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How do I know if I’m at risk for Alzheimer’s disease?

Based on the sheer number of people who have Alzheimer’s disease — over 6 million! — you might assume that significant loss of ability to think, remember, or understand is a natural part of aging.1 More than half of Black Americans think this is true.2 

But actually, it’s not.

Significant loss of mental ability — like what happens when a person has dementia or Alzheimer’s disease — is not a normal part of getting older. But scientists estimate that by 2060, more than 2 million Black Americans will be living with Alzheimer’s disease or other types of dementia.3 

It’s important to keep this in mind so that you can understand your own risk of developing the disease and why it’s so important for scientists to find a cure.

What is Alzheimer’s disease?

Let’s start by getting a good understanding of what dementia and Alzheimer’s disease really are. You might be wondering whether these two conditions are the same or not. And if they’re different, then how? 

Think of dementia like an umbrella term. It’s not a single, specific disease. Rather, it refers to a group of symptoms related to a loss of mental abilities. When a person has dementia, they have trouble4:

  • Thinking
  • Remembering
  • Learning
  • Making judgments or decisions
  • Speaking

Alzheimer’s is a brain disease that falls under the dementia umbrella. In fact, it’s the most common type of dementia, and it affects Black communities disproportionately. 

When a person has Alzheimer’s, their brain deteriorates over time. This is why Alzheimer’s is known as a progressive disease. As more nerve cells die and more brain tissue is lost, the symptoms of the disease get worse. A key goal of Alzheimer’s treatment is to slow down the progression of the disease.5

How does Alzheimer’s disease affect Black communities?

While Alzheimer’s disease can and does affect all people, Black Americans are twice as likely as white Americans to develop Alzheimer’s or other forms of dementia, according to the Alzheimer’s Association. More than 1 out of every 5 Black folks age 70 and older live with Alzheimer’s disease.2

For many people with late-onset Alzheimer’s, the first symptoms begin to show up in their mid-60s. A person who develops Alzheimer’s with symptoms starting earlier — like between their 30s and their 60s — is said to have early-onset Alzheimer’s disease.6,7

You likely know of someone who has developed early-onset or late-onset Alzheimer’s. Even for a person who develops the late-onset disease, a person in their 60s is still young and has so much life left to live. An Alzheimer’s diagnosis can be difficult to accept and can have a lasting, harmful impact on Black families who are affected by the disease. 

How do I know if I’m at risk for Alzheimer’s disease?

As of now, there is still no cure for Alzheimer’s disease. And one of the biggest challenges to understanding, treating, and preventing Alzheimer’s disease is the fact that most of what scientists and doctors do know is based on white Americans with Alzheimer’s. They know much less about non-white groups. 

That’s why it’s so important for scientists to learn as much as they can about how Alzheimer’s happens and progresses in the body, who gets Alzheimer’s, and what makes certain people — Black folks, for example — more likely to develop the disease than others.

In terms of causes, scientists believe that a combination of a few different types of risk factors can determine whether a person gets Alzheimer’s. While age is a well-known risk factor — the older you get, the higher your risk for developing Alzheimer’s disease — there are certainly others including: 

  • Genetic risk factors 
  • Lifestyle-based risk factors
  • Environmental risk factors

Genetic risk factors

Certain genes can make a person more likely to develop early-onset or late-onset Alzheimer’s. And since genes are passed down through families, family history can be an important factor. 

Specific versions of the apolipoprotein E (APOE) gene have been linked to a higher risk of developing Alzheimer’s disease in some people. Mutations (changes) in the amyloid precursor protein (APP) gene and the presenilin genes have been connected to increased risk too.7 . When a person has a certain type of gene or a certain mutation in a gene, it can cause abnormal proteins to form, which can lead to Alzheimer’s disease.

One thing to note about gene variants is that they don’t always behave the same way in all people. Most of what’s known about genetic risk factors for Alzheimer’s is based on white people with the disease. Much more research is needed to understand which genetic risk factors are most relevant for Black communities, and how they can impact your risk of Alzheimer’s.

Important questions to ask:

  • Has anyone in my immediate family developed early-onset or late-onset Alzheimer’s?
  • Has anyone in my immediate family developed any type of dementia?
  • Has anyone in my family ever had genetic testing for Alzheimer’s disease?

Lifestyle risk factors

There are also certain lifestyle-based risk factors that can influence your risk of Alzheimer’s disease. Notable risk factors include8:

  • Smoking
  • Obesity
  • Having diabetes, high blood pressure, or high cholesterol

You may notice that many of these risk factors are also linked to chronic diseases like heart disease. Similarly, many of the changes you could make to lower your risk of heart disease could also help lower your risk of Alzheimer’s disease. For example, stopping smoking, being physically and mentally active most days of the week, eating a balanced diet, and staying on top of your wellness check-ups.

Important questions to ask:

  • Can I eat a healthier diet most days of the week?
  • Can I stop smoking or smoke less?
  • Can I become more active — physically and mentally — each day?

Environmental risk factors

Many scientists believe that toxins and contaminants in the environment can also play a role in the development of Alzheimer’s or other types of dementia. Examples include air pollution, pesticides, and metals like aluminum in common sources like drinking water.9 However, much more research needs to be done in this field in order to say for sure whether there is a direct impact on your risk of developing Alzheimer’s. 

Important questions to ask: 

  • Do I live in safe conditions?
  • How is the air quality in my home and community?
  • What occupational hazards am I exposed to at work?

Conclusion

Regardless of your own individual risk, chances are that at least one of the loved ones in your life will develop Alzheimer’s disease. One of the most important ways you can help is to continue to learn about the causes, risk factors, and warning signs of Alzheimer’s and to get involved with projects that help scientists learn more about treatment and prevention of Alzheimer’s in Black communities.

References

  1. 2021 Alzheimer’s Disease Facts & Figures https://pubmed.ncbi.nlm.nih.gov/33756057/ 
  2. Black Americans and Alzheimer’s https://www.alz.org/help-support/resources/black-americans-and-alzheimers 
  3. U.S. burden of Alzheimer’s disease, related dementias to double by 2060
  4. Alzheimer’s and Dementia https://www.alz.org/alzheimer_s_dementia 
  5. Alzheimer’s Disease & Related Dementias https://www.nia.nih.gov/health/alzheimers/basics
  6. What is Alzheimer’s Disease? https://www.nia.nih.gov/health/what-alzheimers-disease 
  7. Alzheimer’s Disease Genetics Fact Sheet https://www.nia.nih.gov/health/alzheimers-disease-genetics-fact-sheet 
  8. Causes: Alzheimer’s Disease https://www.nhs.uk/conditions/alzheimers-disease/causes/ 
  9. Environmental Risk Factors for Dementia: A Systematic Review ​​https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059894/

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