Original article
High School Football and Risk of Neurodegeneration: A Community-Based Study

https://doi.org/10.1016/j.mayocp.2011.12.016Get rights and content

Abstract

Objective

To assess whether high school football played between 1946 and 1956, when headgear was less protective than today, was associated with development of neurodegenerative diseases later in life.

Methods

All male students who played football from 1946 to 1956 in the high schools of Rochester, Minnesota, plus a non–football-playing referent group of male students in the band, glee club, or choir were identified. Using the records-linkage system of the Rochester Epidemiology Project, we reviewed (from October 31, 2010, to March 30, 2011) all available medical records to assess later development of dementia, Parkinson disease (PD), or amyotrophic lateral sclerosis (ALS). We also compared the frequency of dementia, PD, or ALS with incidence data from the general population of Olmsted County, Minnesota.

Results

We found no increased risk of dementia, PD, or ALS among the 438 football players compared with the 140 non–football-playing male classmates. Parkinson disease and ALS were slightly less frequent in the football group, whereas dementia was slightly more frequent, but not significantly so. When we compared these results with the expected incidence rates in the general population, only PD was significantly increased; however, this was true for both groups, with a larger risk ratio in the non–football group.

Conclusion

Our findings suggest that high school students who played American football from 1946 to 1956 did not have an increased risk of later developing dementia, PD, or ALS compared with non–football-playing high school males, despite poorer equipment and less regard for concussions compared with today and no rules prohibiting head-first tackling (spearing).

Section snippets

Study Population and Medical Records Abstraction

During the years of interest, 1946-1956, Rochester had only 2 high schools: Lourdes High School and Rochester High School. Yearbooks were available for these high schools, documenting rosters of football players, as well as members of the band, glee club, and choir (non–football players). We created lists of the male members of these respective groups; football players who also participated in band, glee club, or choir were included only in the list of football players. The yearbooks contained

Results

We identified 512 male football players and 203 male members of the band, glee club, or choir from high school classes between 1946 and 1956. Among these, we were able to successfully match 438 football players (86%) and 140 band, glee club, or choir members (69%) to a record in the REP system (Figure 2).

The median period of follow-up in the system was 50.2 years (interquartile range [IR], 13.7-57.5) for the football players and 42.7 years (IR, 8.8-55.4) for the non–football players. The age at

Discussion

Our findings suggest that playing American football in high school between 1946 and 1956 did not increase the long-term risk of developing dementia, PD, or ALS later in life. Indeed, the frequency of PD and ALS was lower in the football group than in the band, glee club, and choir group; however, the 2 groups did not differ statistically. Although the dementia frequency was higher in the football group (3% vs 1.4%), the difference was not significant (P=.55).

Our concern was that the repetitive

Conclusion

Our findings suggest that high school football players from a well-defined community who played from 1946 to 1956 did not have an increased risk of dementia, PD, or ALS compared with non–football players. These data should be interpreted in light of the many differences between today's high school football players and those of the distant past. Although today's players have better equipment, trainers and physicians who are more knowledgeable about concussions, and rules against spearing, they

Acknowledgments

The authors thank all the personnel of the Rochester Historical Society and Lourdes High School for their help and support.

Statistical analyses were conducted by B. R. Grossardt, MS, Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN.

References (22)

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    Grant Support: The study was supported by National Institutes of Health Grant R01-AG034676, the Rochester Epidemiology Project (Principal Investigator: Walter A. Rocca, MD, MPH).

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