Former professional footballers are significantly more likely to experience depression, anxiety and cognitive difficulties in mid-life than people who have not played contact sports, according to a new study presented at the Alzheimer’s Association International Conference.
The research, conducted by Imperial College London, assessed the brain health of 124 retired professional footballers aged between 30 and 60.
It found that 31 per cent of participants recorded scores indicating clinically significant depression, compared with a healthy control group with no history of contact sports or head injuries.
The study, funded by the Football Association (FA) and the Professional Footballers’ Association (PFA), included former players from the Premier League, Championship and Women’s Super League.
Brain scans reveal changes
Researchers also found that 42 per cent of the former footballers recorded clinically significant anxiety symptoms, compared with 25 per cent among non-footballers.
Brain imaging showed lower grey matter volumes in several regions responsible for memory, attention, decision-making and emotional regulation. The scans also indicated reduced overall brain volume, while the former players rated their own thinking and decision-making abilities lower than those in the comparison group.
Heather Snyder, Senior Vice-President of Medical and Scientific Relations at the Alzheimer’s Association, said the findings could help identify brain changes before clinical symptoms emerge.
“This is the first and largest study of its kind looking at the brain health of retired football players in mid-life, and we are seeing these brain changes at a point before we could expect to see clinical symptoms,” Snyder said.
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“The study raises the possibility that there may be things we can detect in the brains of individuals at an earlier time, and if we understand what is happening, we may be able to intervene and benefit their brain health.
“Findings like those in this study and others are going to inform players, clinicians, sports organisations, and parents, so that they really understand what may be a risk in contact sports and enable them to make decisions.”
Growing concerns over heading
The findings add to growing evidence linking repeated head impacts in football, particularly heading the ball, to long-term neurological conditions.
Researchers noted that chronic traumatic encephalopathy (CTE), a disease associated with repeated head trauma, can only be definitively diagnosed after death through examination of brain tissue. The condition has been linked to memory loss, mental illness, behavioural changes and mood disorders during life.
Snyder said further research is needed to understand the biological processes behind the brain changes and their long-term effects.
“In the UK there has been a tremendous amount of attention on the need for research on understanding the link between football players and the long-term impact on brain health,” she said.
“We need to really now take it forward and understand why we’re seeing these brain changes, what the underlying biology is, and what the long-term consequences are.
“When we’re thinking about our brain health, one of the best things you can do is to protect your head from injury as best you can when you’re playing sports.”
Previous research and safety measures
The latest findings build on previous studies that have linked football with an increased risk of neurodegenerative disease.
Former England striker Jeff Astle, who died in 2002 after years of neurological illness, was the first footballer whose death was officially linked to repeatedly heading footballs. Other former players, including Gordon McQueen, Keith Pontin, Alan Jarvis and amateur footballer Goff White, have also had their deaths formally associated with football-related brain disease.
Earlier this year, University of Glasgow consultant neuropathologist Professor Willie Stewart said former professional footballers face a much greater risk of developing degenerative brain conditions.
“Former professional footballers are at much higher risk of degenerative brain diseases, dementias and related disorders,” Stewart said.
“What we see is the risk is about three and a half times higher than it should be. There is a very unique change in the brain which only appears in athletes that we don’t see in other individuals.”
In response to growing evidence, football authorities have introduced measures to reduce head impacts. Heading has been restricted in children’s football in England, Scotland and Northern Ireland, while the FA has issued guidance limiting high-force headers during training. The Scottish Football Association has also banned heading in training on the day before and after professional matches.
Researchers said they will continue monitoring the participants to better understand how brain changes develop over time and whether early intervention can reduce the long-term impact on former players.
