Researchers from Imperial College London, University College London (affiliated with the Institute of Sport, Exercise and Health), and the UK Dementia Research Institute examined 200 former professional rugby players aged 30 to 61. While no cases of early-onset dementia were identified, some participants showed raised levels of key brain markers linked to neurodegeneration—suggesting that repeated head impacts may have long-term effects on brain health and could increase the risk of dementia later in life.
These findings are based on initial assessments from an ongoing study. Researchers plan to track the group over the next four years to monitor any changes in brain health.
The researchers note that dementia would not typically be expected in this relatively young group. However, advanced brain imaging and blood tests revealed subtle changes that highlight the need for continued monitoring and further research.
The results are detailed in two papers published this week in the journal Brain, contributing to the growing body of evidence on the long-term effects of repeated head trauma in professional sports.
A few key points further to the findings:
- Despite more self reported symptoms (e.g. depression, anxiety, behavioural changes, sleep disturbance), former players performed similarly to non-athlete controls in memory and cognitive tests.
- A protein in the blood called p-tau217 — (with increased amounts linked to Alzheimer’s and CTE)— was significantly raised in 23% of former players, though still below levels seen in Alzheimer’s patients.
- MRI scans showed reduced volume in the hippocampus and frontal regions — areas tied to memory and behaviour — especially in players with longer careers.
- Exposure was measured by career length, playing position, and number of diagnosed concussions; 63% had played as forwards.
- Over one in ten players met research criteria for traumatic encephalopathy syndrome (TES), though researchers caution that the tool has limitations.
Professor David Sharp, Director of the UK Dementia Research Institute Centre for Care Research & Technology at Imperial College London, who co-led the work, said: “We didn’t see any cases of early dementia in this group of former players, which is reassuring. However, the changes in blood biomarkers and brain imaging abnormalities show some long-term effects of repeated head impacts on the brain.
“We would not usually expect signs of dementia in mid-life, but we need to follow-up our cohort to clarify whether our biomarker results indicate that some retired players have early neurodegeneration that might lead to later dementia.”
Dr Neil Graham, from the Department of Brain Sciences at Imperial College London, said: “Previous research in this area has explored the link between head injury and cognitive decline in older retired players. Our work with former players adds to this complex emerging picture.
“There doesn’t seem to be an increased rate of dementia in the particular cohort we studied, at this midlife stage, but some of the biological hallmarks of neurodegenerative disease are increased, which is concerning. Following up this group over time will be essential to understand the implications of these findings to long-term brain health, and to better understand how head injury interacts with genetics and other environmental factors.”
Dr Richard Sylvester, co-lead of the study, from the Institute of Sport Exercise and Health at University College London, said: “These findings suggest that neurological symptoms in former rugby players in mid-life may not all be due to head injuries sustained participating in sport and even cognitive and behavioural changes in this group are not commonly a sign of dementia.
Dr Thomas Parker, NIHR Clinical Lecturer, from the Department of Brain Sciences at Imperial College London, said: “This study highlights the significant brain health concerns of individuals who have played rugby at the elite level. These findings support the introduction of larger scale brain health screening programmes for former athletes exposed to head impacts. This will help us to better understand the long-term outcomes and provide the appropriate care to these individuals.”
The research is part of a long-term study, with participants set to be followed for the next four years to track changes in brain health. The findings add to growing evidence of a complex relationship between repeated head trauma in contact sports and long-term dementia risk.
Keep reading.
Links to the studies in Brain Journal: Biomarker evidence of neurodegeneration in mid-life former rugby players and
Brain health concerns in former rugby players: clinical and cognitive phenotypes.
