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August 2, 2021

Professional Soccer and Dementia Risk—The Ugly Side of the Beautiful Game

Author Affiliations
  • 1Department of Neurology, University of California, San Francisco, San Francisco
  • 2Weill Institute for Neurosciences, University of California, San Francisco, San Francisco
  • 3Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco
  • 4Memory and Aging Center, University of California, San Francisco,
  • 5Associate Editor, JAMA Neurology
JAMA Neurol. 2021;78(9):1049-1051. doi:10.1001/jamaneurol.2021.2246

While an increased risk for late-life neurodegenerative disease and dementia has consistently been observed in professional athletes with very high exposure to repetitive head impacts, such as former professional boxers and US football players, much less is known about neurologic outcomes in sports with lower head trauma exposure. Soccer, known to most of the world as football, is by far the most popular sport globally, with an estimated 270 million active players worldwide.1 The Brazilian superstar Pelé famously referred to soccer as “the beautiful game,” inspired by the fancy footwork and orchestral movement displayed by footballers at the highest level. However, heading the ball (known as headers) is also an integral part of the game, and additional incidental head impacts occur via collisions with other players or the ground. A 2017 summit on head injury in soccer concluded that the frequency of headers increases from the youth level to the professional level.2 Both overall header exposure and the force of impact generated by headers were deemed relatively low but with considerable individual variability. Linear forces generated by heading the ball can range from as low as 5g to as high as 60g. Studies have inconsistently detected acute and chronic sequelae of soccer headers,3 with some studies reporting associations between more frequent headers, worse cognitive test performance, and compromised white matter integrity on magnetic resonance imaging.4

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    1 Comment for this article
    Brain Injury from Heading in Soccer
    Charles Brill, MD, Soccer dad | Thomas Jefferson University
    How about a "helmet" that is a replica of the scalp, thin, soft, compressible, light weight to absorb much of the energy impinging on the head?