Q: Does the FIELD study confirm that dementia is more common in former professional footballers than in the normal population?
The FIELD study has confirmed that from the details of the former professional footballers analysed in this study, they lived three and a quarter years longer and were less likely to die of heart disease, respiratory disease or cancer.
However, they were more likely to die of dementia. The research found that 11% of the former professional footballer's health records declared that they had died from dementia, compared to around 3% for the socio-demographically matched sample.
Therefore, professional footballers in this research sample were 3.5 times more likely to die of dementia than other causes of death in this age range.
However, this group of former professional footballers did not on average die earlier of dementia than dementia sufferers in the general population.
The study was only focused on former professional footballers and does not look at amateur-level footballers
Q: Was the FIELD study entirely independent from The FA and the PFA?
Yes. The FIELD study was completely independent from The FA and the PFA.
The FA and the PFA funded the FIELD study, however neither body had any influence on the method of the study, who was involved, how it was conducted or what the results were.
Q: How reliable are the results of the FIELD study?
The former professional footballers studied in the FIELD study cover a large time span as they were born between 1900 and 1976. Since that time there have been a number of changes to the game of football. Therefore, it's not possible to know what the results would be for professional footballers today.
Although the results may not completely reflect the current risks of football, the study results and statistics for the players in the study are very reliable. They've been scrutinized independently and published in The New England Journal of Medicine, a very highly respected medical journal.
Q: Why was the FIELD study done in Scotland and not England?
The player database and comprehensive digitalised NHS medical records are only available in Scotland.
Q: What advice is The FA giving following the publication of the FIELD study?
Importantly, we don’t want this study to prevent people from playing football.
The FA’s independently chaired Medical & Football Advisory Group reviewed the findings of the FIELD study and don't believe there is enough evidence at this stage to make changes to the way modern-day football is played, at any level of the game.
The Medical & Football Advisory Group have recommended that that we take the following steps:
1. To re-issue the current FA Concussion Guidelines, which were originally launched in 2015 and that we work with football bodies, such as FIFA and UEFA, to consider further steps to improve head injury management, for example by supporting UEFA’s proposals to introduce concussion substitutes.
2. To re-issue best-practice advice for coaching heading
3. We remind all those playing football that there are a number of more general known risk factors for dementia. These include lack of physical activity, smoking, high blood pressure, high cholesterol, poor diet and excessive alcohol intake. Everyone should be aware of these risk factors which are well established and are all preventable.
The Medical & Football Advisory Group also agree that further research – across the game – is required and we are committed to ensuring we get the answers to the questions we need to provide clarity.
Q: Is concussions in the game the cause?
The FIELD study can't show that, but we know that concussions and particularly repeat concussions can be dangerous, so we recommend that everyone playing the game is aware of head injury management and our FA Concussion Guidelines
Q: Is heading the ball the cause?
The FIELD study can't show this, but unlike concussions there is no evidence to show that heading can cause long term damage.
Q: Was heading the old leather footballs the cause?
The FIELD study can't show this and players who started using the modern, synthetic balls in the mid to late 1980s are too young to have a comparable sample size in the study.
Q: Should heading be banned in youth football?
We don’t have any evidence to suggest that heading in youth football would be more of a risk than at other stages in a professional footballer’s career.
Heading is actually significantly less common in children’s games. Our analysis shows that on average there are only around 1.5 headers per game in youth football.
The Medical & Football Advisory group currently don't advise any changes to the rules of the game, but they have supported practical guidelines for heading practice which are common sense and in line with modern coaching practice.
The Medical & Football Advisory Group will continue to review the information available and use this to make recommendations in the future.
We'll continually review our position on this based on current evidence and expert advice.
Q: Heading is banned in youth football in the United States, will The FA follow suit?
We feel it’s important that we make evidence-based decisions on matters such as this.
As it stands there's no evidence to suggest that heading should be banned in youth football.
In fact, heading is actually significantly less common in children’s games than people often think, and our analysis shows that on average there are only around 1.5 headers per game in youth football
Q: Where can I get more information about Dementia?
If you're worried about dementia, either in yourself or friends or family, Alzheimer’s Society and Alzheimer’s Research both have support lines that will help you.
Experts at Alzheimer’s Research have provided us with some advice that everyone, footballers or not, can use to help reduce their risk of dementia:
- Remain physically active. Regular physical activity is one of the main protective factors against dementia.
- Eat healthily and keep your weight well controlled.
- Don't smoke.
- Have your blood pressure and cholesterol checked and treated if it's too high.
- Drink less alcohol – 14 units per week should be your limit.
- Keep your mind active – reading, learning new skills and staying socially active can all help to protect you from dementia by maintaining the function of your brain.
