3 Myths About Alzheimer’s Disease You Should Stop Believing
A complex neurological condition that strikes more than 5 million Americans, Alzheimer’s disease is complicated and scary. But misconceptions about Alzheimer’s risk factors and ways to prevent Alzheimer’s can stand in the way of your health.
Ming Hai for Reader's DIgestWhy aren’t more people taking steps to reduce their risk of Alzheimer’s disease? The answer to that question is complex, but at least some of it stems from pervasive societal myths about who is at risk for this disease. Understanding these myths can help you to put them in their place, as well as find the motivation you need to get off the couch, stock the fridge with produce, and sign up for that yoga class. Let’s take a look at some of the more common myths that may stand between you and your ability to outsmart Alzheimer’s.
Myth #1: “If I live long enough, I will get Alzheimer’s disease.”
Many people assume that forgetting and a lack of mental clarity are normal consequences of aging. They’re not, and the best way to show this is with a story about a remarkable autopsy. Within hours after 115-year-old Hendrikje van Andel-Schipper died of cancer, scientists transported the Dutch woman’s body to the University of Groningen in the Netherlands. As expected, during autopsy they found tumors in Andel-Schipper’s stomach, liver, kidneys, and armpit. It’s what they didn’t find that stunned them. In her brain, they’d expected to see tangles of dead or damaged cells and clusters of plaque, both signs of Alzheimer’s disease.
To their amazement, however, they found no hardened plaque and very few tangles. Her blood vessels were equally free of disease. And when the scientists tediously counted the number of a specific type of brain cell in one part of Andel-Schipper’s brain—and then counted again just to be sure—the tally reached higher than 16,000, roughly the number of cells they would have expected to find in a healthy 60-year-old in the equivalent region of the brain. They concluded, “. . . in contrast to general belief, the [age] limits of human cognitive function may extend far beyond the range that is currently enjoyed by most individuals. . . .”
She’s no anomaly. We can infer from their life accomplishments that many others lived into old age with vibrant cognitive health, though scientists didn’t have the opportunity to dissect others’ brains. The artist Pablo Picasso produced a torrent of etchings and paintings in the years just before his death at age 92. Actor George Burns won an Academy Award at the age of 79, starred in a film just two years before his death at age 100, and remained witty. When asked his secret of achieving old age, he famously said, “If you live past one hundred, you’ve got it made. Very few people die past that age.” Jimmy Carter, Henry Kissinger, Betty White, and many others have remained sharp-witted well into their 90s.
And then there’s Jeanne Calment, who lived to age 122. French neuropsychologist and epidemiologist Karen Ritchie examined Calment four years before her death. Ritchie found that the then 118-year-old Calment was incredibly sharp-witted. After meeting with Calment several different times over a period of many months, Ritchie concluded that Calment had “no evidence . . . of senile dementia.”
Myth #2: “If Alzheimer’s disease runs in my family, I’ll eventually get it no matter what I do.”
The genes that we inherit from our parents do influence whether we will eventually develop Alzheimer’s disease, among others. But we’ve learned that they don’t predict our future with absolute certainty. Whether we carry an Alzheimer’s gene or not, our risk for developing the disease doubles every five years after age 65, and it reaches nearly 50 percent after age 85. In other words, we all have close to a 50 percent chance of developing Alzheimer’s disease after age 85. For someone who has one copy of the ApoE4 gene, however, risk reaches 50 percent a decade earlier, by age 75. Someone with two copies of this gene (inheriting one from each parent) has a 50 percent chance of developing Alzheimer’s disease by age 65.
Those statistics, however, are not quite as dire as they may seem. First, while ApoE4 raises risk, other genes may also be present that lower risk. Second, as research is showing, you can outsmart the ApoE4 gene and diminish the likelihood of future cognitive impairment by making lifestyle changes to protect your brain.
For example, in one study, fit study participants who were carriers of the ApoE4 gene had brain scans comparable to those of people at low risk for developing Alzheimer’s disease, whereas sedentary study participants who were carriers of the same gene experienced a 3 percent shrinkage in this area of the brain over the same period of months. In another study, participants who were carriers of the ApoE4 gene were able to postpone the development of Alzheimer’s disease by almost a decade if they spent their adult lives immersed in intellectually enriching activities.
It’s important to understand, however, that you can’t outsmart all Alzheimer’s genes. Several years ago, neurologist Francisco Lopera told me of 12 interrelated families in Antioquia, Colombia, whose members were experiencing Alzheimer’s symptoms often around age 45. For most people, dementia symptoms don’t set in until after age 65 or later. Intrigued, I agreed to help Lopera discover the gene mutation that might be at work. We soon learned that the extended family members with early-onset dementia numbered in the thousands, and they were passing on a segment of DNA from one generation to the next that contained a defective gene called presenilin 1 (PSEN1). If one parent has this particular gene mutation, there’s a 50 percent chance that each of his or her children will have it, too. Those who inherit the mutant gene will develop early-onset Alzheimer’s and, at the moment, there’s nothing they can do to stop it.
I tell you the story of this large Colombian family because sometimes people confuse the ApoE4 with this or other PSEN1 gene mutations that they may have heard or read about in news reports, mistakenly thinking that, based on their family history, an Alzheimer’s diagnosis is inevitable when, in reality, it’s not. If you have a strong family history of Alzheimer’s disease, you can quickly get a sense of which gene your family members are likely passing down by considering two questions:
1. Have any of your family members developed Alzheimer’s before age 60?
2. Did you develop Alzheimer’s symptoms before age 60?
If you answered “no” to both questions, then you probably do not have one of the rare, very serious mutations such as the one in the presenilin gene. Yes, you may have one or two copies of ApoE4, but these are the genes you can challenge and possibly outsmart.
If you answered “yes” to either or both questions, remember that these gene mutations are exceedingly rare, so you may not have any detectable mutation. However, you may wish to undergo genetic testing. Genetic testing is expensive, and it is not usually reimbursed by insurance. It’s also a serious undertaking, which not only affects you but also your children and your grandchildren. But it may help you to plan for the future.
Myth #3: “I don’t need to worry about Alzheimer’s disease because no one in my family has it.”
It may surprise you to know that you can develop Alzheimer’s disease even if you can’t think of one family member with this disease. We’re all at risk for Alzheimer’s. Remember the statistics I mentioned earlier: We all have a 50 percent chance of developing Alzheimer’s disease after age 85. Most people diagnosed with late-onset Alzheimer’s disease do not test positive as carriers for any of the known Alzheimer’s genes.
In addition to genetics, many other factors play a role in determining your risk for developing Alzheimer’s. You may be at higher risk for Alzheimer’s because of a past history of concussions, because of high blood pressure or another health problem, or because of your lifestyle.
No matter whether you can trace Alzheimer’s disease through several generations of your family or not, it’s still important to take steps to outsmart this disease. This disease is very common as we age, so everyone is at risk.
Protect your brain from dementia and stay sharp for life with the 75-plus tips in Outsmarting Alzheimer’s by Kenneth S. Kosik, MD. Learn more and buy the book here.