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Alzheimer and genetics
Spoken text of the video
Section 1: Intro
Speaker (male): Chapter 50. Alzheimer’s disease and genetics. This is a specific training for the Alzheimer Sensor genetic test. You will find this sensor here in the program. It has two benefits. One is prevention and the other one is better treatment. In terms of early diagnosis, this genetic test is not really very helpful. So, it is really for these two benefits. For people who do not have it yet will benefit from it as well as people who have already developed the disease.
Section 2: Alzheimer’s Disease
Let us talk about Alzheimer’s disease. In the case of Alzheimer’s disease, we have a number of unfolded proteins. The proteins are built but they are not folded and built correctly and they tend to accumulate in the brain. However, it is still unclear if these unfolded proteins are the cause or an effect or a consequence of the disease. It is still unclear which role these play. What we do know is that there are also free radicals, oxidative stress, that tend to accumulate more in the brain and they start to damage all types of systems.
Among other reasons, this causes areas in the brain to die off. This causes memory loss and cognitive problems. Now, if you look at a normal and healthy person from birth until death, with a normal life expectancy around 80 years, the progression of Alzheimer’s disease is usually on average like this: for six years you do not have a problem. Then, the first symptoms occur and it takes around five years to get the correct diagnosis. You do suffer from Alzheimer’s disease. Then, it takes another seven years until you then die prematurely at the age of 72 because of this disease. People say Alzheimer’s disease is not treatable. There is no cure for it. This is still absolutely correct. There is a lot of research on it and a lot of promising therapies, so I do not think this will remain true for much longer, but currently this is still the case.
However, and this is what makes it interesting for preventive genetic testing, there are lifestyle factors that have been shown to influence the likelihood of the development as well as the onset of the disease, when it happens. The lifestyle factors that we can control can influence the disease’s probability andwhen it also occurs later in life. The risk factors are increased cholesterol. Blood fats that increase are a risk factor. High blood pressure is a risk factor. Having the disease diabetes type 2 is also a risk factor. As I have said, also free radicals are a big issue. Free radicals are those toxic molecules that are produced and start to damage the brain. Prevention by changing lifestyle factors has shown to decrease the risk. For example, if you exercise three times a week, you reduce your risk by 30 %. If you have a lot of social contacts or a member in clubs and you have a lot of contact with other people compared to sitting at home and watching TV all day, this also significantly delays the onset and reduces the likelihood of the disease.
Smoking again is a risk factor for many diseases, not just lung cancer, also speeds up Alzheimer’s disease and should be avoided at all costs. Mentally challenging activities and higher education have shown to be beneficial. So, especially people with higher risk should train their brains rather than watching talk shows. They should do mentally challenging activities to keep their brains active and trained. The Mediterranean diet has shown to be beneficial for mental health and a diet rich in antioxidants is also beneficial, which is not surprising since free radicals, oxidative stress, and antioxidants like vitamin C, E, folate or folic acid are known to neutralize free radicals. Scientific studies have also shown that drinking two to five cups of coffee reduces the risk by 64 %. This is also very likely due to antioxidants.
Coffee has extremely many antioxidants, free radicals inhibitors, which help you decrease the risk by 64 %. In addition, antioxidants taken in higher dosages as supplements are likely to improve the outcome and the onset. While healthy life might be 80 years and Alzheimer’s disease unchecked without prevention might give you a lifespan of 72 years, with 7 years of severe symptoms. Prevention is likely to delay the onset and reduce the likelihood of the disease from developing. Then, you get 75 years of no problems. Then, some symptoms might develop and you reach your lifespan of 80 years without even having the diagnosis. While it is still untreatable, when it develops, there are lifestyle factors that reduce the likelihood and delay the onset. Often, 10 years later is completely sufficient because it is a disease that just occurs later on in life.
Section 3: The genetics
Alright, how about the genetics. There are three different versions of a certain gene, the APOE gene. E2, which means it has a certain genetic letters, gives you the protection against Alzheimer’s disease. E3 gives you the normal risk of the disease. E4 gives you a predisposition to Alzheimer’s disease, a higher risk. There is protective, normal and higher risk versions. Alzheimer’s disease is a co-dominant inheritance. In case you do not know what that means, please do watch the inheritance of genetics training. It just means the more bad genes you have, the higher your risk is. So, there are different combinations and every person has two copies of this gene.
If you have two of the protective version, you have 0.7 fold risk. It is a lower risk than that of the general population. If you have E2 and E3, it is also 0.7. If you have E3 and E3, this is the general trend and half of the population has this, it is normal risk. E2 and E4 is a higher risk, 2.5. E3 and E4, it is 3.2. This is my personal risk. E4 and E4 is 15 fold risk. This is complicated genetic statistics. This is not something that we usually communicate to our patients. This is how we show it in the report. So, you can either have the average risk that of the general population or you have the protective effect or the increased risk. Depending on where the arrow is, you might have a lower risk. Then, prevention is less important for this person. If it is here, it is very important for this person. This here is the gene. As I said, these are the possible different combinations. 66 % have no increased risk. 7 % have protection and an increasing number has a higher risk. This is the science behind it.
Alright. That was the genes. If we find out that you have an increased risk, we can create a specific prevention program that modifies your lifestyle and this is all in the report. It is very easy to read what the preventive measures are. The diet has changed, you are encouraged to be mentally active and so on. Then, you can reduce the likelihood of the disease from developing and delay the onset. Then, as I have said, there are also drugs that are commonly used for Alzheimer’s disease. Please, do watch the Pharmaco genetics training for this. From there, we know that a drug is metabolized by a certain gene or enzyme. If this enzyme or gene is broken through a genetic variation, you might take this drug regularly, but it is not removed from the body. So, it increases every time you take it and then it can cause a significant increase in this drug in your blood stream and eventually it can cause severe side effects or a drug might not even be activated by the body due to genetic variations.
So, what we can do is we test the relevant genes that are relevant for the drugs that are used in combination with Alzheimer’s disease. This helps us to improve treatment because we get the right drugs, we avoid the ones that do not work or cause side effects or we adapt them in the right dosage. As I said, please do watch the Pharmaco genetics training and you will learn a lot more about how we can optimize the specific treatment. This test is really recommended for people who do not have Alzheimer’s disease yet. They want to delay it or reduce the likelihood of developing it if they have a high risk. When they develop it, it is also relevant for improved treatment. These are the two factors that are important and it is recommended for healthy people as well as for people who already have this disease.
This is the end of chapter 50, Alzheimer's disease and genetics as a training for the Alzheimer Sensor.