Rugby players affected in later life by impacts to head – study
EXPOSURE to multiple concussions may affect rugby union players’ cognitive function in older age, a new study has found.
The BRAIN Study, which involved 146 former players, found those over 75 with three or more reported concussions had significantly worse cognitive function on average than their peers who had fewer or no head injuries.
The issue of head injuries in rugby has been increasingly in the spotlight in recent years.
Last month, we reported how a leading brain injury academic believes rugby union could be “a lot more aggressive” in tackling contact reduction in the sport.
And in December last year, former Dragons player Adam Hughes, then just 30, went public after being diagnosed with having brain injuries and post-concussion symptoms.
He became the the youngest player to join the legal action taken by a group of nine former players against World Rugby, the Rugby Football Union and the Welsh Rugby Union for alleged negligence, following in the footsteps of former Wales flanker Alix Popham and England World Cup winner Steve Thompson among others.
The group have suffered brain injuries which they say are as a result of repeated concussions suffered during their careers.
Popham, who has had early onset dementia diagnosed, estimates that he experienced more than 100,000 subconcussive collisions during his career.
In the latest research, scientists from the London School of Hygiene and Tropical Medicine (LSHTM), Queen Mary University of London and the Institute of Occupational Medicine worked with former players aged 50 and over who had represented England, Oxford University or Cambridge University.
It found overall, and in the under75s, that those who reported three or more concussions in their career had no worse average cognitive function than those who reported suffering between zero and two concussions.
However, the study found that the 29% (14 out of 48) of over-75s who reported three or more concussions in their career did have significantly worse cognitive function on average than those of the same age but with a smaller number of concussions, or none at all.
The study leads said those individuals may be at greater risk of more problems, such as memory loss, in the future.
The research team said the findings had implications for the clinical management of older former rugby players, and possibly former players in other contact sports who may be at increased risk of impaired cognitive function.
Professor Neil Pearce, from LSHTM, said: “Evidence is accumulating on the possible long-term health risks in former contact sport athletes.
“However, each sport is different and there is currently little evidence from rugby players. This study adds to this knowledge gap, and shows that playing elite rugby may affect cognitive function in older age.
“It’s important more research is conducted to confirm this, and on those who played in the early years of professional rugby.”
Participants’ cognitive function was measured using the Pre-clinical Alzheimer Cognitive Composite (PACC) score.
After adjusting for a large number of potential confounding factors including age, smoking and playing position, participants aged over 75 with three or more concussions scored about two points lower on average on the PACC score.
This does not indicate disease, but may indicate an increased risk of eventually developing neurodegenerative conditions such as Alzheimer’s disease.
In total, 116 of the respondents (80%) reported at least one rugbyrelated concussion.
Dr Simon Kemp, the Rugby Football Union’s medical services director, said: “This study, that started in 2017, adds to our developing understanding of the potential long-term consequences of head impacts and concussions.
“The agreed group of participants were aged 50-plus principally because of the greater likelihood that we might detect any neurocognitive decline if present. It is important to also conduct research with younger retired players.
“A new research programme launched with Premiership Rugby and two independent experts will run alongside the Advanced Brain Health Clinic opening in London on October 25.
“This specialist clinical service will provide the assessment and management of retired elite male and female rugby players between the ages of 30 to 55 who have concerns over their individual brain health.”
A spokesperson for World Rugby said: “We welcome continued research into the welfare of players past, present and future in line with our stated ambition to be the most progressive sport in the world when it comes to player welfare. We do not stand still in this commitment.
“We will continue to do everything we can do, from the child and community game through to the elite level, to reassure on participation safety as well as the lifelong benefits to health and happiness from playing rugby.”