Will I get Alzheimer’s Disease?
by Henri Roca, MD, Clinical Functional Medicine Specialist
People sometimes ask, “Will I get Alzheimer’s disease? Can we check an APOE4 gene test to find out?”
I rarely suggest getting this particular gene test. Just because a person may have a gene does not necessarily mean they will develop the disease. We often think that our lives are controlled by our genes. In some sense they are. In a larger sense, our lives are controlled by the interaction between our genes and our environment. These interactions determine how our genes will manifest themselves. Not everyone with the APOe4 gene gets Alzheimer’s. Many people who do not have the gene, on the other hand, do get the disease.
Rather than ordering the test, I take an extensive history. Those individuals who have a family history of Alzheimer’s disease generally have a 10 to 30 percent increased chance of contracting the disease themselves. (Scroll to the chart below for a list of potential risk factors.)
The challenge we all face is how to live in such a way that we can be healthy and disease-free our entire lives. Often other genetic inefficiencies materially contribute to the question of how our environment interacts with the expression of our genes, all genes, even those that can effect Alzheimer’s disease.
For example, the adequacy of our diet interacts with genes that use B vitamins and magnesium. Vegetarians need to be particularly concerned with these genes. Our exposures to toxins, medications, and internal hormone balance interact with genes that operate our detoxification system. Stress and nutrition interact with genes that produce brain chemicals (neurotransmitters) that control mood. Autoimmune processes, nutrition and gut function, all interact with genes that run our inflammation system.
Since toxins, inflammation, neurotransmitter balance, hormone balance, and nutrition resources all can have a SIGNIFICANT effect on our risks for Alzheimer’s disease and can be MODIFIED by nutrition, herbs, vitamin, minerals, supplements, stress reduction, and exercise, I find genetic tests that investigate how our body resolves imbalances in these issues to be helpful in reducing Alzheimer’s disease risks.
If you are interested in looking into the usefulness of genetic testing for MODIFIABLE risk factors, consider making an appointment by calling 203-863-3615. Genetic tests that may be run include detoxification enzymes gene tests, inflammatory and anti-inflammatory molecule gene tests, neurotransmitter production enzyme gene tests, neurotransmitter destruction enzyme gene tests, and nutritional genetic tests.
Below is a list of genes with the potential to directly contribute to Alzheimer’s disease. Since these genes do not necessarily cause the disease, but rather contribute to the disease in unknown ways, they are called genetic risk factors.
Genetic Risk Factors for Alzheimer’s disease
APOE ε2 is relatively rare and may provide some protection against the disease. If Alzheimer’s disease occurs in a person with this, it develops later in life than it would in someone with the APOE ε4 gene.
APOE ε3, the most common, is believed to play a neutral role in the disease – neither decreasing nor increasing risk.
APOE ε4 is present in about 25 to 30 percent of the population and in about 40 percent of all people with late-onset Alzheimer’s. People who develop Alzheimer’s are more likely to have an APOE ε4 than people who do not develop the disease.
Early-onset Alzheimer’s disease occurs in less than 5% of people and usually in people age 30 to 60. It appears that any one of a number of different single-gene mutations on chromosomes 21, 14, and 1 can contribute to abnormal proteins to formation. Mutations on chromosome 21 cause the formation of abnormal amyloid precursor protein (APP). A mutation on chromosome 14 causes abnormal presenilin 1 to be made, and a mutation on chromosome 1 leads to abnormal presenilin 2.
The science world is finding new genetic contributors to Alzheimer’s disease all the time.
Healthful Actions That Modify Alzheimer’s Disease Risk
Control weight, insulin, diabetes
Control inflammation**
Detoxify**
Evaluate and replenish nutritional deficiencies**
Optimize gut function
Normalize neurotransmitters, reduce stress, resolve depression**
Optimize hormone levels
Encourage learning and newness
**Genetic testing available
Risk for Developing Alzheimer’s Disease
X 38 if your age is greater than 85
X 10 if you have ever had a stroke
X 7 to 7.5 if your age is between 75-84 or if more than 1 family member had Alzheimer’s Disease
X 4.4 if you have ever been dependent or overused alcohol, tobacco, or any other mind altering substance
X 3 to 3.5 if 1 family member had Alzheimer’s Disease or if you have ever had diabetes or cancer
X 2 if you are between 65-74 or if you have ever had several head injuries or if even one head injury that resulted in loss of consciousness. If you have ever had seizures, hypertension, increased cholesterol, depression, cardiovascular disease; if you do little to no exercise, only had a high school education, have a job that requires little creative thought, or if you have ever smoked
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