Risk Genes For Vascular Dementia
Some studies have reported links between APOE and vascular dementia, but others have not. It seems that APOE e4 may be a risk factor for vascular dementia, but a weaker one than it is for Alzheimer’s disease. It is not clear whether APOE e2 is associated with lower risk of vascular dementia as it is with Alzheimer’s.
In addition, researchers have found several genes that affect a person’s chances of developing conditions such as high cholesterol, high blood pressure and type 2 diabetes. These conditions matter because they can significantly raise a person’s chances of developing vascular dementia later in life. Similarly, a family history of stroke or heart disease – both closely linked to vascular dementia – can raise a person’s risk of developing it.
Overall, however, genes seem to play a much smaller role in the development of the common forms of vascular dementia than they do in late-onset Alzheimer’s disease.
Lifestyle choices, such as diet and exercise, are probably even more important in vascular dementia risk than they are in Alzheimer’s disease.
Reduce your risk of dementia
Read our tips and advice on how to reduce your risk of developing dementia.
Is There A Cure Can Vascular Dementia Be Treated
- Unfortunately, there is currently no cure for vascular dementia or for reversing the changes in the brain caused by vascular dementia. Management includes identifying the underlying cause and treating it to prevent further strokes. This may help slow down the progression of vascular dementia.
Treatment includes medications for maintaining blood pressure, cholesterol and blood sugar in the normal range. Treatment also focuses on preventing clots, incorporating lifestyle strategies such as regular exercise, adopting the Mediterranean diet, avoiding smoking, minimizing alcohol, and engaging in physiotherapy and rehabilitation to regain strength.
Cell Adhesion And Endocytosis
Endocytosis is central to AD because APP, A, and APOE are all internalized through the endolysosomal trafficking pathway, and alterations in APP trafficking through intracellular compartments can directly influence APP proteolytical cleavage . Several genes identified in GWAS-LOAD studies are associated with cell adhesion and endocytosis, including BIN1, CD2AP, EPHA1, PICALM, and SORL1 .
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Vascular Dementia And Vascular Cognitive Impairment: A Resource List
Vascular dementia, a most common form of dementia in older adults, and vascular cognitive impairment result from injuries to vessels that supply blood to the brain, often after a stroke or series of strokes. The symptoms of vascular dementia can be similar to those of Alzheimers, and both conditions can occur at the same time . Symptoms of vascular dementia and VCI can begin suddenly and worsen or improve over time.
Caregivers of people with vascular dementia or VCI face a variety of challenges. Learning more about these disorders can help. This resource list is a place to start. All resources on this list are available free online.
The items on this list are in three categories:
The Dementias: Hope Through Research
This booklet from the National Institute on Aging and the National Institute of Neurological Disorders and Stroke describes different kinds of dementia, including vascular dementia. It discusses brain changes, symptoms, and treatments for many dementias, as well as risk factors and diagnosis for dementia generally. It also summarizes dementia research supported by the National Institutes of Health. The booklet includes a glossary and list of resources.
Vascular Dementia: What Is It, and What Causes It?
Available from the Alzheimers Society, London.
What Other Factors Cause Alzheimers Or Dementia
People with no trace of the ApoE gene can still develop dementia and Alzheimers. There are other risk factors which doctors believe contribute to these conditions. They include:
Fortunately, all of these lifestyle factors can be addressed to counter the onset of Alzheimers and dementia. Strategies for preventing the onset of cognitive disease will vary with every individual, but clinical research continues to indicate that healthy lifestyles can make our brains more resilient.
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What Role Do Our Genes Play In Dementia
As dementia is so common, many of us will have a relative living with the condition but this does not mean we will develop it too.
Dementia is caused by diseases that affect the brain, such as Alzheimers disease. The likelihood of developing dementia will usually depend on a complex mix of factors like our age, medical history and lifestyle, as well as our genes. Most cases of dementia are not directly caused by genes we inherit from our parents.
Tests For Vascular Dementia
There’s no single test for vascular dementia.
The tests that are needed to make a diagnosis include:
- an assessment of symptoms for example, whether these are typical symptoms of vascular dementia
- a full medical history, including asking about a history of conditions related to vascular dementia, such as strokes or high blood pressure
- an assessment of mental abilities this will usually involve several tasks and questions
- a brain scan, such as an MRI scan or CT scan, to look for any changes that have happened in your brain
Find out more about the tests used to diagnose dementia.
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More Alzheimers Research Is Needed
Experts continue to research the complex biological and environmental factors that influence Alzheimers disease, but, if you are concerned about your risks, talk to your doctor about your family history and other health concerns that you may have.
Early detection is crucial to getting the maximum benefits of treatment, and it can give you more time and more say in planning for your future.
Has heredity been a factor in your loved ones Alzheimers diagnosis? Please share your story in the comments below.
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Do Genes Cause Diseases
Genetic mutations can cause diseases. If a person inherits a genetic mutation that causes a certain disease, then he or she will usually get the disease. Sickle cell anemia, cystic fibrosis, and some cases of early-onset Alzheimers disease are examples of inherited genetic disorders.
Other changes or differences in genes, called genetic variants, may increase or decrease a persons risk of developing a particular disease. When a genetic variant increases disease risk but does not directly cause a disease, it is called a genetic risk factor.
Identifying genetic variants may help researchers find the most effective ways to treat or prevent diseases such as Alzheimers in an individual. This approach, called precision medicine, takes into account individual variability in genes, environment, and lifestyle for each person.
The expression of geneswhen they are switched on or offcan be affected, positively and negatively, by environmental and lifestyle factors, such as exercise, diet, chemicals, or smoking. The field of epigenetics is studying how such factors can alter a cells DNA in ways that affect gene activity.
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What If Your Parent Or Grandparent Has Hereditary Dementia
If a parent or grandparent is diagnosed with a hereditary type of dementia, its important to understand the familys risk factors. Genetic counseling can help adult children and grandchildren understand how their genes affect their risk, what signs and symptoms to watch for, and what tests and treatments are available. In some cases, you and your family may have the option to participate in genetic research.
Vascular Contributions To Cognitive Impairment And Dementia
Vascular contributions to cognitive impairment and dementia are conditions arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior. Cognition and brain function can be significantly affected by the size, location, and number of brain injuries. Two forms of VCIDvascular dementia and vascular cognitive impairment arise as a result of risk factors that similarly increase the risk for cerebrovascular disease , including atrial fibrillation , high blood pressure, diabetes, and high cholesterol.
Symptoms of VCID can begin suddenly and progress or subside during one’s lifetime. VCID can occur along with Alzheimer’s disease. People with VCID almost always have abnormalities in the brain on magnetic resonance imaging scans. These abnormalities include evidence of prior strokes, often small and asymptomatic, as well as diffuse changes in the brain’s “white matter”the connecting “wires” of the brain that are critical for relaying messages between brain regions. Microscopic brain examination shows thickening of blood vessel walls called arteriosclerosis and thinning or loss of components of the white matter.
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Dementia And Down Syndrome
People with Down syndrome are born with an extra piece of DNA. This means they also have an extra copy of the APP gene. This leads to the build-up of amyloid plaques in the brain, which play a role in the development of Alzheimers disease. While not everyone with Down syndrome will go on to develop symptoms of Alzheimers, most people with the condition over the age of 40 will have amyloid build-up. It is estimated that about 50% of people with Down syndrome develop symptoms like memory loss, usually in their 50s and 60s.
To find out more about Down syndrome and dementia you can contact Downs Syndrome Association helpline on 0333 1212 300 or visit their website www.downs-syndrome.org.uk.
Which Types Of Dementia Are Hereditary
Among the many questions people ask after a dementia diagnosis is whether other family members are at risk for the same condition. In most cases, the answer is no or its not clear. Some rarer types of dementia can sometimes be hereditary, and some health habits shared by family members can raise the risk of developing non-hereditary dementia. Heres what you need to know about hereditary risk for different types of dementia.
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Outlook For Vascular Dementia
Vascular dementia will usually get worse over time. This can happen in sudden steps, with periods in between where the symptoms do not change much, but it’s difficult to predict when this will happen.
Home-based help will usually be needed, and some people will eventually need care in a nursing home.
Although treatment can help, vascular dementia can significantly shorten life expectancy.
But this is highly variable, and many people live for several years with the condition, or die from some other cause.
If you or a loved one has been diagnosed with dementia, remember that you’re not alone. The NHS and social services, as well as voluntary organisations, can provide advice and support for you and your family.
How Is Vascular Dementia Diagnosed
In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography . This imaging test uses X-rays and a computer to make horizontal, or axial images of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram . This test measures electrical activity in the brain
- Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
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Gene Mutations Occur In Rare Forms Of Vascular Dementia
According to a report by Genetics of Vascular Dementia Working Group, there has been one study in 24 twins that has tried to look into vascular dementia heritability intimately.
This, however, failed to identify a noteworthy genetic component. This led to the general interpretation that the environment plays a bigger role in the development of vascular dementia when compared to genetics.
Conversely, there is some evidence that the illness may have a significant genetic component.
This has led to the conclusion that vascular dementias genetic background remains well established for monogenic disorders.
Monogenic illnesses are Mendelian disorders, where modifications in one gene are implicated in the disease process. These usually showcase inheritance patterns like dominant, additive, or recessive genetic models.
Evidence has been brought forth that the dysfunction of single genes causes vascular dementia. This can also help to answer the query be is vascular dementia hereditary.
Clinical Implications Of Understanding The Genetics Of Vad
An important implication of unravelling the genetic causes of VaD would be a biological understanding of its origin. However, what genetic studies have actually demonstrated so far is that clinical definitions are rather heterogeneous one of the primary challenges will be to create robust definitions of VaD phenotypes, along with the selection of appropriate controls and replication in independent samples .
Understanding the causal genes and their underlying disease mechanisms can also lead to the identification of pathways. These can provide attractive targets for intervention and subsequently stimulate drug development, for which the related field of AD provides a good example. The identification of causative mutations in APP, PSEN1 and PSEN2 in familial AD cases has led to the amyloid cascade hypothesis that changes in the APP gene and its processing results in the aggregation and deposition of amyloid-, and this presumably leads to disease. In GWAS of sporadic AD, the identification of APOE and, more recently, a variety of other genes that are known to be implicated in pathways such as immune response, endyctosis, and lipid metabolism may lead to novel directions in drug discovery .
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Key Points About Vascular Dementia
- Vascular dementia is a disorder characterized by damaged brain tissue due to a lack of blood flow. Causes can include blood clots, ruptured blood vessels, or narrowing or hardening of blood vessels that supply the brain.
- Symptoms can include problems with memory and concentration, confusion, changes in personality and behavior, loss of speech and language skills, and sometimes physical symptoms such as weakness or tremors.
- Vascular dementia tends to progress over time. Treatments can’t cure the disease, but lifestyle changes and medicines to treat underlying causes might help slow its progress.
- Surgical procedures to improve blood flow to the brain can also be helpful. Other medicines might slow the progression of dementia or help with some of the symptoms it can cause.
- A person with vascular dementia may eventually need full-time nursing care or to stay in a long-term care facility.
Who Is At Risk For Vascular Dementia
Some risk factors for vascular dementia can be managed others, like age and gender, cannot. Among all factors, high blood pressure carries the greatest risk vascular dementia almost never occurs without it.
Likewise, a high risk of stroke goes hand in hand with risk for vascular dementia. One-quarter to one-third of strokes are thought to result in some degree of dementia. People who smoke, consume excessive amounts of alcohol, have diabetes, or heart disease also have a higher rate of the condition.
Vascular dementia most commonly occurs in people between the ages of 60 and 75. Men seem to be more vulnerable than women, and the condition affects African-Americans more often than other races. People whose age, sex, or race puts them at increased risk of vascular dementia have that much more reason to manage risk factors within their control.
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Severe Mobility Problems Including Falls
People with late-stage vascular dementia often struggle to walk at all, and are prone to falls. Physiotherapy is often prescribed, but many people will need round-the-clock care.
Read our guide to helpful dementia products, sorted by the problems they solve. Including living aids and products for sleeping better, preventing falls, and GPS tracking.
What Causes Vascular Dementia
Vascular dementia is caused by a lack of blood flow to a part of the brain. Blood flow may be decreased or interrupted by:
- Blood clots
- Bleeding because of a ruptured blood vessel
- Damage to a blood vessel from atherosclerosis, infection, high blood pressure, or other causes, such as an autoimmune disorder
CADASIL is a genetic disorder that generally leads to dementia of the vascular type. One parent with the gene for CADASIL passes it on to a child, which makes it an autosomal-dominant inheritance disorder. It affects the blood vessels in the white matter of the brain. Symptoms, such as migraine headaches, seizures, and severe depression, generally start when a person is in his or her mid-30s but, symptoms may not appear until later in life.
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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.
Is Dementia Passed On Through Our Dna
Medical research seems to suggest that it is very unlikely that dementia can be passed on through our DNA. But in rare cases, some diseases that lead to dementia can be passed on through our DNA. But it is still extremly rare that if a family member such as a parent or grandparent has developed one of the many different kinds of dementia, that their children will inherit the disease at some stage in their life.
This is not to say that somebody with Alzheimers cannot have not passed on the disease from parent to child. It is possible they could have. In some rare cases of Alzheimers, the disease can be inherited from a parent. But this is very rare.There is a group of four genes a person can carry that can lead to a greater risk of Alzheimers. With 3 of the four genes being responsible for early onset dementia in people in their 30s, 40s and 50s with the other gene being responsible for Alzheimers in older people, usually over 65 years of age.
In the majority of cases of Alzheimers the disease is mostly associated with old age. Most cases are diagnosed with people in their 70s and 80s which is often referred to as Senile dementia.
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