Risk Factors of Developing Alzheimer’s Disease

This is the Truth, Lies Alzheimer's Show. A warm welcome to all of our listeners. We appreciate every single one of you. I'm Ken Poglia, but more importantly, I'm here to bring you your host, Alzheimer's and dementia expert, best-selling author, and world-renowned public speaker, Lisa Skinner. We've got a very special episode planned for you today. As promised from the last episode, Lisa Skinner will discuss how a person can minimize their risk of developing Alzheimer's disease. But first, some business. Welcome to Global Media Network LLC and Passionate World Talk Radio. Passionate World Talk Radio is a wholly owned subsidiary of Global Media Network LLC. Our motto is: Educate, Enlighten, and entertain. And with that, I'm very pleased to bring you the host of today's program and the host of the Truth, Lies Alzheimer's show, Lisa Skinner. Lisa, how are you?

I'm doing great. Thanks for that wonderful introduction, Ken. You're awesome. So, as Ken told you, on today's episode, as promised, I'm going to share with you what the risk factors are and what can be done to minimize the risk of you developing Alzheimer's disease. Currently, there is no proven way to fully prevent Alzheimer's disease. There are characteristic changes to the brain that are seen with Alzheimer's disease, but what actually causes those changes is not fully determined. It is likely due to a combination of genetic, lifestyle, and environmental factors. And there are currently more than 6 million Americans living with Alzheimer's disease in the U.S. today. Most of them are age 65 or older that may have dementia caused by Alzheimer's disease. And more than 50 million people worldwide are living with dementia. It is projected that number is going to more than triple to 152 million cases globally by the year 2050 if a cure is not found. There are over 100 different causes of dementia, with Alzheimer's disease being the number one cause. However, experts in a recent report say 2 in 5 dementia cases could potentially be delayed or even prevented by certain lifestyle choices. The various risk factors from early life to midlife and old age are linked to people's risk of dementia. Less education, for example, before the age of 45 is associated with 7% of dementia cases Because the more we learn in early life, the more cognitive reserves we build up in our brains. The leading risk factor from the age of 45 to 65 is hearing loss, which is linked to 8% of dementia cases. But using hearing aids can help offset this risk. Recent research from Johns Hopkins University reveals that Mild hearing loss is linked with walking problems, increased falls, and dementia. In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, MD, PhD, and his colleagues found that mild hearing loss doubled your dementia risk. Moderate loss tripled risk, and people with severe hearing impairment were 5 times more likely to develop dementia, followed by a traumatic brain injury, hypertension, alcohol abuse, and obesity. Smoking at ages older than 65 is linked to 5% of dementia cases, followed by depression social isolation, physical inactivity, air pollution, and diabetes. The brain scans show us that hearing loss may contribute to a faster rate of atrophy in the brain. Atrophy means shrinking. Lynn says hearing loss also contributes to social isolation. You may not want to be with people as much, and when you are not engaged in conversation as much, then you become isolated and put yourself at more risk for developing dementia. These factors may contribute to development of dementia. As you walk, your ears pick up subtle cues that help with balance. Unfortunately, hearing loss mutes these important signals, Lynn notes. It also makes your brain work harder just to process sound. This subconscious multitasking may interfere with some of the mental processing needed to walk safely. Research shows that everything from genes and noise exposure to medications, head injuries, and infections can play a role in hearing loss. Trouble detecting soft or high-pitched sounds is often the first sign that shows up and have been damaged. Soft sounds include phone conversations or background noise in settings such as restaurants. High-pitched sounds may include children's voices. Ringing in the ears, also called tinnitus, is another early sign of possible hearing loss. Many conditions have been found to increase the risk of dementia. Scientists continue to unravel the complex brain changes involved in the onset and progression of Alzheimer's disease, and it seems likely that changes in the brain may be a decade or more before memory and other cognitive problems actually begin to emerge. During this preclinical stage of Alzheimer's disease, People seem to be symptom-free. However, toxic changes are already taking place in the brain. Abnormal deposits of proteins form amyloid plaques and tau tangles throughout the brain. Once healthy neurons stop functioning, they lose connections with other neurons and begin to die. The majority of people are not typically diagnosed with dementia until they are already into the mid-stage of the disease. For this reason, it's often difficult to distinguish signs of memory loss as part of the normal aging process with a brain disease until it progresses and becomes blatantly obvious. One of the great mysteries of Alzheimer's disease is why it largely strikes older adults. While scientists are learning how age-related changes in the brain may harm our neurons and affect other types of brain cells to contribute to Alzheimer's damage. These age-related changes include, again, atrophy or shrinkage of certain parts of the brain, inflammation, vascular damage, production of unstable molecules called free radicals, and my— mitochondrial dysfunction, which is a breakdown of energy production with a cell. Research suggests that a host of factors beyond genetics may play a role in the development and course of Alzheimer's disease. There is evidence that there is a relationship between cognitive decline and vascular conditions such as heart disease. Stroke, high blood pressure, as well as metabolic conditions such as diabetes and obesity. A nutritious diet, physical activity, social engagement, and mentally stimulating pursuits have all been associated with helping people stay healthy as they age. These factors may also help the risk of cognitive decline and Alzheimer's disease. Clinical trials are testing some of these possibilities. So let's take a more detailed look at some of the risk factors. And I must tell you that the more you have that apply to you, the higher your risk is. However, the good news is some of these risks are modifiable. In other words, they can be changed or treated. So, the number one risk factor is advancing age. And for obvious reasons, it is one of the non-modifiable factors that cannot be changed. Statistically, one out of three people over the age of 85 has Alzheimer's disease. Within the older population, Latinos have a 1.5 times the risk chance of developing Alzheimer's disease as their Caucasian counterparts, while African Americans have twice the risk of— that Caucasians do. These groups have a higher rate of cardiovascular disease compared to whites as well, which increases the risk of Alzheimer's disease. And the probability of being diagnosed with Alzheimer's disease nearly doubles every 5 years after you reach the age of 65. Our second highest risk are genetics. And of course, genetics are also nonmodifiable or changeable. People who have a parent or sibling who who developed Alzheimer's disease are 2 to 3 times more likely to develop the disease than those with no family history. If more than one close relative has been affected, the risk increases even more. Also, having certain versions of genes like the APOE4 increases your risk of developing Alzheimer's disease. There are two types of Alzheimer's disease. There's early onset and there's late onset. Both types do have a genetic component and researchers have not found a specific gene that directly causes the late onset Alzheimer's disease. However, having a genetic variant of the APOE4 gene on chromosome 19 does increase a person's risk. That gene is involved in making a protein that helps carry cholesterol and other types of fat into the bloodstream. If a person carries the APOE4 gene, it can increase their risk for developing Alzheimer's disease and is also associated with an earlier age of disease onset.. And that's different from early onset Alzheimer's disease. Although having one or two APOE4 alleles increases the risk of developing Alzheimer's disease, about 25% of people carry one copy of the APOE4 gene and 2 to 3% carry 2 copies. More than 50% of Alzheimer's patients have the APOE4 gene. 50 per— 15% of healthy people have the gene variant. Inheriting an APOE4 allele does not mean that a person will definitely develop Alzheimer's disease. Some people with the APOE4 allele never get the disease. And others who develop Alzheimer's disease do not have any of the APOE4 genes. Number 3, cardiovascular disease is the number one modifiable risk factor to developing Alzheimer's disease. Studies have shown that there's a strong link between heart health and brain health. Those who are free of heart disease or related conditions are at a lower risk of developing Alzheimer's disease or another kind of dementia than those who have cardiovascular disease. Conditions that damage the heart and blood vessels reduce the blood flow to the brain, and it is believed that this magnifies the cognitive problems that are caused by the buildup of the protein plaques and tangles. Coronary artery disease, atrial fibrillation, valve disease, and heart failure raise the risk of dementia. So, preventing or managing high blood pressure, high cholesterol, diabetes, and heart disease may actually lower your risk of developing Alzheimer's disease, as all of these can lead to damage to the blood vessels or heart. High blood pressure can cause blood clots in arteries, blocking blood flow to the brain. Stroke and loss of brain cells may follow, and the brain could subsequently shrink. People with high blood pressure in midlife are more likely to develop dementia later in life. Some researchers even suggest that high blood pressure as an early— that shows up as early as our 30s could increase dementia later on in life. There is some evidence that these conditions in and of themselves can raise your risk of dementia, and when combined, it can greatly increase other risk factors that can raise your risk threefold. For example, having diabetes and too much cholesterol buildup into the plaques in the arteries— clogged arteries can lead to heart attacks and strokes. And each of these conditions raises a person's risk of dementia. I mentioned before that cholesterol can also build up in the brain. Which can trigger beta amyloid buildup, which is a protein found in the brains of Alzheimer's patients. A study by Lancet Health Longevity indicated that high cholesterol in middle age leads to an increased risk of dementia and Alzheimer's disease. In people with cholesterol measured below age 65, the risk of dementia being diagnosed more than 10 years later was about 60% higher in those with LDL cholesterol levels above 200 milligrams. The Mediterranean diet has been linked in various studies with lowering cholesterol. Diabetes is caused by the pancreas not producing enough insulin, a hormone that regulates how sugar is distributed throughout our bodies. When the brain doesn't get enough sugar, fatigue and cognitive impairment happen in the short term, while metabolism changes and cellular damage occur in the long run. Each of these factors increases the likelihood of someone developing dementia. Now, Type 2 diabetes is believed to double a person's risk and possibly lead to developing dementia. Years earlier than someone who does not suffer from diabetes. Additionally, diabetes and dementia also share a subset of modifiable risk factors. So, it is critical that you implement regular exercise and healthy eating in your lifestyle to help reduce your risk of both those conditions. A 2002 study found that people with mild cognitive impairment were more likely to progress to dementia if they had cardiovascular problems. Number 4, lifestyle risk factors. These two are considered modifiable. You can do something about your lifestyle choices. Although age and family history are out of your control, several modifiable factors can influence your chances of developing Alzheimer's disease. The evidence is mounting for the promotion of exercise and a healthy diet to reduce Alzheimer's risk, as well as avoiding tobacco. 14% of Alzheimer's cases worldwide may be attributed to smoking. According to the World Health Organization, even secondhand smoke may increase your dementia risk. Limiting alcohol consumption is important. Poor sleep habits or sleep apnea that result in less deep sleep or daytime drowsiness may actually raise your risk as well. Studies have been conducted on several types of activity including running, weight resistance training, and yoga, all of which showed the potential to reduce your risk of dementia because physical workouts have been proven to enhance the development of new brain cells in our brains. Exercise lowers the risk of age-related brain impairment and protects the brain against degenerative conditions like Alzheimer's disease or mild cognitive impairment. Even reducing your sedentary time has been connected with dementia prevention, such as dancing and gardening. What you put in your mouth has a significant connection to the health of your brain. You've heard the old adage, You are what you eat, and studies are proving that to be true. A healthy diet that helps reduce the risk of Alzheimer's disease includes whole grains, nuts, legumes, fruits, and leafy green vegetables, among other foods, as well as limiting your sugar. There is a strong connection between higher blood sugar and dementia risk. That exists. And the link is so profound that Alzheimer's disease has been nicknamed Type 3 diabetes. You ever heard that before? I certainly have. But maintaining good control of your blood sugar, whether you have diabetes or not, can be thought of as a preventive medicine for your brain. Research shows that a high-calorie diet can impair memory if it causes inflammation in certain parts of the brain. So in other words, inflammation is definitely linked to risk of developing Alzheimer's disease. In a 2009 study, women above the age of 60 who reduced their calorie intake by 30% showed significant improvement in their verbal memory scores. That's pretty significant. So eating these recommended foods has been correlated with a host of health benefits including improved brain functioning and fewer changes that are seen in Alzheimer's disease. Additionally, lower levels of vitamin B12, D, and vitamin E have all been associated with decreased cognitive functioning in some of the research studies. In particular, a deficiency in vitamin B12 can cause significant memory loss and confusion that may be at least partially reversed through vitamin B12 supplementation. Likewise, higher levels of vitamin D and vitamin E have been linked to dementia prevention. So, my advice is talk to your doctor to see if you might be deficient in some of these vitamins and then ask for his recommendation as to whether or not you— it would be in your best interest to start taking them. But always, always check with your doctor first. Maintaining a healthy weight and keeping your body mass index in a healthy range, especially in your middle years, has also been tied to dementia prevention. Staying socially active and engaging in intellectually stimulating activities have also been shown to have a protective effect against Alzheimer's disease. Low education level, so less than a high school education, has long been associated with increasing the risk of Alzheimer's disease. While it's your brain that has Alzheimer's disease or another dementia, paying attention to your entire body is important. Deficits in vision and hearing can cause or increase confusion. Physical exercise has been associated with improved cognition with or without dementia. And in addition to exercising regularly, try to pay attention to the good nutrition. We know that certain foods have been tied to better cognitive functioning. That said, watching what you drink and eat can play an important role.— in your brain functions and may help decrease your risk of developing Alzheimer's disease or another dementia. A new study done by the American Academy of Neurology published July 27, 2022 found that eating ultra-processed foods is associated with increasing one's risk of developing dementia. The study concluded that on average, for every 10% increase in your daily take of ultra-processed foods, people had a 25% higher risk of developing dementia. Some of the significantly high ultra-processed food intake worth mentioning include beverages, sugary products, and ultra-processed dairy. Lower risks of dementia was associated with replacing ultra-processed foods in a person's diet with unprocessed or minimally processed foods. A person can also lower their risk of developing dementia by keeping mentally active. Mental activity has been associated with increased cognitive reserve, which in turn has been connected with dementia prevention. Exercise your brain to keep it sharp by doing things like crossword puzzles, Sudoku, jigsaw puzzles, playing card games, learning a foreign language, learning a musical instrument, or taking classes. So, another statistic that's interesting is isolated elderly— the isolated elderly have 28% more likelihood to develop dementia than their peers. Older people who are socially isolated face that greater chance of developing dementia than do their counterparts who are not socially isolated according to a study by Johns Hopkins researchers published in the Journal of the American Geriatric Society. Social isolation is generally defined as having few social relationships and few people to interact with on a regular basis. The study involved 5,022 U.S. residents who were 65 or older with an average age of 26 who were dementia-free at the start of the study and were not living in a nursing home, residential care facility, or another institution. About 23% were considered socially isolated, but most participants, as a matter of fact, 77% of them were not. During a 9-year span, all of the participants were tracked and periodically given cognitive tests. In that time, about 26% of those who were socially isolated developed dementia compared with about 20% of those who were not socially isolated. The study found no significant differences by race or ethnicity. It did not focus on why or how social isolation increased the prevalence of dementia, but prolonged isolation— social isolation— has definitely been linked to proven physical and mental health risk factors for dementia. Again, including hypertension, heart disease, depression, and reduced cognitive activity. And this is according to the National Institute on Aging. Also, people who are socially isolated may be less likely to take advantage of health services available to older Americans. So, the Centers of Disease Control and Prevention, say social isolation affects roughly a fourth of U.S. adults 65 and older. About 6 million Americans do have the most common type of dementia, which is the Alzheimer's disease, according to the CDC. Another thing that we know now post the COVID-19 pandemic is that the number one cause of death of the COVID-19 was due to loneliness and isolation. So, this is real. This is absolutely real. Now, spending time with friends also has been identified as an important factor factor, and it is said that it is both for maintaining quality of life and for reducing the risk of developing Alzheimer's disease. And it's not the number of friends you have, but rather the quality and depth of the friendships that matter. Social interactions have also been associated with improved cognitive functioning. Human beings were meant— we are wired to interact with other human beings. Getting plenty of sleep is recommended by the National Institute on Aging. Many of you have sleep apnea, where you stop breathing multiple times while you're sleeping, and it is critical to get that properly treated. Sleep apnea has many risks associated with it, including an increased risk of dementia. However, if it's properly treated by using a CPAP machine and monitoring this condition, it can help lower that risk. Both early life and later life depression have been found to increase the risk of developing dementia. The why is uncertain. However, the effects of depression can affect your brain function. So once again, let me emphasize that with each risk factor that applies to any one individual, the more risks you have, the greater your risk is in developing Alzheimer's disease. Some of these things cannot be changed. However, many of the risks that I've discussed with you here today can be lowered by making certain diet and lifestyle changes. The earlier you start, the lower your risk. Not every risk factor for Alzheimer's disease is within our control, but many are. And it's estimated that a person can reduce their risk for developing dementia by about one-third if they address those modifiable risk factors. That's significant, folks. Dementia and Alzheimer's disease do not follow a one-size-fits-all diagnostic process, and some people who have multiple risk factors never develop the condition, while other adults with relatively few risk factors still end up developing the disease. So the bottom line is the more you can minimize your risk of— lowering your risk of developing Alzheimer's disease by treating, changing, modifying lifestyle choices and reducing your risk then your chances of developing dementia are not absolute. It can hit anybody at any time, but you can lower your risk by implementing these lifestyle changes and diet changes and mental and physical activities. And brain activities will all help to lower that risk. And you'll live a really fulfilling life too, I guarantee it. So, that is the information that I wanted to share with you on today's episode. I hope you all have found it extremely helpful and valuable. And it's never too late. You can implement any of these changes that we talked about to help lower your risk of developing Alzheimer's disease and dementia at any age and at any stage of your life. So before I close, I'm going to turn the microphone back over to Ken, who will make a few announcements, and then I'll be back in a minute to let you know what we'll be talking about on next week's episode.

Thank you for listening to the Truth, Lies, and All the Power Show with your host Lisa Skinner. This program can be found on our website at passionateworldtalkradio.com under the shows tab and on YouTube forward slash Passionate World Talk Radio. We're available on all major social media platforms including on Facebook under Lisa Skinner Author, and you can purchase Lisa's book and find out more about her on her website at truthliesalzheimers.com. With that, Lisa, happy to hand it back over to you. It was a great show, some really, really helpful reminders and take us home.

Okay, thanks, Ken. One last note: it's very important to me that you know that this show is about you and how my experiences, expertise, and strategies will be able to help you and your loved one have an easier time while struggling through this disease. I know how hard it is. Therefore, I'd love it if you would send me your comments and suggestions on what topics you'd like me to cover on my weekly show, or if you have any questions that you'd like me to address. You can send them to my personal email, which is dementiawhisperer1@gmail.com. And if you're listening to this on YouTube, or if you got here through our social media page, Please leave your comments or questions, and I promise I will do my very best to address them. I will genuinely look forward to receiving your thoughts and ideas, and in the meantime, please take care of you. I'll talk to you next week. Thanks!