Launch of Brain Health Clinic for former Scotland internationalists is a crucial step in fight against dementia

Early diagnosis is key to minimising impact of the illness

Former Scotland and LionsI internationalist Gordon Bulloch, Professor Craig Ritchie, Scottish Rugby’s Chief Medical Officer Dr James Robson and gormer Scotland internationalist, Jilly McCord launch the Brain Health Clinic. Image: © Craig Watson -
Former Scotland and LionsI internationalist Gordon Bulloch, Professor Craig Ritchie, Scottish Rugby’s Chief Medical Officer Dr James Robson and gormer Scotland internationalist, Jilly McCord launch the Brain Health Clinic. Image: © Craig Watson -

THE launch earlier today [Wednesday] of a pilot Brain Health Clinic for former Scotland international players is an important step towards the goal making dementia a “very rare” condition throughout society within the next two decades, believes Professor Craig Ritchie, who is spearheading the project through his role as a director of Brain Health Scotland (a Scottish Government funded initiative which works in partnership with Alzheimer Scotland to inspire and empower everyone in Scotland to protect their brain health).

The clinic will invite former male and female Scotland players to take advantage of the service to help assess possible risks to future brain health. This will involve a three-stage investigation phase involving blood testing, brain scanning and health/lifestyle interviews which will help build a picture of how the clinicians can best support the individual with a brain health plan.

The patient will see the clinician at least two or three times over several months, with their GP notified of outcomes. Their results will provide a valuable benchmark to monitor future brain health.

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The clinic concept is designed to develop both a service to former players exposed to contact sport and also a blueprint which forms the basis of a service that is being developed within the NHS for the public and will be rolled out nationally by 2025.

Brain Health Scotland, Alzheimer Scotland, the University of Edinburgh and World Rugby have all contributed time, expertise and resources towards the project, alongside Scottish Rugby, which is funding and hosting the pilot.

“I’m genuinely hopeful that in 10 to 20 years’ time, dementia will be very rare condition if we do this well,” said Professor Ritchie. “We now know that brain changes take place in mid-life that if left unmanaged could lead to dementia in later life. We also know a lot about the risk factors for these changes and what can accelerate or slow them down. We still need to know more, but we know enough to start working with, and for, former players to help them manage their brain health.

“I think the biggest hurdle, to be honest, has been setting up services like this,” he added. “We need to be able to get to people before they get to the dementia stage of illness, because if we are only seeing people who have a dementia syndrome then it is too late. We’re not going to cure somebody with dementia, unfortunately. Like everything else in medicine, if you can pick up something early, the prognosis is so much better.

“Scotland is leading the way in this from both a research and a clinical perspective, with a lot of the stuff we are doing here at Murrayfield also taking place elsewhere in Scotland, and we’re being watched by the rest of the world.”


Brain injury and the impact it has on players’ lives after retirement is a huge concern in rugby at the moment, which has been brought into sharp focus by a group of former leading players, including former England hooker and 2003 World Cup winner Steve Thompson, bringing a legal action against World Rugby, the Rugby Football Union and the Welsh Rugby Union for failing in their duty of care.

Dr James Robson, Scottish Rugby’ Chief Medical Officer, says he is satisfied that appropriate steps are being taken to ensure that the modern sport does not pose an unreasonable risk to players, but stressed that ignoring the historic issue is not an option.

“The evidence we’ve got from football shows that footballers are at three times greater risk of developing dementia, and that would appear to come from heading the ball because we know that goalkeepers don’t have the same risk as the outfield players. We don’t have that research into rugby, but why would we wait for that research to show increased risk? Let’s look at things which might be of benefit now,” he said.

“About five or six years ago, there was a whole swathe of negative publicity about rugby in general, and rugby injuries in particular, and one of the questions which was posed to me then was: ‘Are you anxious that you are putting people off playing by talking about injury so much?’ I said: ‘People should be more worried if you aren’t talking about it, because in every walk of life you have got to delineate risk, research what causes that risk and then you’ve got to modify that action so that you reduce the risk.’

“I can’t say what is in the future, but I can say that we now have the ability to influence brain health and that’s one aspect of player welfare we’ve not had before. I hope it becomes mainstay in the very near future.”

While the clinic is restricted to former international players, Robson stressed that the overriding aim is get the ball rolling with this limited sample group before going on to help the whole rugby community and reach wider afield.

“We could open this clinic and be absolutely inundated so se’ve got to start somewhere, and the easiest place to do that is to offer it for ex-internationals, male and female,” he reasoned. “Once we start to work through that cohort, we can broaden it out. What we’ve got to do is start the clinic and learn how to modify it to make it the best possible facility. So, start small and grow it from there.

“I think this will be followed by other sports, who will start their own clinics. I’ve always been firm believer in the NHS, I grew up in the NHS, but it is under immense strain, so I don’t want to wait for them to do what they will do in order to create a service for the general public, when I can actually do something for our rugby players now.”

Former Scotland internationalist and British & Irish Lion, Gordon Bulloch, said: “I’m happy to support this initiative and the work the new Brain Health Clinic will deliver. None of us are getting any younger and no-one knows what is around the corner so it’s best to be as prepared as you can. I think the work that’s gone in so far to develop the clinic to offer this service to former players can only be beneficial. Brain health and physical health go hand in hand and the more we can understand this area the more support we can give players of earlier generations and those who are playing now in the future.”

Former Scotland internationalist, Jilly McCord, added: “It is particularly reassuring to know that this service will be more than a one-off assessment and will continue to offer help and advice in the future. I know that many former players worry about the impact that rugby may have had on their brain, and this is a very positive step in addressing these concerns and offering tangible support.”

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About David Barnes 3816 Articles
David has worked as a freelance rugby journalist since 2004 covering every level of the game in Scotland for publications including he Herald/Sunday Herald, The Sunday Times, The Telegraph, The Scotsman/Scotland on Sunday/Evening News, The Daily Record, The Daily Mail/Mail on Sunday and The Sun.


  1. This is a very good initiative and hopefully it drives improvements in treating brain disease.

    I do question Dr Robsons assertion “satisfied that appropriate steps are being taken to ensure that the modern sport does not pose an unreasonable risk to players”. This is straight from the World Rugby book of excuses/defences for up coming legal cases.”

    We have created a 23 man/woman game. That’s far removed from the 15 players of old. Meaning fresh players, of abnormal size and weight are entering the field.

    The laws around tackle and rucks and mauls are creating more collisions.

    Is it that World Rugby are frozen by fear of current legal action that they are incapable of making law changes that will improve player safety? Reduce number of subs; subs for injury only; tackle be,ow the waist; no taking players out of rucks and mauls

    • Dom, there have always been abnormally large players. Society is in general bigger than it was, couple that with better nutrition and fitness regimes and we are where we are.
      Limiting subs to injuries is impossible to police, hence tactical ones legalised.
      Otherwise I agree totally with your comment. Not applying laws as written has caused so many issues on collisions. Going back to that basic idea – just apply the laws as written would go a very long way. Or WR should have the guts to propose to rewrite them to allow the human torpedos over rucks, judo throws etc etc, because these are most certainly not binding on to a team mate or opponent or trying to stay on their feet

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