Repetitive Heading in Soccer Increases Risk of Cognitive Impairment: JAMA

Professional soccer players may face a higher risk of developing neurodegenerative diseases, finds a recent nationwide cross-sectional study published in the Journal of American Medical Association. The study, conducted between August 2020 and December 2021, aimed to examine whether heading frequency in soccer was associated with an increased risk of cognitive impairment in retired players aged over 45 years. The findings suggest that repetitive heading during a professional soccer career may indeed be linked to a higher risk of cognitive impairment later in life.

The study included 459 retired male professional soccer players registered with the Professional Footballers’ Association or a League Club Players’ Association. Researchers collected data on heading frequency and other soccer-specific risk factors, such as player position and concussions, through self-reported questionnaires.

The players were divided into three groups based on heading frequency: 0 to 5 times, 6 to 15 times, and more than 15 times per match or training session. Cognitive impairment was defined using the Telephone Interview for Cognitive Status-modified, along with other cognitive tests and self-reported physician-diagnosed dementia/Alzheimer's disease.

The results revealed that the prevalence of cognitive impairment was 9.78% for players who headed 0 to 5 times per match, 14.78% for those who headed 6 to 15 times, and 15.20% for those who headed more than 15 times per match. Comparing players who reported 0 to 5 headers per match, the adjusted odds ratios (AORs) were 2.71 for players reporting 6 to 15 headers and 3.53 for players reporting more than 15 headers (P = .03 for trend). Similar results were found for heading frequency during training sessions.

Additionally, the study found that concussions involving memory loss were also associated with a greater risk of cognitive impairment (AOR, 3.16).

These findings highlight the potential risks associated with repetitive heading in soccer, shedding light on a critical concern for retired players. However, the exact mechanisms by which heading may contribute to cognitive impairment remain unclear. Therefore, further research is needed to determine the upper threshold for heading frequency that could help mitigate this risk.

Reference:

Espahbodi, S., Hogervorst, E., Macnab, T.-M. P., Thanoon, A., Fernandes, G. S., Millar, B., Duncan, A., Goodwin, M., Fuller, G., Ferguson, E., Bast, T., Doherty, M., & Zhang, W. (2023). Heading Frequency and Risk of Cognitive Impairment in Retired Male Professional Soccer Players. In JAMA Network Open (Vol. 6, Issue 7, p. e2323822). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.23822