Suicide and depression in former contact sports participants : population-based cohort study, systematic review, and meta-analysis
Batty, G. D., Frank, P., Kujala, U. M., Sarna, S. J., & Kaprio, J. (2023). Suicide and depression in former contact sports participants : population-based cohort study, systematic review, and meta-analysis. EClinicalMedicine, 60, Article 102026. https://doi.org/10.1016/j.eclinm.2023.102026
© 2023 The Author(s). Published by Elsevier Ltd.
Background Former participants in sports characterised by low intensity repetitive head impact appear to have elevated rates of later dementia, but links with other psychological health outcomes such as depression and suicide are uncertain. We quantified the occurrence of these endpoints in former contact sports athletes against general population controls using new data from a cohort study and a meta-analysis. Methods The cohort study comprised 2004 retired male athletes, who had competed internationally as amateurs for Finland across a range of sports, and 1385 general population controls. All study members were linked to mortality and hospitalisation registries. In the PROSPERO-registered systematic review (CRD42022352780), we searched PubMed and Embase to October 31 2022 for cohort studies that reported standard estimates of association and precision. Study-specific estimates were aggregated in a random-effect meta-analysis. The Newcastle-Ottawa Scale was used to appraise the quality of each study. Findings In survival analyses of the Finnish cohort data, former boxers (depression: hazard ratio 1.43 [95% CI 0.73, 2.78]; suicide: 1.75 [0.64, 4.38]), Olympic-style wrestlers (depression: 0.94 [0.44, 2.00]; suicide: 1.60 [0.64, 3.99]), and soccer players (depression: 0.62 [0.26, 1.48]; suicide: 0.50 [0.11, 2.16]) did not have statistically higher rates of major depressive disorder or suicide at follow-up relative to controls. In the systematic review, 7 cohort studies met inclusion criteria. After aggregating results with the Finnish cohort, retired soccer players appeared to have a lower risk of depression (summary risk ratio: 0.71 [0.54, 0.93]) relative to general population controls, while the rate of suicide was statistically the same across groups (0.70 [0.40, 1.23]). Past participation in American football seemed to be associated with some protection against suicide (0.58 [0.43, 0.80]) but there were insufficient studies of depression in this sport to facilitate aggregation. The aggregation of results from the soccer and American football studies showed directionally consistent relationships and there was no indication of inter-study heterogeneity (I2 = 0%). Interpretation Based on a small cluster of studies exclusively comprising men, retired soccer players had a lower rate of later depression and former American football players had a lower risk of suicide relative to comparator groups. Whether these findings are generalisable to women requires testing. Funding The preparation of this manuscript was unfunded. ...
Publication in research information system
MetadataShow full item record
- Liikuntatieteiden tiedekunta 
Additional information about fundingThe preparation of this manuscript received no direct funding. GDB is supported by the UK Medical Research Council (MR/P023444/1) and the U.S. National Institute on Aging (1R56AG052519-01; 1R01AG052519-01A1); PF by the UK Economic and Social Research Council & Biotechnology and Biological Sciences Research Council (Soc-B Centre for Doctoral Training); and JK by the Academy of Finland Centre of Excellence in Complex Disease Genetics (336823). ...
Showing items with similar title or keywords.
Dementia in former amateur and professional contact sports participants : population-based cohort study, systematic review, and meta-analysis Batty, G. David; Frank, Philipp; Kujala, Urho M.; Sarna, Seppo J.; Valencia-Hernández, Carlos A.; Kaprio, Jaakko (Elsevier, 2023)Background Although there is growing evidence that former professional athletes from sports characterised by repetitive head impact subsequently experience an elevated risk of dementia, the occurrence of this disorder in ...
Physical activity reduces the risk of pneumonia : systematic review and meta-analysis of 10 prospective studies involving 1,044,492 participants Kunutsor, Setor K.; Seidu, Samuel; Laukkanen, Jari A. (Springer Science and Business Media LLC, 2022)The beneficial effects of regular physical activity in promoting health and preventing chronic diseases are well documented. The relationship between regular physical activity and the risk of pneumonia is uncertain. We ...
Physical activity and risk of atrial fibrillation in the general population : meta-analysis of 23 cohort studies involving about 2 million participants Kunutsor, Setor K.; Seidu, Samuel; Mäkikallio, Timo H.; Dey, Richard S.; Laukkanen, Jari A. (Springer, 2021)Regular physical activity is well established to be associated with reduced risk of cardiovascular disease outcomes. Whether physical activity is associated with the future risk of atrial fibrillation (AF) remains a ...
Physical activity as a protective factor for dementia and Alzheimer’s disease : systematic review, meta-analysis and quality assessment of cohort and case-control studies Iso-Markku, Paula; Kujala, Urho M; Knittle, Keegan; Polet, Juho; Vuoksimaa, Eero; Waller, Katja (BMJ Publishing Group, 2022)OBJECTIVE - Physical activity (PA) is associated with a decreased incidence of dementia, but much of the evidence comes from short follow-ups prone to reverse causation. This meta-analysis investigates the effect of study ...
Physical activity and risk of venous thromboembolism : systematic review and meta-analysis of prospective cohort studies Kunutsor, Setor K.; Mäkikallio, Timo H.; Seidu, Samuel; de Araújo, Claudio Gil Soares; Dey, Richard S.; Blom, Ashley W.; Laukkanen, Jari A. (Springer, 2020)The inverse association between physical activity and arterial thrombotic disease is well established. Evidence on the association between physical activity and venous thromboembolism (VTE) is divergent. We conducted a ...