Did you know that women have a higher incidence of Alzheimer’s disease than men?
Approximately 17% of women compared to 9% of men. This may be because women have a longer life expectancy.
There are some risk factors for Alzheimer’s such as family genetics which you can’t change.
But according to a review in Lancet neurology 2011, almost 50% of cases can be changed by modifying certain lifestyle factors such as smoking, obesity, physical inactivity and uncontrolled heart disease.
According to scientists, small fragments of of a protein called beta-amyloid is deposited in the brain. There is another protein called tau which can lead to degeneration of neurons. The most common findings on pathological specimens are plaques that consist of beta amyloid and neurofibrillary tangles containing tau.
The most typical pattern seen in Alzheimer’s is the gradual loss of neurons and the connections or synapses between neurons. These are the neurons that allow memory and other mental functions to perform. Neurotransmitter’s which are brain chemicals carry messages along nerve cells may also decrease.
After the first symptoms appear, individuals can continue for 2 to 20 years but become increasingly dependent. This can have an enormous impact on family and spouses.
Early diagnosis of Alzheimer’s is critical. There are medications which may slow down the disease process early in the history of the disease.
Risk generally increases after the age of 65 and then doubles every five years.
In families with the early onset form of Alzheimer’s there are three genes which are known to cause this type of disease. They’re called amyloid precursor protein gene, presenilin 1 and presenilin 2.
All three cause elevated beta-amyloid production which has been identified in the Alzheimer plaques.
The more common late onset Alzheimer’s has a genetic link but is not as strong.
APOE4 is one version of the gene for Apolipoprotein E which is a protein that plays a role in several biologic pathways. This can be found in about 40% of patients with late onset Alzheimer’s. The problem is 25 to 30% of the population can carry this gene.
What is important to remember is that there are risk factors which can be controlled such as heart disease, high blood pressure, high cholesterol, obesity and smoking.
All contribute to the increased risk of stroke which is also a direct cause of dementia.
Should you have the APOE test or not?
Since it is present in such a high percentage of the population, it is not advised to test in healthy people without dementia. The predictive power is low. It does have value in individuals with high LDL-cholesterol for treatment planning since statins (the drugs that lower LDL-cholesterol) don’t work as well in people who have the APOE4 allele.
So what can you do to reduce your risk of Alzheimer’s?
Maintain a normal blood pressure.
Keep your cholesterol in the normal range.
Watch your weight.
Avoid type 2 diabetes
Wear a helmet while bike riding or performing dangerous sports.
Reference: Women’s Health Fifty and Forward (Harvard Health Review).