Football and Dementia

 by Muhammed Sahil

The link between dementia and football was never a concern for anyone playing the game. The link was unknown until awareness had stemmed from 2002, when Jeff Astle who was a former West Brown and England player had passed away at the age of just 59. Following his death, the coroner declared that “the trauma caused to the front of his brain was likely to have had a considerable effect on the cause of death."

What is dementia?

 It’s not unusual for memory to be affected by certain factors such as stress, tiredness or by certain medications, especially at old age but dementia on the other is not a natural component of ageing. Furthermore, It’s a common misconception that dementia is just about memory loss but it can also affect the way you think, feel, speak and behave. 

So what Dementia is really defined as is a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning and it isn’t simply cut down to one disease. In fact there are many different causes and types such as Alzheimer’s disease.

Some symptoms of dementia include problems concerning memory loss, difficulties in performing daily activities, understanding and your mental sharpness/quickness. Individuals with the disease may have other issues such as losing interest in their usual actives or struggling to manage their emotions/behaviour. Personality changes may occur as well such as loss of empathy and they may even have hallucinations. Though there is no current treatment, early diagnosis ensures that individuals can get the right support and treatment but also so they can maintain their mental functioning for longer as it can still deteriorate. With over 850,000 currently living with dementia in the UK, through early diagnosis, followed by the support and treatment, many people have been able to live an active, satisfied life with dementia.

How does heading a ball affect the brain?

Though a single header is unlikely to cause any damage to the brain, frequent heading increases the risks of developing dementia and even dying from this mental disease, When the ball strikes your head, the brain, which floats within the skull cavity, bounces against the back of the skull’s wall causing bruising. In addition, a study conducted by the University of Columbia had found that the blood levels containing certain proteins which are associated with damage to nerve cells increase after heading a ball. 

In terms of dementia, Jeff Astle had provided some worrying signs following his footballing life. He suffered from eating disorders and struggled to carry out everyday tasks himself. He couldn’t even recognise any of his 3 children. He was known for his heading and the Englishman had a successful career, scoring 174 goals in 361 appearances, including 5 apps for England and he was also part of the 1970 World Cup squad. During the inquest of his death back in 2002, Derek Robison, the consultant neurologist-pathologist who worked at the Queen’s medical centre in Nottingham had said there was much evidence of trauma to the brain, quite like that of a boxer. At that time, footballs were much harder compared to nowadays so the risk were far more greater. The Neuropathologist believed that the trauma caused to the front of his brain was likely to have had a great effect on his death. Not only were footballs heavy in the early 20th century but they would become waterlogged, doubling their weight, leading to many players being knocked out after heading. 

12 years on from the inquest, a re-examination of his brain in 2014 had found that he had died from Chronic traumatic encephalopathy (CTE) which is a progressive brain condition linked to various disorders including dementia, depression and memory loss. This condition has been linked to boxing and American football but Astle’s death had created the spark into research and analysing the link being football and dementia. 

Due to the notable concern, the FA have taken action by banning heading in training for all children in England, Scotland and Northern Ireland under the age of 12. 

Extra research 

In 2017, a study was conducted by UCL and Cardiff university. It was on six former players and the result was that 4 of them had shown signs of CTE, further strengthening the link. Professor Huw Morris from UCL had drawn on the fact that exboxers present the same sort of changes due to repeated brain injury and so in terms of football, repeated heading shows the same signs. He said that for the first time in a series of footballers, “we have shown that there is evidence that head injury has occurred earlier in their life, which presumably has some impact on them developing dementia."

After in 2019, another study was conducted by Glasgow University and found that former pros were 3.5x more likely to die of dementia than those in the general population of the same age range.

Despite all the rising research and extensive evidence, long term research is required in order to prove that a causal relationship exists.

The main difficulty is the fact that dementia isn’t caused by one factor. Age, lifestyle and genetic factors all need to be taken into account. Physical trauma to the brain e.g. in heading is a factor but other factors in terms of an unhealthy lifestyle such as being overweight or smoking also increases risk. Therefore it’s difficult to single out a cause for dementia due to the vast amount of other factors,

Despite the issue, this shouldn’t put a barrier on further research. Recently, a study was launched by Queen Mary University of London, the institute of occupational medicine and  the London School of Hygiene, which consists of 300 ex pro football players. Those aged 50-85 will perform a series of tests with the purpose of assessing their cognitive and physical capabilities.

In order to compare data between those who do head the ball e.g. strikers and those who head the ball less often e.g. defenders extra data on the players’ careers throughout the game along with lifestyle factors will also be gathered. Once the results have been gathered, they’ll then go on to being compared to the 1946 Birth Cohort which is a general population study that has monitored the process of ageing in a group born in that particular year.

Neil Pearce who is the lead professor from LSHTM portrayed the fact that there is not much knowledge about the long term effects of heading a ball repeatedly but for the first time, this study will provide “persuasive evidence of the long term effects on cognitive function from professional football.”

Many great former pros have signed up to this including Alan Shearer who currently holds the all time Premeir Leagues goal scoring record with 260 goals including 46 of those coming off his head. It was good to hear that the former Premier league winner had a CT scan as part of the study which showed that his brain was unaffected but he is only one from all the other participants. Others may show different signs especially since there will also be a large age range. Furthermore he is most likely to be one of the youngest of the group at age 50 but once the study is completed, the researchers will be able to draw to a conclusion and analyse the differences between the different age groups.

As more research continues in this field, the link between football and dementia will become more clear.