• A brain health screening service for rugby players has been launched to identify cognitive issues.
• All Blacks great Conrad Smith supports the test, which provides reports to general practitioners for further assistance.
• The test aims to alleviate anxiety and track cognitive changes from age 20 onwards.

Calling all past, present and future professional rugby players. New Zealand now has access to a brain health screening service – lauded by former All Blacks centre Conrad Smith – designed to identify and support those with dementia and other cognitive issues.

All professional rugby players, no matter their age or stage, encounter brain health concerns attached to concussions or repeat head knocks.

A new online test, designed by medical experts and rolled out by World Rugby in Ireland, Australia, Wales and South Africa has now been launched in New Zealand.

While not proclaiming to be a silver bullet or to cure dementia and other cognitive issues, the brain health screening service aims to alleviate the anxiety players confront by providing a free, easy-to-use online test that generates comprehensive reports for general practitioners, who can then offer specialist assistants if required.

Smith, the former All Blacks and Hurricanes centre turned International Rugby Players head of operations, is among those throwing his support behind the push for all players to undergo an examination, having completed the test and received a clean cognitive bill of health.

Conrad Smith: "It will offer a lot of peace of mind." Photo / Photosport

“It’s a game-changer in a lot of ways,” Smith said. “I’m sure players from yesteryear would’ve loved it but that fact it’s here now, and accessible to all professionals, it’s a great service. It will offer a lot of peace of mind, which is something that’s desperately needed for a lot of players.

“There is that unease. You’re not sure what you should do, what steps you should take. It’s still down to the player but these are good messages around seeing your GP, managing your risks. That’s what we want all rugby players to be doing, not just sitting there worrying.

“It gives you peace of mind as a former player to know you’ve done everything you can and that’s what you have to continue to do. It’s something I’ll continue to manage.”

In his 13-year professional career, Scott Fuglistaller played as an openside flanker for Wellington, the Highlanders and the Melbourne Rebels. Today, he’s a New Zealand Rugby Players’ Association representative. He recalls his anxiety after his career finished.

“I had concerns when I left the game,” Fuglistaller said. “I was fortunate to have an in-person neuro psych test done with a specialist in Auckland, which was a game-changer for me as it eased the uncertainty of what I was feeling. I was associating things going on in my life to a possible brain injury.

“As an openside, I had a number of concussions so there was always that connection there.

“When I first heard this was going to be a tele [online] help-delivered approach, I wasn’t sure how in-depth it would be able to go, but I was unbelievably surprised at how close it was to an in-person neuro psych assessment.

“The results were exactly the same for me. The biggest thing is around the ease of it. In New Zealand, we’re geographically challenged, our health system is challenged, our players are all over the country. Getting access to quality practitioners is a challenge so the tele approach is the only way to get it done en masse.

“It’s going to be a game-changer for that uncertainty that comes with retiring. I anticipate New Zealand will have a high uptake on this.”

Scott Fuglistaller: "I had concerns when I left the game." Photo / Photosport

The brain health screening service involves a series of questions designed to test mental function. Participants engage in further cognitive assessments, such as drawing sketches and recounting numbers. The test takes around 50 minutes to complete, with a report then sent to the assigned general practitioner, and a designated support person included on the results.

A list of 14 modifiable risk factors, which covers everything from advice on lifestyle to exercise, diet, alcohol consumption and behaviour to manage dementia, is also included.

In the last five months, the brain health screening service has conducted 180 tests.

The aim is to test players from 20 years old – as they enter the professional arena – through to their post-playing days. This allows a baseline to be tracked should any cognitive changes occur.

Former World Rugby chief medical officer Martin Raftery is leading the project that was first designed in 2021.

Raftery says the online test was developed in response to World Rugby accepting greater care for former players following a Lancet Commission report that identified dementia as the greatest welfare issue facing an ever-ageing society.

Raftery denied a probe that World Rugby was, in fact, cajoled into action following a lawsuit against the global governing body that now includes 725 former union players and more than 280 former league players suffering with a range of life-altering neurological conditions.

“In some respects, it is because people say rugby caused someone to get dementia. Every injury is multi-factored. The Lancet Commission is saying the same thing – the biggest risk factor is age and there are other things you can control,” he said.

“We can’t fix head injuries you’ve had in the past but we want to concentrate on what we can improve and that’s modifiable risk factors.

“A lot of people think dementia is set in stone, that you can’t improve or avoid it, but we can help our past players. Yes, concussion and head injuries are a big issue for the sport. We accept that. We’re addressing that in other areas.

“What we’re trying to say is we want to look at our past and present players and ask what’s the best thing to offer them? That’s addressing cognitive decline, which you can treat.

“Over time, players are used to getting their medical needs delivered to them on a plate. We want former players to take control and this is one way to do that. It’s a risk assessment and then if you’ve got a problem, we can direct it to their doctor.”

Liam Napier is a Senior Sports Journalist and Rugby Correspondent for the New Zealand Herald. He is a co-host of the Rugby Direct podcast.