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Who Is at Risk for Dementia

This is the second in a series of posts on dementia in advance of the release of my new book, How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia. It will be released soon through Family Solutions Press of Los Angeles and available from Amazon. We will keep you up to date on details.

Who is at risk for dementia? The simple answer is that in only about one in twenty cases is there any leading indicator or marker for Alzheimer’s in the form of a specific gene, and these are the early onset (before middle age) cases. There also is the ApoE4 gene variant. Individuals with one copy of this variant can have as much as four times the risk as others in developing the disease, and two copies of ApoE4 increase the risk to tenfold. Women also are at somewhat greater risk than men. And sadly, not only are women more likely to be diagnosed with the disease, but they also are more likely to be a caregiver to someone with the disease. For all other cases, it is simply a matter of increasing risk as one ages.
The risk factors in general across all the dementias tend to revolve around birthdays, poor diet, poor exercise, poor intellectual/ social engagement as well as diabetes, high blood pressure or depression. For the dementias that are specific to either Parkinson’s or Huntington’s, the cognitive compromises simply accompany the physical progressions of these diseases.

The processed food consumption that has been linked to our global epidemic of obesity is also tied to the rising rates of Alzheimer’s disease world-wide. We don’t mean to sound the alarm about sugar, but we came across an article recently that tied together a number of facts and trends that we all may have seen. And we all should be very alarmed!
As professional care managers, we often work with older adults who have developed medical conditions that reflect a lifetime of poor health and nutrition habits. We see the elevated blood pressure and the obesity that can arise from sedentary lifestyles and poor diet. One of the more common developments we see is the onset of type-2 diabetes resulting from a lifetime of too many sweets, poor diet in general and lack of exercise that have resulted in what doctors call “insulin resistance,” the pancreas’ inability to keep producing enough insulin to process all the carbohydrates or sugar.

What you may not know is that the brain also produces insulin, and that when faced with a prolonged assault from more sugar than it can process, its ability to produce insulin may falter and then fail. The result has been referred to as “type-3 diabetes.” The research has been piling up. For instance, people who suffer from type-2 diabetes (type-1 is the form that people are either born with or develop as an immune response) have deposits of amyloid-beta in their pancreas. Sound familiar? Yes, amyloid beta deposits in the brain are a signature marker for Alzheimer’s disease. And this also begins to explain why type-2 diabetics are estimated to be anywhere from 50 percent to 100 percent more likely than others to also develop insulin-resistant Alzheimer’s disease.

Type-2 diabetes does not cause Alzheimer’s disease, but type-3 diabetes is caused by the same poor diet that causes type-2 diabetes. This may begin to also explain why the rates of the two conditions both have tripled in the United States in the past forty years. This, along with a lot of other inflammatory conditions related to the heart and the circulatory system. In related research scientists have found that one of the more common medications used to treat type 2 diabetes, metformin, has a neuroprotective benefit as well as its indicated benefit in addressing blood sugar levels and pancreatic function. The research coming out of a close analysis of Veterans Administration data by a doctoral candidate at Tulane University suggests that metformin can have a long term neuroprotective effect that can stave off the brain deterioration of Alzheimer’s and Parkinson’s.

In my book, we cover what we know about dementia, what can be done to stave off the effects of dementia and most importantly what caregivers can do for their loved ones with dementia and for themselves.

Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.


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