Women, Dementia, and Alzheimer’s Disease

Women, Dementia, & Alzheimer’s Disease

Understanding your risks for brain disorders and how to improve your brain health.

Perhaps you grew up with an elderly aunt who everyone said was “dotty.” Or maybe you lost your grandmother to Alzheimer’s, or are currently dealing with your mother’s gradual slide into dementia. If so, it’s critical that you understand your own risks for Alzheimer’s disease and related brain disorders.

“It’s not uncommon for us to recall a loved one with dementia,” notes Demetrius Maraganore, MD, FAAN, Co-Director of the Tulane Center for Clinical Neurosciences and Professor of Neurology. “And the billion dollar question is what we can do to prevent it.” Alzheimer’s costs $300 billion a year in the U.S. and the cost is rapidly rising. Dr. Maraganore’s Tulane clinical practice is in brain health and the evaluation and management of memory disorders, including Alzheimer’s disease. His passion is helping patients achieve successful brain aging by preventing cognitive decline and dementia in at-risk persons.

Understanding your risks

Data published by the Alzheimer’s Association estimates that at any age, women have twice the risk for developing the disease than men. The most startling fact is that 1 in 5 women and 1 in 10 men will develop Alzheimer’s in their expected lifetime. And while not every study confirms these general differences, most show that women are more predisposed to the disease, even when taking life expectancies into account. These differences may be due in part to sex hormones, as estrogen and testosterone seem to protect the brain from age-related cell death. Comments Dr. Maraganore, “Men continue to produce sex hormones throughout their lives, but women stop producing them during menopause (usually occurring between ages 45 and 55), and lose estrogen’s protective effects. A higher risk is found in women who had their ovaries removed or who experienced menopause for age 45.”

Genetics

Every human being inherits one copy of every gene from their mother and one from their father. Variation in the Apolipoprotein (APOE) gene is the major genetic determinant of whether a person will develop Alzheimer’s dementia in their lifetime. One in four persons carry at least one copy of the APOE risk variant. APOE gene testing can classify individuals as being at low lifetime risk (less than 10%, no copies), moderate lifetime risk (25%, one copy), or high risk (50% risk, two copies).

Another key factor?

Aging. Most cases of dementia and Alzheimer’s aren’t seen until age 65 or older, and “early onset dementia” (younger than age 65) is less usual. After age 65, with each passing year, the incidence of new Alzheimer’s cases soars. While scientists don’t yet have the ability to reengineer people’s genomes, one-third of Alzheimer’s cases are preventable (not due to genetic factors). For them – and even for those two-thirds who are predisposed to risk of the disease – by modifying health risk factors, the odds of developing the disease can be reduced, so that it doesn’t occur until later in life if at all. Among the risk factors for age-related cognitive decline that can be modified for better brain health are:

Dementia is a complex trait. There is no one risk factor that is a determining cause. And there are habits that can prevent dementia, including being physically active, getting adequate sleep, lifelong learning, eating nutritious foods (and adhering to the Mediterranean diet in particular), and more.

Heart disease/ hypertension Stroke Diabetes High cholesterol Obesity Depression Smoking Excessive alcohol consumption Poor nutrition Head injuries Sleep deprivation Physical inactivity

Good news

Dr. Maraganore notes, “research has shown that healthy habits earlier in life can positively impact brain health later in life,” and that’s why he launched the Tulane Healthy Brain Aging Initiative, that teaches concerned individuals how to reduce the odds of developing cognitive decline and dementia (“prevention clinic”) at two locations. The office visits include several risk factors and cognitive health assessments. A team of specialists then works with each patient to implement a personalized medicine plan to modify risks and to improve brain health. Dr. Maraganore adds that, “there are methods to not only protect the brain from aging, but to also restore its function to youth; and through the combination of lifestyle, behavioral, and medical interventions, we can reduce the odds of dementia by more than 50%.” Patients can self refer to the Brain Health Program; a physician’s referral is not required. For more information, see www.TulaneNeuro.com. And see our www.nolaboomers. com website for the clinic’s Brain Health Quiz.

Tulane Brain Health Program has two locations:

Metairie at East Jefferson Hospital (504.503.7001) Covington at Lakeview Hospital (985.951.3222)

Trevor Wisdom is the managing editor of Nola Boomers.