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Tuesday, November 20, 2012

Alzheimer's Risk Factors November 20, 2012

Richard Blesdine, MD, a geriatic physician has written a clear article on the risk factors for developing Alzheimer's disease. He has divided them by type-those we can change will appear in this column on Thursday


AD risk factors that you cannot change
There are two kinds of risk factors: those you can't control and those you can. Here are some risks factors that you should be aware of, even if you can't change them.
Family History: Having one parent with AD doubles your risk; two parents with AD puts you at five times greater risk.
Age: About 5 percent of Alzheimer's patients have early onset disease, but the vast majority of cases are late-onset. Seventy-four is the most common age for detection. Dementia is never an inevitable part of aging, but getting older is a risk factor. The number of Alzheimer's cases doubles every five years after age 65 and AD risk hits about 50 percent after age 85.
Genetics: People with two copies of the apolipoprotein (ApoE4) gene appear to be at about 10 to 15 times greater risk, and one copy triples the risk. That said, having one or even two copies of the gene does not mean you will definitely develop Alzheimer's. For this reason, most physicians do not recommend taking the blood test for ApoE4, except in research settings. (A different variant of the same gene, ApoE2, provides some protection against the disease.) New genes that increase risk continue to be identified, holding out promise for greater understanding of basic mechanisms, and, therefore, hope for prevention.
Multiple mutations of a number of genes are the most common cause of early-onset AD (before age 60). Members of these unfortunate families with such mutations definitely will develop AD.
On the bright side, earlier this year researchers reported an exciting discovery: a rare gene mutation that appears to offer strong protection against Alzheimer's, even for people at high genetic risk.
Being a woman: More women than men develop Alzheimer's Disease. Although women outlive men, and age is a powerful risk factor, the weight of evidence suggests that women are still at slightly higher risk than men. And there is no doubt that women bear the major burden of caregiving for persons of both sexes with AD.
Down's Syndrome: About half of all people with Down's Syndrome will develop symptoms of Alzheimer's by their 50s, but almost all at autopsy show the typical pathologic features of AD.
Risk factors that you can change
The lifestyle changes listed below are not revolutionary, except in this respect: You may never have realized they can cut your risk of dementia. And authorities say that every little bit helps.
"Alzheimer's disease whittles away cognitive reserve, which is the brain's ability to tolerate damage without loss of thinking abilities. Anything that can be done to avoid brain damage and/or increase cognitive reserve can potentially delay dementia symptoms," says Norman Relkin, M.D., Ph.D., founding director of the Weill Cornell Memory Disorders Program and a member of the Board of Directors of the American Federation for Aging Research.
I will quote the rest of this article on Thursday.

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