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According to the Alzheimer’s Association, in the years between 2000 and 2015, while heart disease deaths have decreased by 11%, deaths related to Alzheimer’s disease have increased by 123%.
Alzheimer’s currently affects 5.7 million Americans, a number that is estimated to rise to nearly 14 million people by 2050, which would mean that it was afflicting over 3% of the total population.
Alzheimer’s has historically been considered unique among chronic diseases for its relative lack of treatment options, whether curative or preventative. The de- velopment of the disease has been poorly understood, and its progression – the literal losing of ones previously rational and cog- nizant mind – is certainly a scary thing. As such, within the popular culture there has developed something of a helpless blind fear associated with the risk of developing Alzheimer’s disease.
Fortunately, substantial gains have
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been made over the past decade in better understanding the pathophysiology of Alzheimer’s disease, as well as developing research to better understand the risks and determine potential prevention strategies to ward off its progression.
Genetic Factors
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It is now well understood that there is a genetic component to Alzheimer’s disease. Having a first degree relative with Alzheimer’s increases an individual’s risk of development by 10-30%. The stron- gest genetic risk comes with Early Onset Alzheimer’s (where the diagnosis is made before the age of 65). Fortunately, this form accounts for less than 1% of total Alzheimer’s disease cases. These cases notwithstanding, we now understand that there are a number of particular genes that play a factor in Alzheimer’s progression. Perhaps the most discussed is Apolipo- protein E (APOE). Variants of this gene are also associated with higher risk of cardio- vascular disease and Type II Diabetes. It is important to remember that in these cases having a particular gene does not guaran-
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tee development of Alzheimer’s disease. It is simply an additional risk factor, and all the more reason to focus on the preventa- tive strategies that have been shown to be effective. For people interested in knowing their genetic risk, testing is available at our clinic.
The Inflammation Connection
It is now known that low-level, long- term systemic inflammation is an aggrava- tor of most chronic diseases, from cardio- vascular disease to arthritis to cancer, and Alzheimer’s disease is no exception. The clearest example of this is in cases of direct head trauma and concussion. These inju- ries cause immediate acute inflammatory processes to occur within the brain, and also lead to increased risk of developing Alzheimer’s later in life. This is especially the case when injuries occur repetitively, as is the case with some professional athletes. But inflammation in the brain does not only come from direct head injury. Chronic inflammation throughout the body can affect brain changes over time, including the accumulation of amyloid plaques and particular proteins that become the visible hallmark of Alzheimer’s disease on imag- ing. Understanding the how’s and why’s of chronic inflammation can go far in the determination of proactive prevention strat- egies for the avoidance of many chronic diseases, including Alzheimer’s.
“Type III Diabetes?” A vitally important step in the un-
derstanding of Alzheimer’s disease is the acknowledgment of its strong connection with elevated blood sugar and insulin re- sistance. This link is so strong that in 2005
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