Understanding Alzheimer’s disease

Changes in the brain can occur 15-20 years before symptoms are recognizable. Amyloid-beta plaque and neurofibrillary tangle build up in the brain is typically well-established by the time initial symptoms of cognitive decline appear.


Related Conditions Help Explain Probable Processes

The development of Alzheimer’s disease is not caused by a single factor.  Research has shown that heart disease, thyroid dysfunction, type 2 diabetes, inflammation and depression are medical conditions associated with increased risk for Alzheimer’s disease.  There is well-established research demonstrating that managing these conditions through lifestyle behaviors such as diet, exercise, stress management, and adequate sleep is warranted. In fact, the American Heart Association’s stance on brain health is, “A large body of peer-reviewed, published scientific research shows that physical activity, management of vascular risk factors, such as controlling blood pressure, eating a healthy diet and not starting or stopping smoking can help prevent Alzheimer’s disease.”


Role of Brain Stimulation

“The American Heart Association also agrees that other psychosocial measures suggested by the Alzheimer’s Association, such as staying socially engaged and undertaking challenging activities as additional ways to reduce the risk of Alzheimer’s disease and maintain a healthy brain.” As is mentioned in the American Heart Association’s statement, in addition to research on managing vascular risk factors, research has also shown a strong association between socialization, hearing, and both early-life education and ongoing brain engagement (neuroplasticity) throughout the lifespan.


Alzheimer’s Genetics

Research evaluating whether learning genetic risk in conjunction with modifiable lifestyle risk factors for cardiovascular disease found that patients who knew both their non-modifiable genetic risk and modifiable lifestyle risk factors were more likely to take action on their modifiable risk factors. Like in cardiovascular disease, the gene Apolipoprotein E (ApoE) is associated with disease risk.

However, sporadic Alzheimer’s disease (the most common form) is not caused by genetics, but rather genetics are a piece of the puzzle. ApoE genotype is a unique, single-gene indicator for Alzheimer’s disease risk that can provide genetic risk information to patients. There is significant association between ApoE genotype and Alzheimer’s disease risk, with that risk increasing significantly with age for those person’s carrying a single copy of the ApoE-e4 allele and even greater for individual’s carrying two copies of e4.  Please see the white paper for further information on ApoE research.

There are additional protective and risk enhancing genes related to Alzheimer’s disease, as well as genes that influence factors related to cognitive health, such as vitamin and mineral absorption, response to pharmacological treatments and more. To have a better understanding of disease risk, development, and management, the eClinic program includes both biomarker testing for metabolic irregularities indicative of related diseases and genetic testing for risk.  In addition to being informative about disease processes, at-risk patients can benefit from learning their Alzheimer’s genetic risk by being:

  • Empowered to take actionable, risk-modifying steps early,
  • Educated for life-planning decisions, and
  • Identified early for clinical trial enrollment qualification based on genotype information.

No Cure, BUT Actionable Steps Available to Help

While there is not a medicine available to cure Alzheimer’s disease, there is strong evidence that managing these related medical conditions and engaging the brain throughout the lifespan may delay the onset of Alzheimer’s disease for people at high genetic risk, slow the progression of Alzheimer’s disease for people who are in the early stages of disease development, or even possibly reverse some symptoms of mild cognitive impairment.

There is hope in the fight against Alzheimer’s disease, just like there is for heart disease (also an incurable disease), to add more quality years of health to your lifespan through behavioral change and lifestyle choices.

  1. American Heart Association. What is Brain Health? Accessed on October 22, 2018.
  2. Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer’s disease: an analysis of
    population-based data. Lancet Neurol 2014; 13: 788–94.
  3. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017; 3902673-2734.
  4. Ngandu T, Lehtisalo J, Solomon A, et al.  A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015; 385:2255-63.
  5. Widen E, Aro J, Pollanen P, et al. Receiving personal genome-based disease risk information motivates individuals to take action to prevetn cardiovascular disease (CVD). Presented at the American Society of Human Genetics conference in San Diego, CA. October 19, 2018.



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