Dig­ging deeper into de­men­tia

With head­ers linked to brain dam­age, a new study will at­tempt to defini­tively un­wrap the mys­tery

China Daily (Hong Kong) - - SPORTS -

Does head­ing a soc­cer ball give you de­men­tia? That’s the ques­tion neu­ropathol­o­gist Wil­lie Ste­wart is at­tempt­ing to an­swer by com­par­ing the health of thou­sands of for­mer play­ers with non-play­ers.

Soc­cer au­thor­i­ties have been ac­cused of drag­ging their feet on the mat­ter since for­mer Eng­land player Jeff As­tle died in 2002, with the coro­ner cit­ing a brain disease as the cause of death.

Ex-Eng­land, Black­burn Rovers and New­cas­tle United cap­tain Alan Shearer, famed for his prow­ess in the air, has helped raise the pro­file of the is­sue by speak­ing of his de­men­tia fears af­ter years of head­ing balls.

The man tasked with in­ves­ti­gat­ing whether there is a di­rect link is Ste­wart, whose re­search team is com­par­ing the med­i­cal his­to­ries of 10,000 for­mer pro­fes­sional play­ers with 30,000 mem­bers of the gen­eral pub­lic.

The study, en­ti­tled Foot­ball’s In­flu­ence on Life­long Health and De­men­tia Risk, is funded by Eng­land’s Foot­ball As­so­ci­a­tion and the Pro­fes­sional Foot­ballers’ As­so­ci­a­tion, with the aim of gath­er­ing hard ev­i­dence on an emo­tive sub­ject.

It was Ste­wart who in 2014 said that As­tle had died aged 59 from chronic trau­matic en­cephalopa­thy (CTE) stem­ming from head in­juries af­ter ex­am­in­ing the for­mer player’s brain. The con­di­tion is nor­mally as­so­ci­ated with box­ers.

But he is cau­tious in his ap­proach and said delv­ing into big data is cru­cial be­cause the is­sue is cur­rently clouded by anec­dote and spec­u­la­tion.

‘Bad science’

He cites the ex­am­ple of three mem­bers of Eng­land’s 1966 World Cup-win­ning squad who de­vel­oped Alzheimer’s disease — Martin Peters, 74, and Ray Wil­son and Nobby Stiles, both de­ceased.

“The prob­lem is that bad science comes from anec­dotes and they are all we have got,” Ste­wart said at Queen El­iz­a­beth Uni­ver­sity Hospi­tal in Glas­gow.

“Anec­dotes are quite per­sua­sive as quite a lot of the 1966-win­ning team have de­men­tia and other foot­ball teams have been brought for­ward with high rates of de­men­tia but we don’t fully un­der­stand.”

Ste­wart says it is not a sim­ple mat­ter of cause and ef­fect.

“One has to know whether, for in­stance, the other teams in the 1966 World Cup, do they have sim­i­lar lev­els of de­men­tia?” he said.

“Or is it just a quirk of sta­tis­tics that it has fallen on the Eng­land team?”

He says not even As­tle’s CTE is nec­es­sar­ily down to head­ing the ball as is widely as­sumed.

“I can see why peo­ple say that be­cause it is a vis­ual kind of thing to hang on, for peo­ple to ex­plain he headed it, that is why his brain was in­jured,” said Ste­wart.

“It may well be, but there is no di­rect link.”

Ste­wart sug­gests As­tle’s brain dam­age could have been caused by a clash of heads or be­ing kicked in the head dur­ing a rough-and­tum­ble ca­reer.

An ap­par­ently higher rate of de­men­tia among ex-play­ers could even be down to other fac­tors.

“What we might find is, yes, on the sur­face it ap­pears the de­men­tia rate is higher than you ex­pect but that is be­cause we know them (pro­fes­sional play­ers) as they are high-pro­file and it is an age-re­lated disease and play­ing foot­ball has given them a health­ier life.

“It has seen them live to 70, 80, whereas other guys in the same com­mu­nity are dy­ing in their 60s and not get­ting to the age where one typ­i­cally risks get­ting de­men­tia.”

Warn­ing signs

Ste­wart says a study in­volv­ing stu­dents from Stir­ling Uni­ver­sity in Scot­land shows there is an ef­fect on the brain from head­ing soc­cer balls.

“We took them into a lab­o­ra­tory en­vi­ron­ment and used a ma­chine like they do in ten­nis which fires balls at you,” he said.

“We did this 20 times at each stu­dent and we mea­sured the brain func­tion be­fore and af­ter­wards and found out the elec­tri­cal func­tion of the brain had slowed down a bit and their mem­ory func­tion had slowed down as well.

“These mi­nor brain im­pair­ments lasted 24 hours.”

Ste­wart drily ob­served as a re­sult of that study that he would not ad­vise stu­dents who were tak­ing ex­ams to go out and head the ball the evening be­fore but he points out it is dif­fi­cult to ex­trap­o­late the longer-term ef­fects.

Euro­pean gov­ern­ing body UEFA ear­lier this year com­mis­sioned two sep­a­rate stud­ies to look at head­ing in youth soc­cer, show­ing the is­sue is on the agenda.

And Ste­wart be­lieves that the game’s au­thor­i­ties would not shirk from tak­ing tough de­ci­sions if head­ing was even­tu­ally proved to be linked to de­men­tia.

“A few years down the line FIFA or UEFA, if it came to it that head­ing was high risk, they would ac­cept it and say OK, got to change so these guys and women live long and happy lives af­ter­wards,” he said.


Head­ing has come un­der in­creas­ing scru­tiny in re­cent years af­ter a coro­ner ruled that the death of for­mer Eng­land and West Bromwich Al­bion striker Jeff As­tle was the re­sult of brain dam­age pos­si­bly sus­tained dur­ing his ca­reer.

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