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Be proactive about protecting your memory

When you’re in your twenties and thirties, memory loss and Alzheimer’s disease may seem like distant concerns. But taking care of your brain isn’t something you should put off.

Certainly, the vast majority of Alzheimer’s disease is diagnosed in people 65 and older. However, Alzheimer’s cases have been increasing at alarming rates among people between the ages of 30 and 64.

“We’re now seeing people in their fifties, and even their forties and late thirties, with early signs of cognitive decline,” says Dale Bredesen, MD, an internationally recognized expert in the mechanisms of neurodegenerative diseases and author of The End of Alzheimer’s Program (Avery, 2020).

“The brain changes that result in Alzheimer’s disease may start 20 years or more before you’re diagnosed,” says Bredesen. Some experts say Alzheimer’s may more appropriately be called a younger and middle-aged person’s disease.

Now, the good news. Though Alzheimer’s disease was once thought to be something you could do little to prevent, scientists are proving that wrong.

IS YOUR BRAIN IN TROUBLE?

Dementia can impair your memory, thinking, and speech. Alzheimer’s disease is the most common cause of dementia.

“Dementia can sneak up on people because they don’t like to think about the possibility that something is wrong,” says Bredesen. “So, they write off the warning signs.” Plus, the symptoms of early-onset Alzheimer’s (diagnosed before age 65) may not be what you expect.

Later-onset dementia often starts as purely a memory problem and then spreads to other cognitive dysfunction, explains Bredesen. Worsening memory isn’t the only symptom you should be watching out for.

Possible signs of early-onset Alzheimer’s

Younger people with dementia may first experience difficulty with

• speech, such as finding the right words

• organizing things

• recognizing faces or objects

• making calculations, such as restaurant tips

Genetics And Risk

Several genes increase your risk for Alzheimer’s disease, but your genetics don’t determine your destiny.

“Scientific evidence shows that several lifestyle changes can reduce your risk of Alzheimer’s disease, regardless of your genetic predisposition,” says Demetrius Maraganore, MD, who leads the Tulane Healthy Brain Aging Initiative in New Orleans.

That said, genetic testing may help you and your health care practitioner better focus your prevention efforts.

“Consider getting genetically tested to see if you carry the apolipoprotein-e4 (APOE-e4) risk variant for Alzheimer’s disease,” says Maraganore. “APOE is one of the approximately 25,000 genes that you inherit—one copy from your mom and one copy from your dad.” The APOE-e4 variant is the strongest genetic risk factor for Alzheimer’s.

People with zero copies of APOE-e4, which is the majority of us, have a 10 to 15 percent risk of Alzheimer’s disease. But those with one copy of the gene variant have an estimated 25 to 40 percent risk, and those with two copies have a 40 to 55 percent risk of developing Alzheimer’s disease.

Your doctor can test you for APOE-e4, or you can use an at-home test kit, such as one from alzheimersorganization.org. For more information, visit apoe4.info.

A COVID connection

Carrying two copies of APOE-e4 has been linked with double the risk of severe COVID-19. This may be due, in part, to the gene variant’s impact on immune function and increasing inflammation, says Bredesen.

SUBTYPING ALZHEIMER’S DISEASE

You may think of Alzheimer’s disease as a single entity. But many different paths can lead to the condition.

Bredesen classifies Alzheimer’s according to the most likely underlying factors in a given individual, including

• increased inflammation due to APOE-e4 genetics

• high blood sugar and insulin resistance, as in prediabetes and type 2 diabetes

• hormonal disruption (such as thyroid issues) and nutritional deficiency

• toxicity due to factors such as air pollution and biological toxins from mold

• vascular disorders, such as heart disease and high blood pressure

• head injuries, such as those sustained in sports or car crashes

Other factors can also contribute to your risk, including obesity, smoking, excess alcohol intake, poor sleep, certain chronic infections, and impaired hearing. Generally, multiple factors are involved, so prevention should be multipronged.