The University of Glasgow study looking at former Scotland internationals – from both the amateur era and later professional players – has sparked calls for strategies to cut the number of head impacts, including in training.
Consultant neuropathologist Prof Willie Stewart, who led the research, said it raised immediate questions for rugby authorities to mitigate the risks. The risks, compared to the general population varied by condition, with neurodenerative illnesses double, cases of MND rising fifteenfold, and Parkinson's tripling.
“I am genuinely concerned about what is happening in the modern game, and that if, in 20 years’ time, we repeat this study we would see something even more concerning” Prof Stewart said.
“Rugby has talked a lot and done a lot about head injury management and whether it can reduce head injury during (training). Those conversations have gone on a while and the pace of progress is pretty slow.
“This should be a stimulus to them to pick up their heels to make some pretty dramatic changes as quickly as possible to try and reduce risk.
“Instead of talking about extending seasons and introducing new competitions and global seasons they should be talking about restricting it as much as possible, cutting back on the amount of rugby we’re seeing and getting rid of as much training as possible.
“Things like that have to be addressed pretty rapidly.”
The study, published in the Journal of Neurology Neurosurgery & Psychiatry, compared health outcomes among 412 male, Scottish, former international rugby players and over 1,200 matched individuals from the general population.
It was part-funded by the Football Association and Professional Footballers’ Association, building on the landmark 2019 study which found former professional footballers had an approximately three and a half times higher rate of death from neurodegenerative disease than expected.
Stewart said the numbers found had come as a “big surprise” and more work – including a broader study – was now needed to fully understand their meaning, although the immediate message for the game was clear.
“The hypothesis we’re working on is that head injury exposure in sport increases the risk of neurodegenerative diseases and we’re finding that over and again,” he said. “The story we’re getting from all evidence is that exposure to head injuries is a risk we need to do something about.
“The modern game from 1995 onwards has seen that that head injury exposure go up and up and up as far as I’m concerned.”
Dr Jane Haley, Director of Research at MND Scotland, said: “We welcome this very interesting piece of research. While the initial results do seem concerning, the study is based on a small sample size which means that, because MND is a relatively uncommon condition, larger studies will be needed to determine whether this result can be confirmed more widely.
“A connection between elite level sports and MND has been proposed before, but this is the first time an increased risk has been indicated for rugby players. The reasons for these apparent increases are not yet known and need to be explored further. As a charity we are committed to supporting ongoing research into MND to increase our knowledge of the disease, and to help lead us to the discovery of meaningful treatments.”