Playing football may increase the risk for Parkinson’s disease
New study shows risk increases with more years of play, even in high school and college players
Peer-Reviewed Publication(Boston)—Identification of risk factors for Parkinson’s disease (PD) is essential for early diagnosis. Dating back to the 1920s, Parkinson’s disease and parkinsonism—an umbrella term that refers to motor symptoms found in Parkinson’s disease and also other conditions—have long been described in boxers. Repetitive head impacts from tackle football can also have long-term neurological consequences like chronic traumatic encephalopathy (CTE). But research on the association between participation in tackle football and PD is limited.
In the largest study to describe the association between participation in football and the odds for having a reported diagnosis of PD, researchers from the BU CTE Center used a large online data set of people concerned for having PD and found participants with a history of playing organized tackle football had a 61% increased odds of having a reported parkinsonism or PD diagnosis.
In this study, the researchers evaluated 1,875 sport participants — 729 men who played football, predominantly at the amateur level, and 1,146 men who played non-football sports who served as the control group. Participants were enrolled in Fox Insight, a longitudinal online study of people with and without PD sponsored by The Michael J. Fox Foundation for Parkinson’s Research.
Notably, researchers found a link between playing football and increased odds for having a parkinsonism or PD diagnosis even after accounting for known risk factors for PD. Additionally, the data revealed that players who had longer careers and played at higher levels of competition experienced increased odds for having a reported diagnosis of parkinsonism or PD. Football players who played at the college or professional level were at 2.93 increased odds for having a PD diagnosis compared with those who just played at the youth or high school level. Age of first exposure to football was not associated with odds for having a reported parkinsonism or PD diagnosis.
“Playing tackle football could be a contributing risk factor to PD, particularly among people already at risk due to other factors (e.g., family history). However, the reasons for this relationship are not clear and we also know that not everyone who plays tackle football will develop later-life neurological conditions, meaning many other risk factors are at play,” says corresponding author Michael L. Alosco, PhD, associate professor of neurology at Boston University Chobanian & Avedisian School of Medicine.
The researchers also emphasized that they compared the football players to another group of athletes, a noteworthy strength of the study. Furthermore, most of the participants played tackle football only at the amateur level, which is contrast to most of the research to date that has focused on professional athletes.
“Previous research has focused on the association between American football and risk for CTE. However, similar to what has historically been seen in boxers, American football might also affect risk for other neurodegenerative conditions such as PD,” says Hannah Bruce, MSc, first author and research specialist at Boston University Chobanian & Avedisian School of Medicine.
The researchers acknowledge several limitations to their findings and caution that the work is still preliminary. It was a convenience sample of people enriched for having PD who were mostly white, thereby limiting the generalizability of the findings. Diagnosis of PD was also self-reported by participants through online assessments and objective in-person evaluations were not conducted.
This work was in collaboration with The Michael J. Fox Foundation for Parkinson’s Research, the sponsor of Fox Insight. The Fox Insight study was used to collect and aggregate data used in this manuscript. Grant funding was also from NINDS (U54NS115266; K23NS102399).
Note to Editors:
Several authors are staff members at The Michael J. Fox Foundation for Parkinson’s Research, the sponsor of Fox Insight. CHA consulted for Avion, CND Life Sciences, Jazz, and Precon Health. RAS is a paid consultant to Biogen (Cambridge, MA, USA). He is a member of the Board of Directors of King-Devick Technologies, Inc. (Chicago, IL, USA), and he receives royalties for published neuropsychological tests from Psychological Assessment Resources, Inc. (Lutz, FL, USA). He is a member of the Medical Science Committee for the National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation. Chris Nowinski is a volunteer member of the Mackey-White Committee of the NFL Players Association and compensated advisor to Oxeia Biopharmaceuticals. Ann C. McKee is a member of the Mackey-White Committee of the NFL Players Association. MLA has received honorarium from The Michael J Fox Foundation for services unrelated to this study. He also receives royalties from Oxford University Press. The remaining authors have no conflicts of interest to disclose.
JOURNAL
JAMA Network Open
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Association Between American Football Play and Parkinson’s Disease
ARTICLE PUBLICATION DATE
11-Aug-2023
COI STATEMENT
Several authors are staff members at The Michael J. Fox Foundation for Parkinson’s Research, the sponsor of Fox Insight. CHA consulted for Avion, CND Life Sciences, Jazz, and Precon Health. RAS is a paid consultant to Biogen (Cambridge, MA, USA). He is a member of the Board of Directors of King-Devick Technologies, Inc. (Chicago, IL, USA), and he receives royalties for published neuropsychological tests from Psychological Assessment Resources, Inc. (Lutz, FL, USA). He is a member of the Medical Science Committee for the National Collegiate Athletic Association Student-Athlete Concussion Injury Litigation. Chris Nowinski is a volunteer member of the Mackey-White Committee of the NFL Players Association and compensated advisor to Oxeia Biopharmaceuticals. Ann C. McKee is a member of the Mackey-White Committee of the NFL Players Association. MLA has received honorarium from The Michael J Fox Foundation for services unrelated to this study. He also receives royalties from Oxford University Press. The remaining authors have no conflicts of interest to disclose.
Football participation and Parkinson disease among men
JAMA Network Open
Peer-Reviewed PublicationAbout The Study: In this study, 729 participants with a history of playing organized football had higher odds of having a reported parkinsonism or Parkinson disease diagnosis compared with participants in other organized sports. Longer duration of play and higher level of football play were associated with higher odds of a reported diagnosis.
Authors: Michael L. Alosco, Ph.D., of the Boston University Chobanian & Avedisian School of Medicine in Boston, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2023.28644)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
Association of caregiver depression risk with patient outcomes in Parkinson disease
JAMA Network Open
Peer-Reviewed PublicationAbout The Study: Patients with Parkinson disease who had caregivers at higher risk of depression were more likely to have worse quality of life and higher emergency department use than patients who had caregivers not at higher risk of depression. Additional caregiving resources and interventions to reduce caregiver depression symptoms could potentially improve patient outcomes.
Authors: Nabila Dahodwala, M.D., M.S., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, is the corresponding author.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2023.27485)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
JOURNAL
JAMA Network Open