Intended for healthcare professionals


Sport associated dementia

BMJ 2021; 372 doi: (Published 21 January 2021) Cite this as: BMJ 2021;372:n168
  1. William Stewart, consultant neuropathologist1
  1. 1Institute of Neuroscience and Psychology, University of Glasgow, and Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow, UK
  1. william.stewart{at}

Prevention remains the only cure

Recent media reports of high profile former soccer and rugby players with diagnoses of neurodegenerative disease have raised concerns about the dangers of contact sports and led to threats of litigation against sports organisations over perceived failures in duty of care.12 But are concerns that brain health is affected by participation in contact sports justified? Is there evidence supporting a link between sport and dementia, and, if so, what might be done to mitigate risk?

Traumatic brain injury is a leading risk factor for neurodegenerative disease, contributing to 3-15% of cases of dementia in the community.34 A link between traumatic brain injury in contact sport and neurodegenerative disease was first proposed almost a century ago with descriptions of punch drunk syndrome among boxers,5 and the associated pathology was later defined as dementia pugilistica.6 The concern remained largely confined to boxers throughout the 20th century. In the past 20 years, however, the pathology of dementia pugilistica—now termed chronic traumatic encephalopathy—has been increasingly recognised …

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