*   In 2017, The FA and The PFA funded an independent research study from the University of Glasgow.

  *   This study, known as the FIELD study, used medical records to understand the risk of dementia in ex-professional footballers.

  *   Please see the full paper here

  *   Nottingham FOCUS Study - The FA and PFA have provided funding for this study analysing concussion and heading history against neurocognitive performance in ex-professional footballers against a control population. This will allow us to better understand the risk factors that could have caused the results in the FIELD study. The first publication from the FOCUS study, entitled ‘Cognitive impairment and self-reported dementia in UK retired professional soccer players’, can be found here. The second publication from the FOCUS study, entitled ‘Heading frequency and risk of cognitive impairment in retired male professional soccer players’, can be found here.

  *   London School of Hygiene and Tropical Medicine ‘HEADING’ Study - The FA and PFA are supporting the LSHTM’s cross-sectional study looking for the early signs of impaired neurocognition in ex-professional footballers.

  *   International Concussion and Head Injury Research Foundation (ICHIRF) - The PFA has been funding and supporting the ICHIRF study since 2017, which involves former PFA members, over the aged of 50 years old, taking part in longitudinal screening involving MRI scanning, blood tests and physical examination by specialists.

  *   Glasgow BrainHOPE Study - The FA is supporting a new study lead by the University of Glasgow, called the BrainHOPE study. This provides an analysis of mid-life brain health in ex-professional footballers to understand how their brains are ageing and to explore potential interventions which could help reduce risk or speed of developing dementia.

  *   Advanced BRAIN Health Clinic - The FA has partnered with the RFU and Premiership Rugby to expand the Advanced BRAIN Health Clinic. This is a new specialist clinical service and associated research programme for retired professional footballers and rugby players. This provides a proactive approach to the assessment and medical management of individual, retired, elite male and female football players. There is a linked research programme providing novel insights into the risk, causes and management of brain problems occurring following participation in elite rugby and football. Please find a link to the ISEH Advanced BRAIN Health Clinic website here

  *   Whilst there is much research being carried out domestically, very little is known about brain health in players globally. We will continue to work with UEFA and FIFA to explore how the FIELD study could be replicated in other countries.

  *   The FA have started work with the Sports Technology Institute at Loughborough University to help better understand the historic forces in the game with respect to a player’s head. This research will build on previous work the institute has carried out on forces and velocities and will help us to understand whether players today are subject to similar forces when heading the ball compared to the past.

  *   The Premier League has funded research being carried out in the Premier League, Women’s Super League (WSL) and EFL. Instrumented mouthguards are being used to analyse the forces involved in heading during training. Further research will examine the implications of heading in relation to neck strength and neuropsychological assessments.

  *   Some previous studies have shown that concussion is recorded more frequently in women’s sport than in men’s sport. Nottingham Trent University has been working with the WSL And Women’s Championship (WC) on an injury and illness audit which will inform medics and scientists of the prevalence of injury in order to focus on prevention.

  *   We have established baseline figures for heading in match play in England from examining match footage in the professional game over an extended period and by attending grassroots games at steps 7 and below.

  *   The Premier League is funding an independent academic study to validate salivary biomarkers as an objective diagnostic tool for concussion in football.

  *   The Premier League, EFL, WSL, WC and FA Cup are all implementing concussion substitutes trials approved by IFAB.

  *   The trials are assessing whether this system works and will provide robust analysis of the concussion substitution pilots.

*   Chronic traumatic encephalopathy (CTE) is a specific form of degenerative brain disease linked to traumatic brain injury and first noticed in boxers. The only way CTE can currently be diagnosed is via post-mortem brain analysis.

  *   To help increase the understanding and in-life diagnosis of CTE and quantify precedence, long-term assessment of brain health combined with brain donation is essential.

  *   Studies including the Advanced BRAIN Health Clinic, the BrainHOPE study and the ICHIRF study are collecting data which includes looking at biomarkers of brain health and radiological methods to try and look at ways that CTE could be diagnosed in life.

*   Neurodegenerative risk is complex and the volume of research significant so the amount of football specific research is relatively small compared to the large body of wider work on dementia.

*   Football needs to better understand research going on across the neurodegenerative spectrum and try to understand how wider research can be applied in a football setting.

*   The FA contributed to a workshop run by Alzheimer’s Research UK (ARUK) in 2022 to agree with wider stakeholders the best way forward for research in this area.

  *   We will continue to share knowledge across the sector, for example through the Drake Foundation’s Head Impact Research Symposium, and sharing our research more widely within sport.