New Frontiers For Ad Prevention And Treatment
New horizons for prevention and treatment might include how risk might be different for individuals of varied genetic ancestries and ethnicities both here in the US and abroad. The risk may also be different between males and females. Finally, biobanks can only describe association, not causation, between changes in lifestyle and dementia risk. To determine causation, randomized trials are required, and a new US-based randomized clinical trial called POINTER is now underway.
Trying to live a healthy lifestyle, despite its elusive definition, seems to be an obvious way to prevent dementia. What remains to be seen is how studies using biobanks can be informative about the millions of people who already may be suffering from the disease.
The Role Of Genetics: Will I Get Alzheimers Disease
Scientists are still trying to determine the underlying causes of Alzheimers disease. The hope is that one day we will be able to stop the disease from progressing or perhaps even prevent it altogether. To date, researchers have identified a few genes that play an important role in Alzheimers. Some of these genes are simply risk factors for Alzheimers disease. Other genes are hereditary and will cause Alzheimers disease to develop.
There are two types of Alzheimers disease: early-onset Alzheimers disease and late-onset Alzheimers disease. Early-onset Alzheimers disease is rare, occurring in people age 60 and younger. This represents less than 5% of all people with Alzheimers. One type of early-onset Alzheimers disease is known as autosomal dominant Alzheimers disease or early-onset familial Alzheimers disease . This is even more uncommon, affecting less than 1% of all people with Alzheimers. What makes this type of early-onset Alzheimers disease so unusual is that it is caused by a hereditary genetic mutation to one of three genes PSEN1, PSEN2, or APP.
A recent study examined data from 4 large, observational studies of adults ages 60 and older. The study reported the association between various APOE genotypes and the risk of developing mild cognitive impairment or dementia due to Alzheimers by age 85 as follows:
- No family history of dementia
- Being male
Factors that may increase a persons risk of developing Alzheimers include:
What Are The Symptoms Of Early
For most people with early-onset Alzheimer disease, the symptoms closely mirror those of other forms of Alzheimer disease.
Withdrawal from work and social situations
Changes in mood and personality
Severe mood swings and behavior changes
Deepening confusion about time, place, and life events
Suspicions about friends, family, or caregivers
Trouble speaking, swallowing, or walking
Severe memory loss
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What Is Alzheimers Disease
Alzheimers disease damages your brain, gradually destroying memory and thinking skills. Researchers believe that the damage begins up to a decade before symptoms appear. Abnormal deposits of proteins form hard plaques and tangles throughout the brain. These deposits interfere with normal brain function.
As they grow, plaques can interrupt communication between neurons, the messengers in your brain. Eventually these neurons die, damaging your brain so much that parts of it begin to shrink.
Treatment Of Alzheimer’s Disease
Alzheimer’s disease is a progressive and terminal disease that currently has no known cure. The good news is that there are treatment options that reduce the severity of its symptoms and improve the functioning of a person with this condition.
The following drugs have been approved by the FDA specifically for the treatment of different symptoms of Alzheimer’s disease:
- Cholinesterase inhibitors: These are used to improve symptoms of cognitive decline and dementia in people with Alzheimer’s. These include drugs such as Exelon , Aricept , and Razadyne
- Aduhelm : This works by eliminating amyloid proteins, which have been found to be built up in the brains of people with Alzheimer’s disease and potentially cause the condition.
- Namenda : This is typically used to treat moderate to severe Alzheimer’s disease symptoms. It’s thought to work by regulating a chemical messenger called glutamate, which helps rescue its harmful effects on the brain.
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Genetic Overlap With Other Neurodegenerative Diseases
We tested the association of the lead variants within our new loci with the risk of developing other neurodegenerative diseases or AD-related disorders . We also performed more precise colocalization analyses for five loci known to be associated with Parkinsons disease , types of frontotemporal dementia and amyotrophic lateral sclerosis . The IDUA signal for Parkinsons disease was independent of the signal in ADD 3=99.9%), but we were not able to determine whether the CTSB signals colocalized. The TMEM106B and GRN signals in frontotemporal lobar degeneration with TAR DNA-binding protein inclusions probably share causal variants with ADD . Lastly, we were not able to determine whether the TNIP1 signals colocalized for ADD and amyotrophic lateral sclerosis.
What Role Do Genes Play In Dementia
Changes to even small parts of a gene can cause dementia.
A gene is made up of a chemical called DNA. If someone inherits a genetic mutation that causes a health condition, they are more likely to develop that condition. Early-onset Alzheimers disease is an example of an inherited genetic disorder.
Additionally, genetic variants changes to genes can affect a persons risk of disease. Doctors call this a genetic risk factor.
If someone has a genetic risk factor for dementia, then certain environmental and lifestyle factors can affect their chances of developing the condition. These can include:
increased chance of developing the disease. However, this is not necessarily the case for late-onset Alzheimers disease.
A persons risk for late-onset Alzheimers disease may depend on the age of onset, as well as whether the person has gene susceptibility for example, mutations in the apolipoprotein E gene.
While a specific gene does not seem to directly cause the disease, a variant of the APOE gene on chromosome 19 appears to increase a persons risk. This gene plays a role in making proteins that carry cholesterol and other lipids in the blood.
Experts have identified three single-gene mutations that with early-onset Alzheimers disease:
3 in 10 people with the condition have a strong family history of it.
There are other forms of familial FTD in which there is no identifiable genetic cause or the genetic basis is not necessarily autosomal dominant.
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Information About Genetic Testing
Having a test to look for a faulty gene that causes dementia is only appropriate for a very small number of people. This is because inherited dementia is rare.
If you are worried that you have a strong history family of young onset Alzheimers disease or frontotemporal dementia, you can speak to your doctor about this.
Not all gene mutations that cause dementia have been identified, meaning that some families may have many affected members, but no mutation can be found. Therefore, a negative test result cannot always rule out a genetic cause of a disease.
If a test is appropriate, your doctor should be able to refer you to a genetic counsellor or specialist. This could be a cognitive neurologist or memory clinic psychiatrist. They will discuss with you the pros and cons of taking a test and what will be involved. They will also tell you where the results will be kept, who they will be shared with, and what the next steps would be. For people found to have a genetic mutation that causes dementia, these discussions will also cover the options available if you are considering starting a family.
To find out more about genetic testing and what support is available you can visit www.raredementiasupport.org or call 020 3325 0828. Leave a message and you will be referred to the most appropriate team member.
Cause #: Mild Cognitive Impairment
People who already have mild cognitive impairment may be at an increased risk of developing full-blown Alzheimers. A mild cognitive impairment doesnt necessarily impact a persons daily life in a major way. However, it can have some effects on memory, thinking skills, visual perception, and the ability to make sound decisions.
Scientists are trying to understand why some cases of mild cognitive impairment progress into Alzheimers. A
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Genetic Testing For Alzheimers Disease
A blood test can tell which APOE gene you have, but the results canât predict whether youâll get Alzheimerâs. Doctors use these tests mostly for research purposes. The test can tell them who has certain risk factors so they can watch for brain changes in case the disease develops.
Doctors donât typically recommend genetic testing for late-onset Alzheimerâs because the results can be confusing and cause emotional distress. If youâre showing symptoms or have a family history, your doctor may recommend testing to help diagnose early-onset Alzheimerâs. Doctors can usually diagnose Alzheimerâs without a genetic test.
Dementia With Lewy Bodies
Lewy bodies are deposits of a particular type of protein that build up in the brain and damage cells. They can sometimes be found in the brains of people with other types of dementia, such as Parkinson’s disease dementia and Alzheimer’s.
The cause of dementia with Lewy bodies is unknown, but the overlaps with Parkinson’s and Alzheimer’s suggest there could be a genetic link between different types of dementia. However, familial cases of dementia with Lewy bodies are very rare.
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What Is Alzheimer’s Disease
Alzheimer’s disease is an irreversible brain disorder. It is a progressive condition that causes issues with memory, cognition, and behavior.
It was first discovered in 1906 by Dr. Alois Alzheimer, a German psychiatrist and neuropathologist. He examined the brain of a woman who had died following symptoms including memory loss, language problems, and altered behavior. He found unusual clumps in her brain, known as amyloid plaques, as well as tangles in her brain fibers that are some of the main features of Alzheimer’s disease.
Since this initial discovery, many other complex changes in the brain have been discovered among people suffering from disease, including the loss of connection between neurons.
How Can I Reduce My Risk Of Dementia
For the vast majority of people, our genes are only one factor affecting our risk of dementia. There are many other factors involved, such as age and lifestyle. While we cannot change our age or genes, research has found that up to a third of all cases of dementia could be avoided through lifestyle changes.
There are simple things we can do that may help lower our risk:
- do not smoke.
You can find more detailed information about how you can reduce your risk of dementia here.
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Whats Next With Dementia Prevention Research
More research is needed to find ways to help prevent Alzheimers and related dementias. Future research may determine that specific interventions are needed to prevent or delay the disease in some people, but others may need a combination of treatments based on their individual risk factors. Understanding risk factors and choices you can make now is important for both your present and future health. In addition to this website, consider the resources listed below to learn more.
You can also help researchers learn more about preventing dementia by participating in clinical trials and studies. Search the Alzheimers.gov Clinical Trials Finder to find studies that need volunteers.
Reducing Your Risk Of Developing Dementia
As mentioned earlier, genes increase the risk of dementia but do not cause it in most cases. There are multiple risk factors associated with dementia, including cardiovascular diseases, diabetes, and smoking, that can be managed to help in preventing dementia. Maintaining a healthy lifestyle with physical exercise, a balanced Mediterranean diet, low levels of alcohol intake and abstinence from smoking can help in reducing the risk of dementia.
Individuals with substance use disorders are often at an increased risk of developing dementia. In addition, family members of an individual with dementia may turn to substances to deal with the stress of caring for their loved one. If you or a loved one suffers from a substance use disorder, The Recovery Village can help. Contact us today to learn about specialized treatment programs that can work well for your situation.
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If Familial Alzheimers Disease Is Suspected
Genetic testing can identify specific changes in a persons genes. This test can tell if a person has FAD and if a child has inherited the changed gene from a parent and will develop the disease in the future. It cannot determine when the symptoms will begin. It is essential to ensure that suspected cases in the family have, or have had, Alzheimers disease and not some other form of dementia. This can only be done through a medical examination, or a careful analysis of past medical records if the person is no longer alive.
Is Dementia Or Alzheimers Hereditary
When a family member starts showing signs of dementia, it can cause an avalanche of questions and emotions to arise. One of the first questions being, Is dementia genetic?
A reasonable question if youre currently caring for a parent with dementia.
Before we can answer, Is dementia genetic? or How heritable is Alzheimers? we need to define our terms. Alzheimers Disease and dementia are commonly used interchangeably. However, there are significant differences between the two.
First, well explain the difference between Alzheimers and dementia, then answer some more pressing questions, such as Is dementia or Alzheimers hereditary?
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Environmental Risk Of Dementia
Is dementia environmental?
According to the study, Environmental risk factors for dementia: a systematic review , environmental factors can increase the risk of dementia.
Researchers found moderate evidence noting that air pollution exposures increase dementia risk. However, they found strong evidence confirming vitamin D deficiency increases a persons risk of dementia.
So, the answer to Is dementia genetic or environmental? seems to be a muddy, Yes.
People Affected By Dementia Are Often Concerned About Whether The Condition Can Be Passed Along In Families
Here we discuss the role of heredity in Alzheimers disease and other forms of dementia.
Dementia is the term used to describe the symptoms of a large group of illnesses which cause a progressive decline in a persons functioning. It is a broad term to describe a loss of memory, intellect, rationality, social skills and what would be considered normal emotional reactions. Alzheimers disease is the most common form of dementia, accounting for 50% to 70% of all cases of dementia. It occurs relatively frequently in older people, regardless of family history. For females aged 65 to 69 years dementia affects 1 person in 80 compared to 1 person in 60 for males. For both males and females aged 85 and over the rate is approximately 1 person in 4.
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But How Can You Measure Lifestyle And Genetic Risk
The investigators hand-picked a list of common lifestyle factors, including smoking, alcohol consumption, physical activity, and diet, and created a score. A low score denoted a bad lifestyle. A high score denoted a good lifestyle.
However, taking this approach to measure lifestyle risk has several pitfalls:
- First, a vast number of factors comprise lifestyle and environment beyond smoking and physical activity. So any list may be arbitrary. In fact, our research team has argued that choosing a candidate list doesnt capture our complex lifestyles and may lead to false findings. For example, what exactly constitutes a healthy diet?
- Second, using a score makes the individual roles of the factors unclear.
- Third, if connections between factors influence both the score and dementia, then the score might be a weak proxy for other variables that werent considered. In other words, if weight is associated with diet and dementia, then it is hard to untangle the association of diet.
To create the genetic risk score, the investigators used all genetic variants previously identified by a genome-wide association study of Alzheimers disease. These gene variants are strongly associated with patients who have Alzheimers compared with healthy controls). Using this information, the researchers constructed a polygenic risk score.
Short Answer: Its Complicated Many Genes Increase Alzheimers Risk By Some Measure Some Genes Increase Risk By Quite A Lot But Overall Genetics Is Only Part Of The Story
Breakthrough advancements in gene-sequencing technologies have opened up new pathways for understanding health and disease. Scientists can sequence our genetic code to search for genes involved in diseases. In some cases, genes are the key to what causes a disease. For example, carriers of genes like ApoE4, TREM2 and others are thought to have dramatically higher Alzheimers risk .
But the more we probe genetics and disease, the more we are learning that when it comes to the majority of diseases and conditions including Alzheimers a few genes arent going to solve the mystery.
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First off, Caroline Scates, deputy director of Admiral Nurse development at Dementia UK, points out that Alzheimers and dementia are not the same thing.
Dementia is an umbrella term for a range of conditions affecting the brain, which get gradually worse over time, Scates explains with symptoms commonly including problems with memory, thinking and communication, leading to a reduction in skills required for everyday living.
There are over 200 different sub-types. Alzheimers disease is one of these and it is the most common form of dementia, caused by a build-up of proteins called amyloid and tau in the brain, which result in the death of brain cells.
Thats not the only thing thats often misunderstood about these conditions. Here, experts talk us through seven other common misconceptions about dementia
Are Dementia And Alzheimers Hereditary
Alzheimer’s disease is just one of many forms of dementia. Vascular dementia, dementia with Lewy bodies , mixed dementia and Parkinson’s disease are other conditions which can cause symptoms similar to Alzheimer’s.There are tens of millions of people around the world suffering from some form of dementia but the majority of them, 60% to 70%, have been specifically diagnosed with Alzheimer’s disease.Any disease that causes brain damage can result in dementia symptoms. Memory loss, cognitive problems, issues with communication and speech are all signs that something may have caused dementia.
Alzheimer’s and other types of dementia usually affect people over 50 or 60 years of age. If you’ve reached those ages, you may bewondering whether whether dementia is hereditary, especially if a parent or grandparent suffered from this debilitating condition.
Dementia Is Rarely Inherited
Dementia in the family tree often causes concern. Could you be predisposed to dementia? Might you pass the condition along to your children? The good news is that, in almost all cases, dementia is not inherited.
Of course this depends on the type of dementia. Huntington’s disease can cause dementia symptoms, and can be inherited.
In contrast, about 99% of Alzheimer’s cases have little to do with a person’s hereditary makeup. If your parents and/or grandparents developed Alzheimer’s your risk is only slightly higher than if this were not the case.
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