AboutMary Gordon Expertise Several years direct experience as caregiver for family member who died of end stage AD. Did lots of research and dealt with a lot of health care professionals and caregivers over the 7 years from diagnosis to the end. Used various care options from community based resources to increasing levels of institutional. Mother of three, two born during our loved one's decline, so I know what it is to be the ham in the sandwich, taking care of the older generation and the younger at the same time and trying to balance everyone`s needs. Ask me, I`ve probably been there, done that. We made lost of mistakes and learned everything the hard way - but you don`t have to! If I can`t answer your question, I`ll steer you to a place or person who can.
Experience Currently a program manager for a large utility company. My Alzheimers experience comes from having the illness in our family. Out of necessity, we did a lot of research in order to understand the disease, plan for what might come next, and make the right decisions to help and support our loved one. Please note, I am a Canadian living in Toronto, and therefore am not the best person to ask about US regulations and insurance rules!
Question My girlfriend is 58. Her sister has alzheimers. Her sister has had it for about five years or so. I think she is about 62. My girlfriend has two brothers who are older and show no signs of alzheimers. What are the odds that my girlfriend will get the disease?
Answer Gary
The only form of Alzheimer Disease (AD) which appears to have a definite genetic link is a Familial Alzheimer Disease (FAD). FAD forms only a small minority of all cases of AD - it's uncommon. Members of these families have a 50-50 probability of developing AD and it usually appears before the age of 65. Just because a person develops early onset Alzheimer's (before 65) does NOT mean they have FAD - many cases of early onset are sporadic - they just happen and are not related to family inheritance.
If FAD is in your girlfriend's family, she will likely have a family history of people becoming demented in middle age. Sometimes in the past, this wasn't recognized as Alzheimer's, so you might hear stories about relatives going "funny", having nervous break downs, being put away etc.
For routine Alzheimer's disease, there are some genes that have been identified that apparently raise a person's risk of developing dementia. The gene which has recieved the most attention is the APOE gene. Each gene is composed of two alleles (one inherited from the mother and one from the father). There are three different alleles, the APOE2, APOE3 and APOE4. The APOE4 allele is thought to carry the higher risk whereas the APOE2 carries the lower risk. Persons with the APOE4-APOE4 gene combination are thought to have the highest risk while persons with the APOE2-APOE2 combination have the lowest.
The problem with the pure genetic theory is that some persons with the APOE4-APOE4 combination (highest risk) do not develop AD while some persons with the APOE2-APOE2 combination (lowest risk) do. It is for this reason that research is investigating potential environmental factors which may be triggers of the disease. Except for FAD, there is nothing which can be proved or disproved with certainty at the present time. There is some debate as to whether or not the familial form (FAD) is even the same disease as Alzheimer's, or two separate diseases with a similar pathology. So genetic testing doesn't really tell anyone whether they will get Alzheimer's or not.
You have to keep firmly in mind, that even with NO family history of Alzheimer's, your odds of developing some sort of dementia increase with age (and that is true for all of us). By the time you are in your 80's, if you are lucky enough to live that long, your odds of having some cause of cognitive impairment are close to 50-50. Alzheimer's is just one cause. Our brains are delicate and there are a whole raft of health issues that can impact cognition and cause dementia. Thyroid problems, strokes and other vascular blockages, damage from substance abuse, Parkinson's Disease, vitamin deficiencies, drug interactions, Lewy Body dementia, normal pressure hydrocephalus, Pick's disease, and on and on.
Your girlfriend's best odds of keeping her brain intact and healthy, and enjoying a full life, are to do what our mom's and doctors have always told us, and few of us actually take to heart. Keep your weight under control. Exercise. Don't smoke. Don't abuse medications or alcohol. Get enough sleep. Avoid stress. Keep your blood pressure and cholesterol under control. If you have diabetes, take close care of it. Eat well. Get regular check ups and follow your doctor's advice. Stay involved and interested in life so your brain gets some stimulation.
If your girlfriend is worried, she should see her doctor and talk to him about what she knows of her family history. She should also think about things she can do to improve her overall health, so she increases her odds of having a long active life with a healthy brain.
