Sports Increases Alzheimer's & Depression Risk
Football, Wrestling, Soccer, Equitation All Implicated
Early deaths of big-name athletes bring attention to the risks injuries may produce later in life. Former professional football players Mike Webster (died at age 50), Terry Long (suicide, age 45), and Justin Strzelczyk (died age 36) are among the former athletes who developed dementia, depression or similar problems, and died prematurely. Now, using the brains of these and other retired athletes, and with start-up funding from the National Institutes of Health, a research project will expand understanding of how concussion can lead to permanent and increasing brain dysfunction. The project is directed by Dr. Robert Stern, Professor of Neurology at Boston University and co-director of the Alzheimer's Disease Clinical and Research Program.
Boxing is the Model
“Punch Drunk” is how many refer to the loss of sharp thinking and fine muscle coordination of prize fighters who were in the ring too long. Scientists may call it “dementia pugilistica” or “chronic traumatic encephalopathy” (CTE). Damage to the brain from repeated blows clearly can lead to serious permanent injury, and is why many groups are calling for a ban on professional boxing. Recently, research has focused on football.
Research on Football
In a study of over 700 retired professional football players, about two thirds had suffered at least one concussion. (A concussion is defined as a temporary injury to the brain resulting from trauma that causes confusion and often some muscle incoordination.) Players who had three or more concussions had five times the likelihood of mild cognitive impairment, a condition that often is the first step towards Alzheimer's dementia.
In Alzheimer's, amyloid is the culprit that disrupts brain function. Amyloid is a protein made naturally, but the brain can have too much. In the process of making amyloid, soluble Abeta particles are produced. They are toxic to brain cells.
Injuries that affect the brain are called traumatic brain injuries (TBIs). In a study of brain tissue from patients who suffered severe TBI, very high levels of soluble Abeta were found, suggesting that Alzheimer’s or a similar condition had started.
How Can an Injury Years Ago Cause Dementia or Depression?
No one knows for sure—that’s why the new research effort is important. One theory is related to Parkinson’s Disease. When something causes inflammation in the brain, say, for instance, a solid whack of the side of the head, certain brain cells, glia, produce toxic substances. Soon, the glia are cooled down by a substance, for example, Nurr1, and the system reverts to normal. But if Nurrl is inadequate, the inflammation smolders and continues to cause damage, year after year, finally causing enough brain loss for abnormal signs to appear. This model has been seen in familial Parkinson’s Disease.
Boxing, professional football, wrestling, and soccer are in the spotlight because of interest they generate from national TV events. In the community, they do account for many brain injuries, but so do bicycling, playground fun, and baseball. One measure of how dangerous different athletics can be comes from examination of emergency room visits at community hospitals.
Traumatic Brain Injuries in the Community
Bicycling leads the list of TBIs in the community. Here are estimated annual US non-fatal emergency room visits for the top ten activities that involved traumatic brain injuries. (Number of TBIs, rounded, in parentheses)
- Bicycle (40,000)
- Football (23,000)
- Playground (16,000)
- Basketball (15,000)
- All terrain vehicles (11,000)
- Baseball (10,000)
- Soccer (9,000)
- Horseback (7,000)
- Skateboard (5,000)
- Hockey (5,000)
Note to Parents
When your child participates in sports, or even just goofs around the playground, besides thinking of scuffed skin or broken bones, think about the possibility of increased risk of depression or Alzheimer's years later. Insist on proper athletic gear. Items such as bicycle helmets, properly fitted and worn, should not be optional. CDC offers important information on how to prevent brain injuries in school athletics.
Other Sources
“Association between recurrent concussion and late-life cognitive impairment in retired professional football players.” Neurosurgery 2005; 57: 719
“Association of increased cortical soluble abeta42 levels with diffuse plaques after severe brain injury in humans.” Archives Neurology 2007; 64: 541
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