I Could Develop Alzheimer’s Disease.
And what I’m doing about it.
This past summer I found out that I carry one copy of the apolipoprotein E 4 (APOE-4) gene. All of us have two APOE genes, one inherited maternally, the other paternally. There are multiple types of APOEs, the most common being APOE3, then APOE4, and less common APOE2 (this one is actually shown to be protective against Alzheimer’s). The specific APOE4 gene is a risk factor to developing Alzheimer’s disease. About 25% of the population caries one APOE4, and 2-3% of the population inherit two copies. Having one copy of APOE4 can triple your risk of developing late-onset Alzheimer’s, while having two copies can increase your risk by almost 12 times.
It’s important to know that truly anyone could develop Alzheimer’s disease, you don’t have to have an APOE4 gene to develop it, AND it’s also important to remember that having one or even two APOE4s does not garuntee you’ll develop it either. There are many other contributing factors that can impact development of the disease, such as gender (women are twice as likely to develop Alzheimer’s than men), race (African American’s and Hispanic are at higher risk), other inherited genes (LRRK2, SNCA), family history, chronic disease (most impactful being diabetes and high blood pressure), and lifestyle (like chronic stress, exercise, and diet) all play a part.
After I found out my genetic risk, I got to work understanding how Alzheimer’s develops, learned about factors that I actually can control that will make an impact, and how I can implement this new knowledge into my daily life. This is not something that now controls my life, it’s not like I wake up and say “what can I do today to not develop Alzheimer’s?” But I have started intentional practices that I know will support my health, my brain health specifically, with the goal to reduce any further increased risk.
The list below is my personal top three interventions for reducing my risk of developing Alzheimer’s disease. This list is not all encompassing, exclusive, or medical recommendation. I am a healthcare provider, but I am not your medical provider. My opinions and lifestyle choices are my own, gathered from my own research and life experience. Please follow your own intuition and consult your own medical provider related to your own health and well-being.
I am cleaning up my diet (*note cleaning as an active verb, something I’m always working on). Scientists have started to refer to Alzheimer’s disease as type 3 diabetes. The risk of developing Alzheimer’s significantly increases with diabetes, particularly uncontrolled, in a way that suggests Alzheimer’s could be a further progression of diabetes. APOE4 has specifically been shown to disrupt the regulation of insulin and glucose in the brain and body, creating metabolic dysfunction. A diet high in processed food, sugars, and carbs is not supportive to maintaining optimal metabolic function (glucose/insulin balance). I have been eliminating highly processed foods, reducing my sugar intake, and moving more towards a Mediterranean diet. When I eat carbs or sugars I will include fiber, protein, and/or healthy fats to improve the processing and digestion of the carb/sugars and blunt the hyperglycemic (high glucose) spike. If you are interested in this way of eating check out Jessie Inchauspe, The Glucose Goddess. My goal is to have a metabolically flexible system, reduced insulin resistance, and an A1C 4.8-5.1% (A1C is a test that measures average glucose over 3 months, pre-diabetes is equal to or greater than 5.7%).
Exercise is one of the best things you can do to reduce your risk of Alzheimer’s. The Alzheimer’s Society notes that regular exercise can reduce the risk of developing Alzheimer’s by 45%! That’s a lot! This intervention is multi beneficial; exercise is great for your metabolic health and glucose metabolism, improves vascular health, reduces stress, and is daily mind-body challenge for your brain strengthening neuron connections and synapses. I am incorporating both aerobic and strength-building activity into my daily routine. Aerobic activity strengthens the cardiovascular system and lungs. For my aerobic activity I prefer walking or cycling. My goal is 10k steps/day and/or a 30 minute Peloton class. Strength training is wonderful for improving metabolic health because out simply, muscles love glucose. Muscle development and utilizing your muscles reduces increases in stored and circulating glucose and insulin resistance. My favorite forms of strength-building activities are pilates and weight-lifting and my goal is to do a minimum of 20 minutes of strength building exercise 6 days per week.
I’m learning Arabic. I’ll be honest, my main reason for learning Arabic is to communicate with my partner’s primarily Arabic speaking family, but learning about the added benefit that multilingualism can delay the onset of developing dementia, and particularly Alzheimer’s is, definitely motivational. Here’s the scientific brain speak - the challenge of learning a new language creates synaptogenesis, increases synaptic changes and plasticity, leading to structural changes of improved white matter integrity and gray matter density, which then improves cognitive reserve, synaptic integrity, and the overall delay in the onset of dementia. Now when I sit down to do my daily lesson I know that this is a practice that will help me in my relationship and also in my longevity. I love feeding two birds with one scone.
I have also incorporated other life changes to specifically improve my chance of not developing Alzheimer’s, like sauna, reducing alcohol, particular supplements, and flossing. Look for more information on these interventions in Part 2 of “I Could Develop Alzheimer’s Disease? And what I’m doing about it.”
Overall, my newfound knowledge of my increased risk of developing Alzheimer’s does not control my life. Many of these interventions are things I would likely be doing anyway. Understanding how these interventions specifically help me reduce my likelihood of developing this disease is incredibly supportive and motivational for me.
I want to extend my heartfelt love and support to anyone affected by Alzheimer’s disease or dementia, acknowledging the profound pain and challenges it brings into our lives and the lives of our loved ones. If you or someone you love also has an increased risk of Alzheimer’s or dementia feel free to reach out to me for support, or check out some of the resources I’ve used to educate myself, cited below.
Citations:
Alzheimer’s Impact Movement. (2020). Fact Sheet: Race, Ethnicity, and Alzheimer’s. Azlheimer’s Association. Retrieved 2024, from https://aaic.alz.org/downloads2020/2020_Race_and_Ethnicity_Fact_Sheet.pdf.
Anderson, J. A. E., Hawrylewicz, K., & Grundy, J. G. (2020). Does bilingualism protect against dementia? A meta-analysis. Psychonomic bulletin & review, 27(5), 952–965. https://doi.org/10.3758/s13423-020-01736-5
Attia, P., & Gifford, B. (2023). Outlive: The Science & Art of Longevity. Harmony Books.
De Widt, L. (2022, October 3). What is the link between alzheimer’s and type 3 diabetes? - mayo clinic news network. Mayo Clinic. https://newsnetwork.mayoclinic.org/discussion/researchers-link-alzheimers-gene-to-type-iii-diabetes/
Fortanasce, V. (2009). The anti-alzheimer’s prescription: The Science-Proven Prevention Plan to start at any age. Gotham Books.
Kim, S., Jeon, S. G., Nam, Y., Kim, H. soo, Yoo, D.-H., & Moon, M. (2019). Bilingualism for dementia: Neurological mechanisms associated with functional and structural changes in the brain. Frontiers in Neuroscience, 13. https://doi.org/10.3389/fnins.2019.01224
National Institute on Aging. (2023). Alzheimer’s Disease Genetics Fact Sheet. National Institute of Health. Retrieved March 8, 2024, from https://www.nia.nih.gov/health/genetics-and-family-history/alzheimers-disease-genetics-fact-sheet#:~:text=Having%20two%20copies%20of%20APOE,allele%20never%20develop%20the%20disease.
National Institute on Aging. (2023). Thinking About Your Risk for Alzheimer’s Disease? Five Questions To Consider. National Institute of Health. Retrieved 2024, from https://www.nia.nih.gov/health/alzheimers-causes-and-risk-factors/thinking-about-your-risk-alzheimers-disease-five#:~:text=Age%20is%20the%20biggest%20known,their%20risk%20of%20Alzheimer%27s%20increases.N.
Physical activity and the risk of dementia. Alzheimer’s Society. (n.d.). https://www.alzheimers.org.uk/about-dementia/managing-the-risk-of-dementia/reduce-your-risk-of-dementia/physical-activity#:~:text=Regular%20exercise%20can%20reduce%20the,studies%20into%20exercise%20and%20dementia.
U.S. Department of Health and Human Services. (2021, March 16). Study reveals how APOE4 Gene may increase risk for dementia. National Institute on Aging. https://www.nia.nih.gov/news/study-reveals-how-apoe4-gene-may-increase-risk-dementia#:~:text=APOE4%20is%20the%20strongest%20risk,lipid%20imbalances%20in%20brain%20cells.
