Alzheimer's disease risk and APOE4 gene

Research has long shown that people who have two copies of the apolipoprotein E (APOE) 4 gene are much more likely to develop Alzheimer's disease. Now, researchers say in a new study that the gene pair is not just a risk factor, but a genetic form of the disease.

Having two copies of the APOE4 gene almost guarantees you will develop Alzheimer's disease, and symptoms are likely to start appearing at an earlier age, according to a new study. Survey results announced in natural medicine. The study authors say that the growing link between APOE4 and Alzheimer's disease may require other methods to help prevent and treat the disease.

What does this result mean for your risk of Alzheimer's disease? Should I get tested for the APOE4 gene? Below, neurologist Aisha Aisha, co-director of the Alzheimer's Disease Prevention Program at Loma Linda University in California Answers from Sherzai, MD, and Dean Sherzai, MD. The Shahzais also host a podcast about brain health called Your Brain On.

Aisha Sherzai: This is a genetic construct primarily involved in lipid transport between cells. There are certain fat molecules that need to be transported in and out of cells. Cells basically require fat for their infrastructure, production of various chemicals, and internal functions. Receptors on cells allow certain fats and proteins to enter and exit cells. These are controlled by APOE4 genotype.

Aisha Sherzai: Yes, everyone has the APOE gene, whether it's APOE2, APOE3, APOE4, or a combination of the two types.

Some genes work very well. For example, if you have one or two copies of APOE2, you don't tend to have abnormal fat metabolism. If you have APOE3, it's basically a wash. Neither protected nor harmed. But APOE4 does a really bad job. If you have a copy of APOE4, you tend to have abnormalities in this lipid transport. The situation is even worse if you have two copies of APOE4.

Dean Sherzai: Genetics influences everything. Cholesterol, diabetes, high blood pressure, and terminal diseases such as stroke all have a large genetic influence.. The same goes for Alzheimer's disease. genetic risk factors determine the outcome.

In Alzheimer's disease, we know that some genes are 100% penetrant. This means that carriers are very likely to develop features of Alzheimer's disease. [The genes] teeth: app, dog 1 and PSEN2. If you have these genes, you will develop Alzheimer's disease before you are 65 years old. Lifestyle can slow Alzheimer's disease. [changes], but you can almost certainly get it. Previously, APOE4 had the next highest penetration rate. We thought it was about 50% or so. This means that about 50% of people who live to age 85 and have two copies of APOE4 will develop the disease.

This study showed that APOE4 may be more permeable than we thought. The results of this study indicate that the APOE4 gene has a greater influence on whether a person develops Alzheimer's disease.

Dean Sherzai: No, not 100%. It only emphasizes the strong association.

Researchers have found that by age 65, at least 95% of people with two copies of APOE4 have abnormal levels of beta-amyloid in their spinal fluid, a key early feature of Alzheimer's disease. Seventy-five percent of people with two copies of APOE4 tested positive for amyloid in brain scans.

Dean Sherzai: In the general population, approximately 15-25% of the population has one APOE4 gene and approximately 2% of the population has two APOE4 genes. 40% to 50% of people who develop Alzheimer's disease, especially late-onset Alzheimer's disease, have her APOE4 gene associated with this disease. (Editor's note: late-onset alzheimer's disease Symptoms of Alzheimer's disease begin in people's mid-60s and older).

Aisha Sherzai: There are tests available to check your genetic mutations. However, these tests are not typically performed in a clinical setting. A neurologist or primary care physician will not easily dictate her APOE status.it's not [generally] Covered by insurance.

There are outside companies where you can get genetic testing done at your own expense. The decision whether to choose it or not is completely up to you. If you can afford it and want to know, you may be able to pay for it.

Dean Sherzai: If there is more than one person in your family with Alzheimer's disease, it may be controversial. Some insurance companies may agree to this in such situations, but it is rare. There will be a blood test and a swab test, and some saliva will be collected and sent to a lab.

Dean Sherzai: Once Alzheimer's disease is fully advanced, it cannot be reversed. What you can do is prevent the disease or slow its progression.

Nutrition is a very important part.Study after study has shown that plant-dominant or mind diet or mediterranean diet.

Exercise can also reduce your risk. But it doesn't just mean taking a walk around the neighborhood. Really tiring types of exercise, especially strength training, have a big impact on the brain. Studies have shown that if a person with pre-dementia did leg strengthening, his chances of developing dementia decreased by more than 40%.

We also know that mental activity is a great protector because it connects neurons. We have 87 billion neurons, and each neuron can make a few connections, or 30 to 50,000 connections. What determines this is exercise and mental activity. Keep engaging yourself, keep challenging yourself, and work toward your passions. That's what keeps you connected.

Aisha Sherzai: When the word “Alzheimer's disease” comes up, we always start thinking about our brains. You don't have to wait until you're at a certain impasse or at a certain age to think about your brain health. Alzheimer's disease does not begin with the first signs of memory loss. This is a condition in which pathological changes actually occur in the brain 20 to 30 years before the first signs of memory loss appear. Therefore, people in their 30s, 40s, and 50s need to make sure they address their risk factors now so they can maintain a healthy brain in the future.

Talk to your doctor about your cholesterol levels.Understand your blood pressure levels and health status hemoglobin A1c. Understand your numbers so you can adjust them through lifestyle changes and, if necessary, medical treatments such as medication.

Dean Sherzai: It's about building resilience. Your brain is a huge building with pillars. After the age of 20, we either knock down pillars or build more pillars that strengthen that brain. For the majority of the population, and even for those at genetic risk, the sooner we start building pillars, the more likely we are to stop Alzheimer's disease or avoid it altogether. Become.