With so many diseases and conditions to worry about, most people assume it is safe to be concerned with Alzheimer’s disease at an older age. But a new study revealed that an Alzheimer’s risk gene, discovered around two years ago, damages the wiring of the brain around 50 years earlier than the age people are generally diagnosed with the actual disease – 60 years or older.
This means people in their 20s are already being affected by the risk gene, although they aren’t showing symptoms and might not actually develop Alzheimer’s later on.
“For some time, I think we tend to make the mistake that Alzheimer’s disease for example is a disease of late life because it manifests late in life clinically, but the thing that I think is going on and these studies are starting to point out is that there’s a lot of changes that occur in the brain probably very early in life,” said Paul Nussbaum, a licensed clinical neuropsychologist. “You’re probably going to see treatments coming out down the road, that what’ll happen is it’ll stop the trigger early on in life.”
Alzheimer’s is one of about 100 types of dementia, said Nussbaum, also the chair of the advisory board for Alzheimer’s prevention at the Alzheimer’s Foundation of America. He said Alzheimer’s is the most common type of dementia, and has a gradual onset of 10 or more years.
“Typically memory problems occur first,” Nussbaum said. “They tend to get lost, so there’s what we call visual-spatial deficits. Ultimately there are changes and decline in the ability to organize, to plan, to structure, and behavior becomes disinhibited, which means the person begins to be socially problematic.”
This includes walking outside when it’s freezing out in a nightgown, arguing more with others and being sexually inappropriate.
“Dementia is just a clinical word we use to describe clinically a loss of intelligence, memory problems, language disturbance, functional decline … and then personality change,” Nussbaum said. “Once you say, yes there is a dementia, then you have to say well what’s causing it?”
Paul Thompson, one of the researchers and a professor of neurology at University of California, Los Angeles, said this study provides both bad and good news.
“The bad news part is that we basically discovered what a risk gene for Alzheimer’s does to the brain,” Thompson said.
He said the risk gene increases the chances of getting Alzheimer’s to about 20 percent. His study found that 88 percent of 398 Caucasians in the study had the risk gene, according to a Science Daily article.
Although this finding might seem scary, it also reinforces the idea of prevention efforts, even at a younger age. Thompson said the best ways to attempt to prevent Alzheimer’s currently is to exercise, have a healthy diet and stay mentally stimulated. This includes avoiding a high-fat diet, and engaging in cardiovascular exercise.
“If you think this gene is going to give you Alzheimer’s or not, then it’s pointless to even think about how to prevent it,” Thompson said. “It kind of boosts your risk, but not so much that you can’t completely override its effects.”
Nussbaum said some people with the risk gene never actually get Alzheimer’s, and brain reserve could be important in this prevention.
Brain reserve can be helped by lifestyle changes, like eating proper food, having mental stimulation, being social, reducing stress and exercising, he said. Getting a proper amount of omega-3 fatty acids, which is found in fish, can be helpful.
“Whether or not one is predisposed to Alzheimer’s or dementia, we should all be strongly considering and implementing a proactive brain health lifestyle at the earliest of ages,” Nussbaum said. “We’re pretty good in our country about the heart … [but] we’re not there yet with the brain.”
Thompson said people can get tested for the risk gene, although it’s probably a couple hundred dollars.
“Also these tests are used to rule out other types of illness,” Thompson said. “An example of a situation where you would maybe have this test is if someone was losing their memory, and there was no explanation, and they were maybe not in the age range for Alzheimer’s.”
A lot of people want to know as much as they can about possible risks, he said.
“People that really want to be proactive in preventing health problems, they often might go get a bone scan or a genetic test just to see what they’re up against,” Thompson said. “You could take the view that a lot of people have this, so there’s really no need to get screened for it because you probably have it.”
He said you could save money and just assume that you have the gene and exercise, have a healthy diet and stay mentally stimulated to help prevent it from further developing.
Thompson said there are two forms of Alzheimer’s: late-onset and early-onset. Late-onset is found in people ages 60 and older, and sometimes there is a genetic link. Early-onset hits younger people, and there’s more of a genetic link, though it’s rare.
Nussbaum said there’s probably a 30 percent higher chance of getting Alzheimer’s if parents have the disease. He said a study just came out saying the chance is even greater if the mother has Alzheimer’s. He said for the around 5 percent of people who get early-onset Alzheimer’s, there is probably a 50 percent genetic burden on the offspring.
“It’s not just the gene,” Nussbaum said. “That’s important, but it’s not just the gene. What we have to understand is what triggers the gene. What is it that causes that gene to turn on. If we can figure that out, then we can create something that keeps it turned off.”
Women are found to have a slightly higher rate of Alzheimer’s, although Thompson said this could be because they tend to live longer, and it depends on the studies.
Nussbaum said it’s not clear why women are more at risk for Alzheimer’s, but advanced age is the Number 1 risk factor.
Reviewed May 19, 2011
Edited by Alison Stanton