My grandmother was my favorite person in the world. She stepped in and took care of me and my siblings in Trinidad while my mom worked immensely hard to secure a better life for us in the US. My grandma always had great advice for me, and I mean ALWAYS. She was a person who had gained much wisdom through her life experience and was willing to share what she had learned in the most unobtrusive way possible. She was a real sweetheart. Everyone who knew her loved her.
About ten years ago, my grandma began to show signs of mild cognitive decline. Around the same time, a few of her other siblings had started to display similar symptoms. Over time, the decline progressed and my grandma began to experience bouts of confusion where she would begin packing her things to go to Port of Spain or some other city in Trinidad. I’d have to explain to my grandma that we were in the US now and she would need to take a plane to get to said Trinidadian city. Sometimes she got it; sometimes she didn’t. Once I had to lock the door and literally stand in front of it to prevent my grandma from leaving. She looked so sad and confused. The look she gave me broke my heart. I’m tearing up now as I remember it.
Cognitive Decline, Dementia, Alzheimer’s Disease: what’s the difference?
First of all, let’s tackle cognitive decline. Cognitive decline is a process—the process of losing your memory and your cognitive abilities such as thinking and otherwise processing information. A person experiencing the early stages of cognitive decline is said to have mild cognitive impairment (MCI) and people with MCI are at increased risk for developing dementia and Alzheimer’s disease.
Dementia is a disorder that affects your ability to process information. It can affect memory, planning, judgment, and reasoning abilities and frequently leads to personality changes. Dementia can have many different causes and is actually sort of an umbrella term for a variety of things that can take place within the brain leading to the loss of these functions. For example, dementia can be caused by a traumatic brain injury, a person can have vascular dementia as a result of having one or more ischemic strokes, or a person can develop a specific type of dementia as a result of accumulating what’s known as plaques and tangles within the brain.
Alzheimer’s disease is a specific type of dementia that results from the accumulation of what’s known as beta-amyloid proteins and neurofibrillary tangles within the brain. Alzheimer’s is the most common form of dementia in the elderly. Although we recognize the symptoms and can postulate, a person can’t be definitively diagnosed with Alzheimer’s disease while they are living. The definitive diagnosis comes about when the brain tissue is examined after death and these plaques and tangles are visualized within the brain.
The Genetic Component
There are definitely genetic links to dementia and Alzheimer’s disease. Apolipoprotein E (APOE) is a cholesterol carrier within the body. Depending on the allele or type of APOE that you have, you can have an increased or decreased risk of developing dementia and Alzheimer’s disease. Stay with me here. It gets easier after this paragraph. Studies have demonstrated that the strongest genetic risk factor for Alzheimer’s is the ε4 type of APOE. Individuals age 55 years or older who have the ε4 type have about 20% increased risk of developing dementia as a result and the increased risk is 12.9% in those older than 75 years of age. This is compared to those who have the most common type, ε3. Those who have the ε2 type enjoy decreased genetic risk compared to those with the ε3 type.
Individuals with the ε4 type have increased risk of late-onset Alzheimer’s disease and they have increased risk for early-onset Alzheimer’s as well. Nevertheless, not everyone who has the ε4 type of APOE ultimately develops dementia, even when they live comparatively long lives. This suggests that environmental factors may increase or decrease the effect of this genetic variation on the risk of dementia and Alzheimer’s disease.
Preventing or Delaying Cognitive Decline
If you’re like me and you have a strong family history of dementia, you’re probably wondering if there is anything that you can do to prevent or delay the onset. I’ve got great news for you: there is! Here are a few simple things you can do to decrease your risk or rate of progression for cognitive decline:
- Laugh often: Research shows that laughter improves memory loss and dementia. Social interactions and social support play important roles in preventing and delaying cognitive decline.
- Get your glucose levels under control: Research shows that mild cognitive impairment is more likely to progress to dementia in individuals who also have type 2 diabetes. If you’re not diabetic, you’re not necessarily off the hook though. Studies show that higher glucose levels may be a risk factor for dementia, even among individuals who aren’t diabetic. Simple steps you can take today to help enhance glucose control are reducing or eliminating processed foods from your diet and replacing them with whole foods such as whole grains, fruits, and vegetables.
- Eliminate vascular risk factors: Research shows that high systolic (top number) blood pressure and low diastolic (bottom number) blood pressure, stroke, and heart failure are all associated with increased risk for dementia and Alzheimers in both individuals who carry the APOE ε4 allele and those who don’t.
- Take frequent vacations: That’s one way to do it! Research shows that individuals who engaged in leisure activities more often had decreased risk of dementia and Alzheimer’s disease.
As I Always Say, Genetics aren’t the Entire Story
Further research demonstrates that, even in individuals who bare the increased genetic risk associated with carrying the APOE ε4 allele, higher education, active leisure activities, controlling blood sugar, eliminating vascular risk factors, and maintaining a mentally, physically, and socially active life appear to reduce the risk of dementia and Alzheimer’s disease related to APOE ε4 by about 40%. In other words, just because you carry the APOE ε4 allele does not necessarily make dementia your unavoidable fate.
Click here to learn more about Dr. Janelle Louis, ND, the author of this blog post.
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