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Dementia in former amateur and professional contact sports participants: population-based cohort study, systematic review, and meta-analysis

Title: Dementia in former amateur and professional contact sports participants: population-based cohort study, systematic review, and meta-analysis
Authors: Batty, GD; Frank, P; Kujala, UM; Sarna, SJ; Valencia-Hernández, CA; Kaprio, J
Source: eClinicalMedicine , 61 , Article 102056. (2023) (In press).
Publisher Information: Elsevier BV
Publication Year: 2023
Collection: University College London: UCL Discovery
Subject Terms: Dementia; Alzheimer’s; Amateur sports participants; Professional sports participants; Athletes; Epidemiology; Cohort study; Systematic review; Meta-analysis
Description: Background: Although there is growing evidence that former professional athletes from sports characterised by repetitive head impact subsequently experience an elevated risk of dementia, the occurrence of this disorder in retired amateurs, who represent a larger population, is uncertain. The present meta-analysis integrates new results from individual-participant analyses of a cohort study of former amateur contact sports participants into a systematic review of existing studies of retired professionals and amateurs. Methods: The cohort study comprised 2005 male retired amateur athletes who had competed internationally for Finland (1920–1965) and a general population comparison group of 1386 age-equivalent men. Dementia occurrence was ascertained from linked national mortality and hospital records. For the PROSPERO-registered (CRD42022352780) systematic review, we searched PubMed and Embase from their inception to April 2023, including cohort studies published in English that reported standard estimates of association and variance. Study-specific estimates were aggregated using random-effect meta-analysis. An adapted Cochrane Risk of Bias Tool was used to assess study quality. Findings: In the cohort study, up to 46 years of health surveillance of 3391 men gave rise to 406 dementia cases (265 Alzheimer's disease). After adjustment for covariates, former boxers experienced elevated rates of dementia (hazard ratio: 3.60 [95% CI 2.46, 5.28]) and Alzheimer's disease (4.10 [2.55, 6.61]) relative to general population controls. Associations were of lower magnitude in retired wrestlers (dementia: 1.51 [0.98, 2.34]; Alzheimer's disease: 2.11 [1.28, 3.48]) and soccer players (dementia: 1.55 [1.00, 2.41]; Alzheimer's disease: 2.07 [1.23, 3.46]), with some estimates including unity. The systematic review identified 827 potentially eligible published articles, of which 9 met our inclusion criteria. These few retrieved studies all sampled men and the majority were of moderate quality. In sport-specific analyses according to ...
Document Type: article in journal/newspaper
File Description: text
Language: English
Relation: https://discovery.ucl.ac.uk/id/eprint/10172758/
Availability: https://discovery.ucl.ac.uk/id/eprint/10172758/1/1-s2.0-S258953702300233X-main.pdf; https://discovery.ucl.ac.uk/id/eprint/10172758/
Rights: open
Accession Number: edsbas.FB4B1A67
Database: BASE