We sat down with Dr. Victor Henderson in November 2021 and asked him a couple of questions about his current research on neurology and age-related brain disorders (like Alzheimer's), his favorite paper, his love of teaching, and more.
Can you start by telling us a bit about yourself? Was there something in particular that attracted you to the fields of science, public health and your area(s) of study? What has driven you to pursue this work at this point in time?
I initially trained as a neurologist, and my medical background in concert with my epidemiology training informs the research questions I ask and the way in which I interpret research findings. My early interests were in the brain (the most fascinating organ) and cognition (the most fascinating function of the brain). It is painfully evident that age-related brain disorders such as Alzheimer’s disease erode the essence of what it means to be human. These diseases are common and a major public health concern. I found basic research too remote from the brain–behavior relations that interest me most, and I recognized that epidemiology and epidemiologic skills provide a secure foundation for human research.
My early career was at the University of Southern California, where I had faculty appointments in Neurology, Gerontology, and Psychology. There, as well as here at Stanford, where my appointments are in Epidemiology & Population Health and Neurology & Neurological Sciences, I made a major commitment to Alzheimer’s disease research, in part under the aegis of Alzheimer’s Disease Research Centers funded by the National Institute on Aging. Here at the Stanford Alzheimer’s Disease Research Center, it has been my very good fortune to work with, and to be stimulated by, highly creative, impactful scientists. My own challenge, and that of the field, has been to identify health morbidities, genetic risk, lifestyle factors, and specific interventions that have substantial impact on pathogenesis, treatment, and prevention. The frustration is that progress has been incremental rather than saltatory, but I remain firmly optimistic that transformational events are on the horizon.
Can you please give us an overview of your research? What areas do you work in?
A key aspect of my research deals with risk factors for age-associated cognitive decline and dementia, and on therapeutic strategies to improve cognitive abilities in aging and in dementia. During the past several years, I have enjoyed the chance to collaborate with clinical epidemiology colleagues at Aarhus University in Denmark. Denmark is a country with universal health coverage, and its linked medical registries provide opportunities to examine a variety of factors that might affect age-related neurodegenerative disorders, such as sleep disruption, vitamin B-12 deficiency, cancer, stroke, heart failure, and infectious disease.
Do you have a favorite paper or article you have written (and why)?
One favorite, published five years ago, concerned a large clinical trial of estradiol in healthy women who had gone through menopause (doi: 10.1212/WNL.0000000000002980). Estradiol is the principal estrogen produced by the ovaries during a woman’s reproductive years. At the time, it was quite controversial whether estrogen-containing hormone therapy might help or harm memory, and whether effects might differ between women close to the time of menopause and older women further from menopause. Prior clinical trials had assessed cognitive effects of hormone therapy only in older postmenopausal women. This trial, conducted with colleagues at the University of Southern California, compared daily estradiol to placebo. The results were clear-cut. After five years of treatment, estradiol had no meaningful effect on memory or other aspects of cognition compared to placebo, and our findings were the same in both the early and late postmenopausal groups. This article is on my favorite list because it helped answer an important clinical question pertinent to aging, brain and cognition. It is interesting that our answer with respect to cognition differed from our answer for cardiovascular risk (doi: 10.1056/NEJMoa1505241).
Is there a class you love to teach (and why)?
I very much enjoy co-teaching the EPI 251: Design and Conduct of Clinical Trials course, geared towards our epidemiology master’s students. Clinical trials offer the best way to determine whether an intervention — drug, medical device, behavioral intervention, or life-style change — actually improves a particular health outcome. The basic principles are straight forward, but there are innumerable nuances in how to frame the question, administer the treatment, measure its effect, analyze the results, and interpret the findings. In our course, each student develops a clinical trial protocol, and it is satisfying to see the evolution of students’ thinking as their protocols mature. As a bonus, I share teaching responsibilities with a marvelous teacher and colleague, Dr. Rita Popat. In 2022, I look forward to teaching a new course with Dr. Melissa Bondy on the history of epidemiology. Stay tuned; it should be fun!
What do most people not know about you?
My current research deals largely with late life neurodegenerative disorders, such as Alzheimer’s disease. However, I also maintain major interests in women’s health in the context of menopause and cognitive aging. Perhaps the following qualifies as a fun fact: several years ago, I was honored to serve as president of the North American Menopause Society. As one would expect, most members of our board of trustees were gynecologists, and, as a neuroepidemiologist, I sometimes felt out of place. However, I was not the fish furthest from water, as our board at the time also included a veterinarian.
What is a non-academic accomplishment you’re proud of? What are you watching/reading right now?
I collect antiquarian books within a circumscribed area of medical history, and, from time to time, I have been able to track down and purchase “classics” in the field. Although it is not an accomplishment in the usual sense, I have enjoyed building a fairly complete, specialized historical collection. I’m eclectic in my reading choices. At the moment, I am reading Hospital Life in Enlightenment Scotland (Risse). Within the past few months, I completed Marco Polo, The Travels (Cliff, translator), Other Minds: The Octopus, the Sea, and the Deep Origins of Consciousness (Godfrey-Smith), Original Meanings (by Stanford political science professor Jack Rakove), and Narrative of the Life of Frederick Douglass. I recommend Marco Polo, octopuses (but not octopi), original meaning, and Frederick Douglass, but hospital life is not my idea of a page-turner.