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Dementia Risk: Should You Consider Genetic Testing?

By Medisys on October 01 2015 | Brain Health, News

According to the Alzeimer's Society of Canada, there are an estimated 564,000 Canadians currently living with dementia - plus about 25,000 new cases diagnosed every year. By 2031, that number is expected to rise by a whopping 66 per cent.


Does a family history of Alzeimer's mean you are at risk?

Sometimes. The lifetime risk of Alzeimers' disease is nearly 1 in 5 for women and 1 in 10 for men.  Up to 30% of people with Alzheimer’s have a first-degree relative with the disease (a parent or sibling). About 70-75% of cases have no family history. Only about 5% of all Alzheimer’s cases are due to an autosomal-dominant gene. However, approximately 60% of early onset Alzheimer's disease cases have a family history. 

The vast majority of people with Alzheimer’s disease have what is called "late-onset" Alzheimer’s disease. The late-onset form affects 95% of people with the disease, and is by far the most common form of dementia. There is no known single gene attributed to late-onset Alzheimer’s disease.

Researchers have identified susceptibility genes that confer the relative likelihood, or risk, but not certainty, for the late-onset disease. The main susceptibility gene is the apolipoprotein E gene (APOE), which is involved in lipid transport and cholesterol function. One of the three forms of this gene (the APOE ε4 allele) is associated with a 50 – 55% increase in the lifetime risk of Alzheimer’s disease, and only if you have two copies of the ε4 allele. Some people without the APOE ε4 gene develop Alzheimer’s disease, and some people with it never develop the disease at all.  Click here to learn more about genetic testing. 


Is there anything you can do to manage your risk?

Yes! There are many things you can do to reduce your risk of dementia including medical interventions and lifestyle changes. Research suggests that dietary changes (following the MIND diet) can reduce your risk of Alzeimer's by as much as 50%. Other research has shown that certain foods have a brain protective benefit, such as pomegranate. Moreover, healthy lifestyle behaviours including sufficient sleep, regular exercise, and "exercising your mind" have been shown to have significant preventive brain health benefits as well. Click here to discover eight brain boosting behaviours. Your lifestyle choices have an additive effect on the likelihood that a genetic risk for Alzheimer’s will actually express itself during your lifetime.  If you would like to speak with a preventive health physician to learn more about what you could do to manage your risk, click here. 


Alzheimer’s disease vs. normal aging 

Up to 40% of Canadians over the age of 65 will experience at least some degree of cognitive decline - such as a slight decline in memory test results - in most cases, this cognitive loss is simply a part of normal aging. Memory loss that disrupts daily life may be a symptom of Alzheimer's or another dementia.  Here are ten warning signs. Alzheimer’s Disease is the most common form of dementia - accounting for up to 80% of all dementia cases. It is a devastating, progressive brain disease characterized by severe memory loss. There was a time when becoming “senile” was seen as just another part of the aging process. Now we know better. Alzheimer’s, like diabetes or heart disease, is a chronic condition that has both genetic (inherited) and non-genetic causes.


Should you consider genetic testing?

Risk of susceptibility to Alzheimer's disease increases with age, with the highest likelihood found in those over 85. Late-onset Alzheimer’s is difficult to predict, as your risk is influenced not only by genetics, but also lifestyle and environmental factors.  Because late onset Alzheimers' is difficult to predict, genetic testing is not typically recommended to assess risk for this form. Early-onset Alzheimer’s disease occurs before the age of 60, and is rare.  Individuals with a family history of Aleimer's and specifically early onset Alzheimer's may want to consider genetic testing to better understand their risk. 


Not all people diagnosed with Alzheimer’s disease actually have the disease.

Many people diagnosed with Alzheimer’s in life are found, after death, to have another form of dementia altogether. Autopsy is the only way to confirm the diagnosis. Many mis-diagnosed cases have a preventable form of dementia called vascular dementia. This dementia is caused by poor cardiovascular health, which damages the blood vessels of the brain. High cholesterol, diabetes, heart disease, smoking, and high blood pressure are all risk factors for this form of dementia. 


Behaviors that increase your risk of cognitive decline and Alzheimer’s:

  1. Sedentary behaviour (note, if you have a desk job, you are at higher risk of being sedentary
  2. Eating processed foods and consuming an inadequate quantity or variety of fruits and vegetables 
  3. Chronic stress 
  4. Poor sleep health (<6 hours of sleep per night on a regular basis
  5. Poor cardiovascular health, high cholesterol, and high blood pressure 
  6. Being overweight or obese 
  7. Lack of engagement in mentally stimulating tasks 
  8. Consuming too much alcohol (click here to find out how much is too much) 
  9. Smoking (when it comes to cigarettes, there is no safet amount - even one cigarette a day increases your risk) 
  10. Being generally unhappy, unfulfilled, lonely, disconected or unsatisfied 

For most of us, these damaging behaviours are more important than our genetic risk because they may amplify underlying susceptibility, and accelerate brain aging.  Take care of your health, book or inquire about a Medisys preventive health assessment today.  Making brain-healthy choices every day could reduce your chances of cognitive decline, no matter what your genetic risk may be. When it comes to behavior change, today is always the best day to start making your brain health a priority.


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