CTE, Sports & Dementia, with LuMind IDSC’s Dr James Hendrix | EDB 243
Dr. James Hendrix discusses the possible connections between sports-related CTE and dementia.
(20 minutes) Dr. James Hendrix is the Chief Scientific Officer at LuMind IDSC. In that role, Dr. Hendrix directs scientific initiatives for LuMind IDSC. A critical element of his role is to establish the nationwide Down Syndrome – Clinical Trial Network (DS-CTN) and to oversee the first clinical trial in the DS-CTN, the Longitudinal Investigation for Enhancing Down Syndrome Research (LIFE-DSR) Study. The LIFE-DSR study is a natural history study focused on adults 25 years of age and older at high risk for Alzheimer’s disease. Dr. Hendrix is also focused on building potential collaborations with industry, academic and government scientists focused on Down syndrome research to maximize LuMind IDSC’s scientific impact. Prior to joining LuMind, Dr. Hendrix was Director of Global Science Initiatives, at the Alzheimer’s Association.
For more about Dr. Hendrix and LuMind: https://www.lumindidsc.org/
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DR HACKIE REITMAN (HR):
Hi, I’m Dr. Hackie Reitman. Welcome to another episode of Exploring Different Brains. And today we’re lucky to have returning to us from LuMind, one of the world’s authority on Down syndrome and Alzheimer’s, who’s doing so much: Dr. Jim Hendrix. Welcome back.
DR JIM HENDRIX (JH):
Hey, it’s great to be here. Thanks for having me.
HR:
Where are you from?
JH:
Where am I from? Oh, that’s a good question. I was born in Columbus, Ohio A long time ago. But my father was a graduate student, and then when I was five, we moved to Colorado. That’s where I’m, that’s why I say I’m from. And that’s where I grew up. That’s where I went to college and graduate school. I went to Northern Colorado. That’s what University of Northern Colorado I played football there, then Colorado State where I got my PhD. And then, in 93, I moved to the east coast in New Jersey and worked in the pharmaceutical industry for 20 years.
HR:
One of the reasons I started different brains.org is the overlap of all of these different pillars, silos — Alzheimer’s, autism, Down syndrome, concussions, CTE, football, it all kind of blends together. And one might think of, if you will look through the rearview mirror, maybe think of Alzheimer’s as an end result. What are your thoughts on the relationship between CTE, concussions, Down syndrome, and Alzheimer’s? What do you see there?
JH:
So I think it’s, it’s pretty clear that concussion and even even in younger age and younger athletes, so younger people, can increase your risk for dementia later in life or CTE. And I noticed I said dementia and not Alzheimer’s disease. I say the jury is still out on whether it increases your risk of Alzheimer’s disease. In fact, I saw a paper 10 years ago, I think, where some researchers went back and he looked at men who had played football in the late 1940s, early 1950s, high school, college, and looked at see what their rates of Alzheimer’s disease was. And of course, this is the leather helmet days, right? This is very little protective equipment. And, and what they found was that there was no difference in the rates of Alzheimer’s disease among these, these these men currently, and so I think that there’s a there’s still a lot we need to learn about it. CTE seems to be driven…
HR:
Let me say this, because that’s so interesting about the leather helmet football days. And we had a guy when I went to high school, which I had gotten expelled in the first grade that 10th grade. This was my final school and was Snyder High in Jersey City. And it was a big public school, great school, I play basketball there. But our disciplinary in was Milt Singer, who was one of the two Singer Twins, who played without helmets and with leather helmets back in the old precursor to the NFL days. Many people feel the helmets these days are the you know, treatment is worse than the disease. And I didn’t mean to get off on a tangent. But it’s so interesting when you compare the errors when there was — back in those days, one guy in the whole Football League, who weighed over 200 pounds, Joe Stathart I think his name was and then you fast forward to 1985 when the NFL had one guy over 300 pounds, Refrigerator Perry, happened to be the same Ei for a guy named Steven Elmore who tried out for the Jets, who was the first 300 pound guy ever to get in the ring. And now you fast forward to now and every high school teams got a few 300 pounds. They’re around and then you’re gonna have I’m sure you’ll get into later the relationships of obesity and so forth. Sorry I interrupted you…
JH:
That’s okay. I could I could. I’m an old college football player myself and so I can I am very passionate about this. My father played Junior junior college football in the leather helmet days and when I told him about that results, he said, “Yeah, my biggest concern was not to break my nose”. So they didn’t even have facemask and so they were tackling the way that like rugby players tackle, they were tackling leading with their shoulders, they were wrapping up, they were bringing people down that way, they weren’t leaving with their heads. And the problem I see with helmets is the helmets are designed to prevent a skull fracture. But your brain floats in this fluid inside of your skull. So if you go at a high rate of speed and stop suddenly, your brain is gonna slosh forward and bang on the inside of your skull. And that’s what creates the concussions that occurs. I can’t imagine any amount of technology that we’re going to be able to build for helmets that is going to prevent that. So we need is, you know, when I played back in the 80s, it was it was illegal to leave your feet to make a tackle or a block. And now, if you don’t, you don’t, you don’t play college football, you know, because you’re not aggressive enough. So I think we need more safety in that sport. And really, it’s a you know, I agree, I think that the the size of the players that they make a difference, but there’s a lot of other things that we need to do because I do love the sport. I still love the sport. I’d love to I want to protect it because I but I worry that we’re putting putting the young young people that are playing the sport at risk.
HR:
You know, I got a, maybe I’ll have you joined, I’ve been putting together a little team to try to get access to the NFL commissioner to nibble around the edges without hurting the game. With something like this, just for starters, I just want to get cognizance. I want them to recognize there is an issue out there. Not to hurt the game, change the game. And I think that’s something all the little kids could copy that they could outlaw in the NFL is after the running back, runs through banging his head scores the touchdown, what happens? Everybody starts smacking them on the head. And it’s these as the Boston University people feel, it’s the repeat, its not the big hits, it’s those repeat…
HR:
Sub-concussive blows. And I wish that we could do that without endangering the salaries and the money and the economics in the sport itself. It’s it’s tough stuff. Do you see any way to get a reasonable discussion without hurting the game? With collegiate and high school and pros?
JH:
Sub-concussive blows, yeah
JH:
Well I think that the thing is, is that, like with, like, with so many things in life, the top of the pyramid has the biggest influence. Except in one particular case. If parents are sufficiently worried about the safety of football, they’re not going to allow their kids to play. And you’re seeing — actually I’ve been reading in some parts of the country youth football programs being disbanded, disbanded, because there’s not enough interest. And that’s the problem the NFL is that is the top most popular sport in America today. But, you know, in the 1930s 1940s, with boxing and horse racing, were the most popular sports in America. So these things can change. And if American kids don’t play football, where do you get your talent? Right? Because that is the only country that really plays that sport. You know, if American kid stopped playing basketball, or even baseball, you’d still be able to find players in other countries to fill the rosters, but football’s not that way. And so I think we, you know, we have to both influence the NFL to put a safer product on the field, because that will influence the way the players play in college and then, so far in high school, and if parents feel it’s safe, then they’ll be more likely to say OK to their sons that want to play. Now, you mentioned obesity, this is my other concern. We in our country, we always I sometimes I feel like we have an overreaction to everything. And we also know that obesity increases your risk of Alzheimer’s disease. There’s been pretty there’s pretty strong evidence there. And we have an obesity epidemic in this country. We know that. Well, I don’t want in our effort to protect our kids from head injuries that we then you know, we overreact and then we protect our kids and they don’t do they don’t do anything to play video games, right, and they become obese. So, if you know, I think you were probably a similar type of kid: if I hadn’t been able to play an aggressive sport like football, I probably would have sat around a lot. Because that was the kind of sport I liked. Right? That was the kind of sport that excited me. I didn’t want to run track. I didn’t want to swim. I was a horrible swimmer, by the way, but I didn’t want to do those sports. I found them boring and not very fun. Football was fun. For me basketball was fun for me when you mix it up, and you have to, you know, throw an elbow or you know, you go after your opponent. But those are the sports that were fun for me, but but we have to figure out how to make them safe as well.
HR:
That was so well said that’s going to be our best soundbite. I’m going to send that soundbite too… I was gonna say showing my age Pete Roselle.
JH:
I remember Pete Roselle well.
HR:
Well, you know, it’s interesting, because George versie, one of the senior sports writers for the New York Times, whose brother is on TV with that other show. I was talking to George about this fact that did an interview with him about it from the sports writers perspective. He’s a brilliant guy, great writer. And I don’t say that because he did three feature articles on me back when I was having my 10 seconds of fame boxing now, but he’s really a thinker. And we were saying “how can we get the bully pulpit to be able to just get somebody to hear it in a non threatening way?” The way you just said it, okay.
JH:
Well, you know, I saw an excerpt from, from a paper that was published, where it said, talked about how we’ve known about the effects of these repeated histories for for years, yet we don’t do anything about it. And that paper was published about boxing. And it was published in the 1920s. So, you know, we’ve got work to do,
HR:
what would be the biggest thing about Alzheimer’s that somebody might not realize?
JH:
I think that people think that we don’t — we know a lot less than we do. Because it’s been, you know, you pick up the paper, “Oh, another Alzheimer’s drug failed”. You know, there’s no new treatments, it’s a disease with no hope. And I think one of the things that we have to get, you know, get out to people is that there are things you can do to reduce your risk as you age, one of the things that I always like to talk about is that how amyloid shows up first in your brain. And it still shows up 10 to 20 years before symptoms. So if 65 and up is when you’re most likely to start seeing symptoms. That means that your brain might be be changing as early as 45 years of age. So you can’t wait until your senior years to to start worrying about brain health. And in fact, there was a paper in The Lancet about four, maybe three or four years ago, that talked about all the dementia cases, not just Alzheimer’s with dementia, generally, that could be prevented with lifestyle changes, and one of them was education. And basically, if people get at least a high school education, they lower their risk of Alzheimer’s disease. So think about that. You’re talking about childhood education, and educational attainment of children or young people, young adults, changes the course of Alzheimer’s disease when you’re a senior citizen. That means that brain health is a lifetime thing. And that’s what you know, when we’re talking about new sports a few minutes ago, that has no long term impact. All of it has a long term impact. You can’t just say, “I’m going to have a healthy brain when I start worrying about my brain”. You have to start worrying about your brain and taking it seriously. And that’s why, you know, exercise, healthy diet, social interaction, mental stimulation, being a lifetime learner, all of those things really seem to help reduce the risk of Alzheimer’s disease, and it’s never too early or too late to start working on the strategy.
HR:
Beautifully said, beautifully said, you know, when I gave a keynote out at the Aspen brain lab a few years back, and this got me in a little bit of trouble. But one of the things I said was, you know, we have to also start using common sense, and not feel that we have to prove everything over and over, because I said, like, at that conference, you’re gonna hear from the people, and I think it was Maryland, who got a good grin did a great study about how a good diet a Mediterranean style diet plant based man, rewired the brains of these people with autism to an extent, okay, you’re going to hear later, how it had a positive effect on these, for lack of a better term are called a pre Alzheimer’s group. You know, if we were at a different conference, you’d hear how it was good to prevent heart disease, and cancer, and all of the above. So we have to start introducing some common sense into this. As we look around, and we order on McDonald’s and fries. I mean, you know…
JH:
What did my mother say to me? Probably same thing your mother said, eat your vegetables and go out and play. Common sense, right?
HR:
How can people learn more about you and your work and your mission?
JH:
So our website is lumindidsc.org. And we also have, we have quite quite a few resources. We also have a, we have a face. We have a bunch of Facebook groups. So you can look up on Facebook, look up new mind. And you can see-
HR:
There it is. That’s why you are who you are.
JH:
Yeah. And so that way we know you can find different groups that might be the right one for you. I spend most of my time on our research Facebook group, that’s surprisingly, where people share questions or learn from each other. We also have a new offering for families called MyDSC — My Down Syndrome Community where you can sign up on our website and it has lots of resources, provides information on medical care. So specialty medical care, as I said, there’s a problem and we don’t have a lot of access to is particularly for adults. So you can find information about access accessing medical care, and you can ask questions of expert physicians on the MyDSC app. We also if you’re interested in participating in research, there’s research opportunities that you can do from home. I mentioned the habit study we just completed that was something that people did at home, we have a we have a program for people who are concerned about Alzheimer’s disease called my goal now. So this is for caregivers, and it’d be something that they could download on their computer or home computer or their smartphone, to just track symptoms that they’re concerned about as people might be progressing. their loved one might be progressing toward Alzheimer’s disease. And we also have we do surveys from time to time and we have one open right now we have a caregiver survey that people may be interested in participating in is done with a professor at Boston University as well. So we’re trying to provide as much as we can and we have. We also have resources where people can look up ongoing clinical trials, and we’re running a natural history study right now. called the life DSR study of adults with down syndrome age 25 and older who are at risk for Alzheimer’s disease and trying to learn what we can about them.
HR:
Dr. Jim Hendrix, PhD LuMind IDSC, thank you so much for all you doing for so many for all of us with ifferent brains. Take care Jim
JH:
Ok, Goodbye.
