Gale Sayers, Dementia from Head Trauma

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gale sayersGale Sayers is considered by many as possibly the greatest halfback ever. He was one of the fastest side-stepping players in the National Football League and had run 100 yards in a very fast 9.7 seconds. He could run at full speed, stop on a dime to avoid a tackler, and in the next step be at full speed in another direction to avoid the next potential tackle.

In 2013, at age 70 and still in excellent physical shape, Sayers was diagnosed with dementia, probably caused by the terrible impact, twisting and shaking of his head every time he was tackled. Eventually he couldn’t even sign his name, and on September 23, 2020, he died of the ravages of dementia.

The New Padded Helmets
Sayers played too early to benefit from the new padded helmets that have been introduced in an effort to reduce the toll of head injuries in football players.  These helmets are now used in hundreds of colleges and high schools, and this year NFL teams are using them during practice sessions. So far there is no evidence that any helmet prevents Chronic Traumatic Encephalopathy (CTE), the long-term brain damage from repeated head trauma that causes dementia and premature death in later life. The padded helmets may possibly help to prevent concussions, but there is no data to show that they prevent CTE. Between the 2015-2020 National Football League seasons, there were a total of 976 concussions in NFL players, or 162 per year. With the addition of the new helmets, there were “only” 172 concussions. The new helmets have extra padding that helps absorb energy, which may  reduce the force of the hit on the head, but they are not likely to help prevent CTE because they do not prevent the tremendous rotational forces on the brain that damage the brain by twisting the deep tissue in the brain (J Clin Med, Aug 27, 2019;8(9):1318).

Sayers Was The Best
He was All-American at the University of Kansas but was able to play only five seasons in the National Football League (1965-1970) because of serious knee injuries. During that time, he:
• scored 39 touchdowns in only 68 pro games
• averaged 5.0 yards per carry
• was Pro Bowl four times
• was First-team All-Pro five times
• was the youngest player ever to be inducted into the Pro Football Hall of Fame, at age 34

In 1971, he was immortalized in Brian’s Song, the wildly popular television movie about his friendship with teammate Brian Piccolo.

Outstanding in High School and College
Sayers was born in 1943 in Wichita, Kansas, into an athletically gifted family — his older brother was a college track and field star, and his younger brother played running back for the San Diego Chargers. At Omaha Central High School, Gale was the best running back in the state, and he set the state record for the long jump at 24 ft, 10 1∕2 in 1961. Out of more than 75 colleges that interviewed him for athletic scholarships, he chose to go to the University of Kansas, where he set the Big Eight Conference record of 4,020 all-purpose yards, was three time first-team All-Big Eight, and was College Football All-American in 1963 and 1964.

Life in the National Football League
In 1965, Sayers was drafted by the Chicago Bears and in his first season, he scored a NFL-record 22 touchdowns, gained a NFL rookie record 2,272 yards and a league-leading 31.4 yards per kickoff return. Be sure to watch the videos; you will not believe how this guy could run.  He continued to star for the next two seasons, but in the 1968 season, he broke the anterior cruciate and medial collateral ligaments and the meniscus in his right knee. The next year, 1969, he recovered enough to lead the league in rushing with 1,032 yards and averaged 4.4 yards per carry.

In the 1970 season, he injured his left knee, which required surgery, and he did not play the rest of the season. He saw the handwriting on the wall and took classes to become a stock broker, and was the second-highest salesperson in the program at Paine Webber. He attempted to come back as a football player for the 1971 season, but was injured and required a third knee operation. He tried again in 1971, but fumbled twice in three carries and retired from professional football.

The Hero of “Brian’s Song
Sayers was the hero of Brian’s Song, the award-winning television movie about how he and Brian Piccolo  became close friends when they were the first Black and white players in the National Football League to room together, and how he helped Piccolo during the last year before his death from testicular cancer that had spread to his lungs. The movie was based on Sayers’ 1971 autobiography, I Am Third, and starred Billy Dee Williams as Sayers and James Caan as Piccolo.

Career After Football
After his playing career ended, he worked in the athletic department at the University of Kansas, for three and half years, was a television commentator, was the athletic director at Southern Illinois University Carbondale, worked as a stockbroker, and founded a computer supply company in the Chicago area. At age 66, he became Director of Fundraising for Special Projects at the University of Kansas.

Chronic Traumatic Encephalopathy (CTE)
In 2013, Sayers was diagnosed with dementia at the Mayo Clinic, most likely caused by repeated head trauma. Playing just one season of football can damage your brain, even if you have never been reported to have had a concussion (Science Advances, August 7, 2019). Chronic Traumatic Encephalopathy (CTE) is characterized by loss of short-term memory, inability to concentrate, situational confusion, depression, and changes in behavior, personality, speech, and walking, and eventually dementia.

I wrote about CTE when Nick Buoniconti of the Miami Dolphins died, and in 2017, when John Urschel of the Baltimore Ravens retired from football. Two days before Urschel announced his retirement, an article in the Journal of the American Medical Association reported that 110 out of 111 autopsied brains of dead NFL players showed signs of CTE (JAMA, 2017;318(4):360-370). The study also showed that 177 of 202 deceased former football players, who died at the median age of 66 years, had brains that had signs of CTE. The more years of playing football, the greater the signs of brain damage.  Gale Sayers was reported to have sued the NFL in 2013, for the health consequences of his head injuries (ESPN News Service, September 20, 2013).

Treatable Causes of Dementia
More than six million North Americans suffer from dementia, which affects three percent of people age 65-74, 17 percent of those age 75-84, and 32 percent of those age 85 and older. Anything that damages brain cells can cause dementia and many of the causes are treatable, so everyone who notices increasing forgetfulness, confusion or uncontrollable anger should get a medical evaluation for the cause as soon as possible. Known risk factors for dementia include:
• Aging
• Family history of dementia
• History of head injuries
• Diabetes. A high rise in blood sugar after meals causes sugar to stick to and damage cells everywhere in your body including your brain, so risk for dementia is increased by all of the risk factors for diabetes such as excess fat in the liver and high insulin levels (Arteriosclerosis, Thrombosis and Vascular Biology, Mar 1, 1986;6:123–130). Women who store fat primarily in their liver are at significant risk for dementia (Int J of Epidemiology, June 23, 2020).
• Heavy alcohol use (Neuropsychiatr Dis Treat, Jan 9, 2020;16:87–99)
• Smoking (Annals of Clin and Transl Neurol, Sept 5, 2018)
• Everything associated with damaged arteries, such as heart attacks, strokes, and clots and their risk factors: high blood pressure, high cholesterol, diabetes and so forth (AMA Neurol, Oct 1, 2017;74(10):1246-1254).
• Inflammation (Annals of Neurology, July 23, 2002). An immune system that stays active all the time eventually can attack and destroy the brain. Infections, lack of exercise and a pro-inflammatory diet increase inflammation.
• Vitamin deficiencies. Lack of B12, folic acid, pyridoxine or vitamin D can damage nerves and brain cells (BMJ Case Reports CP, May 14, 2019;12:e229044).
• Thyroid disease (Neurobiol Aging, Apr 2009;30(4):600–606)
• Certain drugs taken long-term are associated with increased risk for dementia. These include drugs to treat thought disorders, Parkinson’s disease, depression, chronic obstructive lung disease, overactive bladder, allergies, gastrointestinal disorders, seizures and antidepressants (JAMA Intern Med, 2019;179(8):1084-1093).

For more information and detailed recommendations for a medical workup for memory loss, see Some Cases of Dementia Have Effective Treatments

A Healthful Lifestyle Helps to Prevent Dementia
Once you suffer from dementia, no drug available today can cure dementia or Alzheimer’s disease, but specific healthful lifestyle changes can reduce dementia risk (JAMA, published online July 14, 2019) and even if you have high genetic risk for Alzheimer’s disease, a healthful lifestyle can reduce your chances of developing dementia (Neurology, published online July 10, 2019). These healthful lifestyle habits include:
• avoiding smoking and smoke
• avoiding excess weight (body mass index <25)
• eating a high-plant diet with plenty of fruits and vegetables, and fish twice a week
• exercising regularly

Gale Sayers
May 30, 1943 – September 23, 2020