was observed for gait speed/velocity (SMD = 0.11, P = 0.372). No findings for mood/behavioral symptoms. All pooled effects demonstrated substantial to considerable heterogeneity (74.3% to 91.9%, P<0.001). Conclusions A positive effect of active rehabilitation was observed in patients with tau pathologies suffering from motor, vestibular and cognitive impairments supporting the use of active rehabilitation for CTE management; however, the findings need to be considered with caution given the limited research in some of the tau pathologies, large between-study heterogeneity and wide 95% prediction intervals.

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“…[5] When it comes to neurocognition, recent research has suggested an association between concussions during a sports career and long-term neurodegenerative conditions, such as dementia. [6] Also, scientific evidence shows that retired professional rugby players are associated with small to moderate impairments in cognitive function (e.g. attention, memory, and concentration) when compared with agematched controls.…”

Section: Health Challenges After Retirement From Professional Rugbymentioning

confidence: 99%

No time to waste: necessary health support for retired professional rugby players

Gouttebarge

Rensburg

Kerkhoffs

2021

S. Afr. j. sports med

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There has been increasing scrutiny of professional rugby following the concern that retired players might face several negative health conditions. Currently, support measures addressing the health of retired professional rugby players are not systematically implemented. This is unusual as professional rugby stakeholders have the duty of care to protect and promote the long-term health of retired players. Professional football has a health programme for retired players that is implemented globally. This programme formed the basis for the After Rugby Career Consultation (ARCC) which was developed to empower the sustainable health and quality of life of retired professional rugby players. The ARCC relies on information from three sources: (1) educational material, (2) medical examination, and (3) guidance, referral and/or monitoring. The South African rugby stakeholders have connected to pilot the ARCC as there is no time to waste: a step towards necessary health support for retired professional rugby players is needed.

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Sport associated dementia

Abstract: Prevention remains the only cure

Cited by 6 publications

References 16 publications

Neurodegenerative disease risk among former international rugby union players

Neurodegenerative disease risk among former international rugby union players

The effects of active rehabilitation on symptoms associated with tau pathology: An umbrella review. Implications for chronic traumatic encephalopathy symptom management

No time to waste: necessary health support for retired professional rugby players

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