Recent research suggests that having two copies of the apolipoprotein E (APOE) 4 gene not only increases the risk of developing Alzheimer’s disease but also represents a genetic form of the disorder. This new study, published in Nature Medicine, highlights a strong connection between APOE4 and Alzheimer’s, necessitating different approaches for prevention and treatment.
Neurologists Ayesha Sherzai, MD, and Dean Sherzai, MD, PhD, co-directors of the Alzheimer’s Prevention Program at Loma Linda University, provide insights on the implications of these findings and whether individuals should consider genetic testing for the APOE4 gene.
Ayesha Sherzai: The APOE4 genotype primarily influences lipid transport between cells for essential functions such as fat metabolism and cell maintenance. While some APOE genes function effectively, APOE4 is associated with lipid transport abnormalities, particularly when two copies are present.
Dean Sherzai: Genetics play a significant role in conditions like Alzheimer’s, with certain genes like APP, PSEN1, and PSEN2 showing high penetrance, indicating a high likelihood of developing the disease. The study reveals a greater influence of APOE4 genes on Alzheimer’s risk than previously thought.
Dean Sherzai: While not definitive, testing has shown a strong association between APOE4 and Alzheimer’s disease. Individuals with two copies of APOE4 often exhibit abnormal levels of beta amyloid, a key biomarker for Alzheimer’s, by age 65.
Ayesha Sherzai: Genetic testing for APOE variations is available through external companies, but may not be commonly ordered by healthcare providers. Individuals concerned about Alzheimer’s risk may consider pursuing testing privately if desired.
Dean Sherzai: Genetic testing for Alzheimer’s may be considered for individuals with a family history of the disease, as some insurers may cover testing in certain contexts. Testing typically involves a blood test or cheek swab to assess genetic risk.
Dean Sherzai: While Alzheimer’s cannot be reversed once fully developed, lifestyle modifications can help prevent or slow its progression. Nutrition, exercise, and mental activity are key factors in reducing Alzheimer’s risk.
Ayesha Sherzai: Addressing risk factors early on is crucial for maintaining brain health and potentially delaying Alzheimer’s onset. Pathological brain changes associated with Alzheimer’s can begin decades before symptoms appear, underscoring the importance of proactive brain health measures in younger adulthood.
Monitoring cholesterol, blood pressure, and blood sugar levels, and making lifestyle adjustments accordingly, can help build resilience against Alzheimer’s. Starting preventive measures early in life can significantly impact brain health and reduce the risk of developing the disease.
Dean Sherzai: By supporting brain health through consistent lifestyle choices, individuals can strengthen their brain’s “pillars” and potentially avoid or delay the onset of Alzheimer’s.
Listen to the Sherzais discuss Alzheimer’s on WebMD’s podcast.