BACKGROUND Neurodegenerative disorders have been reported in elite athletes who participated in contact sports. The incidence of neurodegenerative disease among former professional soccer players has not been well characterized. METHODS We conducted a retrospective cohort study to compare mortality from neurodegenerative disease among 7676 former professional soccer players (identified from databases of Scottish players) with that among 23,028 controls from the general population who were matched to the players on the basis of sex, age, and degree of social deprivation. Causes of death were determined from death certificates. Data on medications dispensed for the treatment of dementia in the two cohorts were also compared. Prescription information was obtained from the national Prescribing Information System. RESULTS Over a median of 18 years, 1180 former soccer players (15.4%) and 3807 controls (16.5%) died. All-cause mortality was lower among former players than among controls up to the age of 70 years and was higher thereafter. Mortality from ischemic heart disease was lower among former players than among controls (hazard ratio, 0.80; 95% confidence interval [CI], 0.66 to 0.97; P = 0.02), as was mortality from lung cancer (hazard ratio, 0.53; 95% CI, 0.40 to 0.70; P<0.001). Mortality with neurodegenerative disease listed as the primary cause was 1.7% among former soccer players and 0.5% among controls (subhazard ratio [the hazard ratio adjusted for competing risks of death from ischemic heart disease and death from any cancer], 3.45; 95% CI, 2.11 to 5.62; P<0.001). Among former players, mortality with neurodegenerative disease listed as the primary or a contributory cause on the death certificate varied according to disease subtype and was highest among those with Alzheimer's disease (hazard ratio [former players vs. controls], 5.07; 95% CI, 2.92 to 8.82; P<0.001) and lowest among those with Parkinson's disease (hazard ratio, 2.15; 95% CI, 1.17 to 3.96; P = 0.01). Dementia-related medications were prescribed more frequently to former players than to controls (odds ratio, 4.90; 95% CI, 3.81 to 6.31; P<0.001). Mortality with neurodegenerative disease listed as the primary or a contributory cause did not differ significantly between goalkeepers and outfield players (hazard ratio, 0.73; 95% CI, 0.43 to 1.24; P = 0.24), but dementia-related medications were prescribed less frequently to goalkeepers (odds ratio, 0.41; 95% CI, 0.19 to 0.89; P = 0.02). CONCLUSIONS In this retrospective epidemiologic analysis, mortality from neurodegenerative disease was higher and mortality from other common diseases lower among former Scottish professional soccer players than among matched controls. Dementia-related medications were prescribed more frequently to former players than to controls. These observations need to be confirmed in prospective matched-cohort studies. (Funded by the Football Association and Professional Footballers' Association.).

中文翻译：

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前职业足球运动员的神经退行性疾病死亡率。

背景技术已经在参加接触性运动的精英运动员中报道了神经退行性疾病。前职业足球运动员中神经退行性疾病的发病率尚未得到很好的描述。方和社会剥夺程度。死亡原因由死亡证明确定。还比较了两个队列中用于治疗痴呆症的药物数据。处方信息来自国家处方信息系统。结果超过 18 年的中位数，1180 名前足球运动员 (15.4%) 和 3807 名前足球运动员 (16.5%) 死亡。在 70 岁之前，前球员的全因死亡率低于对照组，此后更高。前球员的缺血性心脏病死亡率低于对照组（风险比，0.80；95% 置信区间 [CI]，0.66 至 0.97；P = 0.02），肺癌死亡率也是如此（风险比，0.53；95% CI，0.40 至 0.70；P<0.001）。被列为主要原因的神经退行性疾病的死亡率在前足球运动员中为 1.7%，在对照组中为 0.5%（亚风险比 [根据缺血性心脏病死亡和任何癌症死亡的竞争风险调整的风险比]，3.45；95% CI , 2.11 至 5.62；P<0.001)。在前球员中，神经退行性疾病的死亡率因疾病亚型而异，在阿尔茨海默病患者中最高（风险比 [前参与者与对照组]，5.07；95% CI，2.92 至 8.82； P<0.001）并且在帕金森病患者中最低（风险比，2.15；95% CI，1.17 至 3.96；P = 0.01）。与对照组相比，前球员更频繁地开出与痴呆相关的药物（优势比，4.90；95% CI，3.81 至 6.31；P<0.001）。被列为主要或促成原因的神经退行性疾病的死亡率在守门员和外场球员之间没有显着差异（风险比，0.73；95% CI，0.43 至 1.24；P = 0.24），但痴呆相关药物的处方频率较低守门员（赔率比，0.41；95% CI，0.19 至 0.89；P = 0.02）。结论 在这项回顾性流行病学分析中，与匹配的对照组相比，前苏格兰职业足球运动员的神经退行性疾病死亡率较高，其他常见疾病的死亡率较低。前球员比对照组更频繁地开出与痴呆症相关的药物。这些观察结果需要在前瞻性匹配队列研究中得到证实。（由足协和职业足球运动员协会资助。）。前球员比对照组更频繁地开出与痴呆症相关的药物。这些观察结果需要在前瞻性匹配队列研究中得到证实。（由足协和职业足球运动员协会资助。）。前球员比对照组更频繁地开出与痴呆症相关的药物。这些观察结果需要在前瞻性匹配队列研究中得到证实。（由足协和职业足球运动员协会资助。）。