September 2, 2026

@michaelokun

What resonates with me about this study is how dramatically we may be undercounting the true burden of neurodegenerative disease. Among 202 former NFL players with clinician-adjudicated dementia, only 30.7% had a neurodegenerative disease listed as the underlying cause of death, and the disease was more likely to make it onto the death certificate when cognitive, executive and functional impairment, or the underlying neuropathology, was more severe. This matters well beyond football. We often build our estimates of Alzheimer’s, Parkinson’s and other neurodegenerative diseases from administrative datasets and death certificates, yet this paper reminds us that what gets counted can depend on how advanced and recognizable the disease becomes. The authors make an especially important point: mortality studies may sometimes be identifying factors associated with disease severity or progression rather than the true incidence of disease. If we underestimate neurodegenerative disease, we risk underestimating the people and families affected, the resources they need, and ultimately the urgency of prevention. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2853502?widget=personalizedcontent&previousarticle=0