NFL Players Face Fourfold Higher Risk of Neurodegenerative Death, Study Finds

A retrospective cohort study of 19,824 former National Football League (NFL) athletes who appeared in at least one regular-season or postseason game between 1960 and 2019 shows that the players are nearly four times more likely to die from neurodegenerative diseases—including dementia, amyotrophic lateral sclerosis (ALS) and Parkinson’s disease—than the general U.S. male population. Among the 1,994 deaths recorded, 178 were attributed to neurodegenerative causes, yielding a standardized mortality ratio of 3.94. The excess risk is especially pronounced for younger decedents: players who died before age 60 experienced a 12-fold higher neurodegenerative mortality rate, and those under 50 faced a 41.7-fold higher ALS mortality risk.

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The analysis, conducted by researchers from Mass General Brigham, Boston University and the Concussion & CTE Foundation, is described as the “biggest retrospective cohort study to date.” It builds on earlier work linking repetitive head impacts to chronic traumatic encephalopathy (CTE) and expands the evidence base by using National Death Index records rather than brain-bank samples.

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• Cohort size: 19,824 players (1960-2019).

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• Overall mortality: 30 % lower than expected for the general population.

NFL players 4x more likely to die due to neurodegenerative disease

• Neurodegenerative mortality: 3.94 × higher (overall); 3.80 × for dementia; 3.88 × for Parkinson’s; 4.55 × for ALS.

NFL players 4x more likely to die due to neurodegenerative disease

• Career length effect: players with >=5 seasons had nearly double the neurodegenerative death risk compared with those playing 1-4 seasons.

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• Position effect: “skill-position” players (non-linemen) showed almost twice the neurodegenerative death rate of offensive and defensive linemen.

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Despite a “Selection Through Athletic Resilience Survivor (STARS) effect” that gives former players longer overall survival, the markedly elevated brain-disease mortality underscores a public-health concern for a population that is otherwise healthier than average. The findings reinforce calls for preventive strategies that reduce cumulative head-impact exposure throughout a player’s career and highlight the need for targeted screening, counseling and long-term care resources for former athletes.

NFL players 4x more likely to die due to neurodegenerative disease

Dr. Daniel Daneshvar, co-senior author and chair of Physical Medicine and Rehabilitation at Mass General Brigham, called the results “tragic but not surprising” and emphasized that the most plausible explanation is CTE. He noted that death certificates often mask underlying neurodegenerative causes, such as pneumonia listed without reference to dementia. Dr. Jesse Mez, co-senior author and associate director of the Boston University Alzheimer’s Disease Research Center, described the fourfold increase in dementia as “immense” and linked it directly to CTE. The NFL’s spokesperson did not respond to requests for comment. Researchers cautioned that the study cannot prove that rule changes or equipment improvements have eliminated risk; longer amateur careers and increased player size may offset safety gains.

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The analysis relied on underlying cause of death from death certificates, which can misclassify neurodegenerative disease and omit contributing factors. The study could not adjust for genetics, military service, substance use, socioeconomic status or detailed racial categories beyond “White” and “non-White.” Consequently, the true magnitude of risk may be under- or over-estimated.

NFL players 4x more likely to die due to neurodegenerative disease

• “This is the clearest population-level evidence we have ever had that NFL players are dying due to neurodegenerative disease at real and measurably higher rates,” — Dr. Daniel Daneshvar

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• “A fourfold increase in dementia rates from a presumed environmental cause is immense — and brain bank studies indicate that CTE is the primary explanation.” — Dr. Jesse Mez

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• “The research suggests that the most effective way to decrease someone's risk of neurodegenerative disease is to decrease the total amount of force to the head they've experienced, by changing when they start playing contact sports, by changing the way they practice,” — Dr. Daniel Daneshvar

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• “Players who spent five or more seasons in the league faced nearly double the risk of neurodegenerative death compared with those whose careers lasted one to four seasons.” — Study authors (quoted in report)

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• “This study demonstrates that, when looking at athletes who have played in an NFL game, including nearly 20,000 players, across every official cause of death, the result is the same: NFL players are dying of dementia and Parkinson’s disease three to four times more often than they should.” — Dr. Daniel Daneshvar

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