| Lifelong Health: Healthy Lifestyle Slows Onrush of Alzheimer's Alzheimer's is a degenerative disease of the brain associated with an insidious breakdown of the brain cells, which are critical for normal memory and intellectual function. The process of degeneration is so slow that symptoms develop 20 years after initial abnormalities develop in the brain. By the time Alzheimer's disease becomes apparent, the problem is widespread and likely irreversible.
Unfortunately, the diagnosis of Alzheimer's is never definitive. Memory testing, blood tests and imaging studies suggest the diagnosis with some evidence of certainty, but never with complete accuracy. Rather, diagnosis is based on the clinical presentation of symptoms and by the exclusion of other conditions that can lead to forgetfulness.
Most importantly, the patient's history and information gained from family members is the strongest determining factor for diagnosing Alzheimer's. Clear and obvious declines in memory, such as repeating the same question or story over and over again, are usually the first warning signs of Alzheimer's. Other problems associated with the disease include difficulties with cooking, paying the bills or working, getting lost easily or becoming less rigorous about cleanliness.
Currently, testing for the gene Apolipoprotein E4 (ApoE4) is the only medical test available that has some predictive value. ApoE4 occurs in about 25 percent of the population.
There are three variants of the gene: E4, which increases the risk; E3, which has no impact on risk; E2, which appears to be protective. We inherit one gene from each parent. About 17 percent of the population has one ApoE4 gene, which confers a 50-percent increased risk of Alzheimer's. Eight percent of adults have inherited the E4 gene from each parent, and they almost always develop the disease.
There are other rare genes that occur in families that have higher incidence of developing memory loss at a very young age. Although controversial, testing for the ApoE4 gene should be done in a patient who is diagnosed before 75 or has a strong family history of the disease. Based on new federal laws, it is now illegal to discriminate against anyone known to have a genetic predisposition to any disease.
Researchers are vigorously attempting to identify more accurate tests to predict and identify Alzheimer's disease. There have been reports that new measurements appear to be of value, including certain proteins identified in cerebrospinal fluid obtained by lumbar puncture, blood tests and imaging studies.
Recently published in the journal Neurology, a report showed that a sensitive brain scan called diffusion tensor imaging (DTI MRI) could identify subtle memory problems in 50-year-olds that could not be recognized by other means. Like most other tests, this measurement may eventually be of no value, but it could lead to other breakthroughs that continually expand our understanding of this disease.
Lack of an accurate diagnosis is a serious problem that needs to be addressed. Alzheimer's disease often occurs in families, and with more definitive diagnoses, younger family members can take the appropriate steps to prevent the illness or mitigate its symptoms.
Numerous studies have examined preventable or treatable factors that lead to a higher risk of Alzheimer's disease. The disease seems to progress more slowly among lifelong learners. Physical activity is important, as is following a heart-healthy lifestyle, which includes eating right and treating elevated cholesterol and high blood pressure.
If you have multiple family members diagnosed with Alzheimer's disease (especially if diagnosis was made at an early age), many experts believe that you should take extra steps to reduce your own risk.
For example, if a parent develops the disease at 65, some recommend that beginning at age 45, the children should be treated as if they have had a heart attack. This involves assuring that the LDL or bad cholesterol is below 70, that the systolic or top blood pressure is never above 120 and that the patient take a medication called an ACE (angiotensin converting enzyme) inhibitor. Population studies indicate that this approach may delay the onset of Alzheimer's symptoms by many years.
Until research shows a clear avenue to gauge your risk of Alzheimer's, take every precaution possible to arm yourself against this devastating illness. Keep your mind sharp, exercise and follow a heart-healthy diet. By doing so, not only will you reduce your risk of Alzheimer's disease, but you will also find yourself on a renewed path to lifelong health.
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Dr. David Lipschitz is the author of the books, "Breaking the Rules of Aging" and "Dr. David's First Health Book of More Not Less." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com. Copyright 2010 Creators Syndicate Inc. |
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