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Alzheimer’s Update: Genetics, Research, and Care

Nov 15, 2017 02:00PM ● Published by Caley Breese

By Caley Breese

In 1983, then-President Ronald Reagan declared November as Alzheimer’s Disease Awareness Month. Little did he know at that time, the disease would one-day affect his own life. His personal struggle with the disease would end with his death in 2004 after being diagnosed in 1994. His hope to find a cure remains.

With recent news regarding Alzheimer’s disease remaining less than optimistic, we reached out to a local expert to find out more about recent research, symptoms, and the possibility of delaying the potential onset of this frustrating and heartbreaking disease.

According to the Alzheimer’s Association, nearly 5.5 million Americans have Alzheimer’s. Additionally, 1 in 10 people over the age of 65 has Alzheimer’s.


What is Alzheimer’s?



Alzheimer’s is a form of dementia and is the most common type among adults. According to the National Institute on Aging, it is a progressive brain disorder that slowly impairs memory, as well as thinking skills and the ability to complete simple daily tasks.

“Alzheimer’s is a degenerative disease, meaning that it leads to degeneration of the neurons of the brain,” explains Dr. Shariff Dunlap, M.D., a neurologist with Anne Arundel Medical Group.  “This in turn will make it more difficult for the brain to communicate with the body, leading to dysfunction such as difficulty eating, walking, talking, and using the bathroom.” More specifically, patients who suffer from the disease often forget how to swallow, and speaking can be affected as the patient struggles to process words in the brain and then relay them to the vocal cords.

While scientists are not fully certain what causes Alzheimer’s, many factors are being looked at in the research process. As the National Institute on Aging states, increasing age is the most common risk factor for Alzheimer’s as well as how age-related changes in the brain can harm nerve cells, thus contributing to the disease. Genetics also play a role in the onset of Alzheimer’s; however, this tends to play a role in the more rare form, early-onset Alzheimer’s.

“There are different forms of Alzheimer’s, of which there is a subset of rare inheritable forms due to genetic mutations,” Dunlap explains. “They often are ‘autosomal dominant,’ meaning they are seen generation after generation. They also tend to occur at a younger age than the more common form of Alzheimer’s.”

Dunlap advises that if Alzheimer’s is common in your family—specifically early-onset Alzheimer’s—then you should speak with your doctor about this sooner rather than later, as this form of Alzheimer’s can develop as early as age 35. Additionally, Alzheimer’s does have a higher occurrence in women than men. According to the Alzheimer’s Association, approximately two-thirds of Americans with Alzheimer’s are women.

Late-onset Alzheimer’s is more common and signs usually show up in adults in their mid-60s. While everyone is different, the factors of developing late-onset Alzheimer’s include a mix of genetics, lifestyle, and environment.

“There is genetic testing for the rare autosomal dominant forms of Alzheimer’s,” Dunlap explains. “There is also a ‘risk gene’ called APOE that increases your risk of having Alzheimer’s. However, it does not dictate that you will develop the disorder.”

Some common symptoms that are associated with Alzheimer’s are memory impairment (the most common and typically initial symptom), executive dysfunction, loss of insight, and decline in problem solving and judgment. Less common symptoms include seizures and motor dysfunction.


Alzheimer’s Fast Facts



(source: Alzheimer’s Association)

More than 5 million Americans are living with Alzheimer’s. By 2050, that number could reach as high as 16 million

Every 66 seconds someone in the United States develops Alzheimer’s

Approximately two-thirds of Americans living with Alzheimer’s are women

This year, Alzheimer’s, along with other dementias, will cost the United States an estimated $175 billion in Medicare and Medicaid billing

Alzheimer’s is the 6th leading cause of death in the United States


Recent Research



Alzheimer’s was first discovered in 1906 by Dr. Alois Alzheimer; however, it was not until about the 1970s that research on the disease really began. In 1974, the National Institute on Aging was formed, playing and continuing to play a key role in the support of Alzheimer’s research. Right now, Alzheimer’s is the sixth leading cause of death in the United States. Researchers and scientists are working tirelessly to find out more and have a better understanding of this progressive disorder.

“There are many institutions across the United States that are funded by the National Institute on Aging that conduct research in regards to Alzheimer’s,” Dunlap says. “Locally, Johns Hopkins would be the closest. Peer journals, conferences, such as the American Academy of Neurology and others are often how information is disseminated nationally and locally.”

Dunlap states that right now there is no evidence that shows we can prevent or delay the onset of Alzheimer’s; however, he advises that keeping up with a healthy lifestyle, such as a nutritious diet, solid exercise routine, and good social interaction, is a great benefit. Exercise increases blood flow and oxygen to the brain, which is advantageous to the brain and can keep our minds healthy for the long run. While there is no cure for Alzheimer’s yet, Dunlap remains hopeful on the research being conducted.

“Over many years, we have a better understanding of what goes wrong with Alzheimer’s,” he says. “The most promising research in my opinion are the ones targeting specific compounds known to be present in Alzheimer’s, such as beta amyloid and tau proteins. The more we learn, the more optimistic we become of the possibility of preventing, stopping, or at least slowing down Alzheimer’s.


Alzheimer’s in the News



The most recent news about the connection between developing Alzheimer’s and sleep is an eye-opener! The New York Times reports that while not everyone with chronic sleep issues will develop Alzheimer’s, a study conducted by the University of Wisconsin shows that even adults with normal thinking and memory skills are at a greater risk for developing the disease if they are poor sleepers. Study participants who reported poor sleep quality where found to have more of the biological markers for Alzheimer’s such as build-ups and tangles of toxic proteins, namely beta-amyloid and tau, as well as brain-cell damage and inflammation. While a direct link is still unclear, the clinical thinking is that the brain neutralizes or eliminates toxins during sleep, so sleep loss could interrupt this important process.


Caregiving



Caring for a loved one with Alzheimer’s can take a physical, mental, and emotional toll on family and friends. The National Institute on Aging recommends that becoming well-educated about the disease and its progression is very important and a good way to deal with the stress of caring for a loved one. A strong support network and securing relief care can also help. “Alzheimer’s can affect the whole family, and it is important that family members are involved if a patient is diagnosed with Alzheimer’s,” Dunlap explains. “Caring for your loved one can become quite burdensome if it is entirely done by one person, particularly in the later stages of the disease. It is important to know that currently there is no cure for Alzheimer’s, and the current mainstay medications do not slow down the process, but rather provide symptomatic improvements.”

Editor’s Note: If you haven’t already, check out last month’s issue of What’s Up? for the first of our two-part piece series on memory and Alzheimer’s, or read online here.

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