Alzheimer's Disease Caregivers Ask: "Am I at Risk?"
Polls show that when people think about their own aging, the fear of developing Alzheimer's disease ranks right at the top of their concerns—as high or higher than the fear of becoming physically disabled or running out of money.
Family members who are providing care for a loved one with Alzheimer's are even more likely to worry about whether they, too, will develop the disease. They see the challenges close up. Any small memory glitch of their own may cause anxiety as they wonder if they could inherit dementia.
Neurologists continue to unravel the mysteries of why certain people develop Alzheimer's while others are spared, and their findings are well beyond the scope of this article. But the short answer is that the relationship between genes and Alzheimer's is complicated.
According to the National Institute on Aging (NIA), the genetic component is different for the two types of Alzheimer's disease:
Early-onset Alzheimer's disease begins to appear when a person is between the ages of 30 and 60. Some cases are sporadic, appearing without any known cause. But most are caused by an inherited change in genes, and are referred to as early-onset familial Alzheimer’s disease (FAD). The NIA says, "A child whose biological mother or father carries a genetic mutation for early-onset FAD has a 50/50 chance of inheriting that mutation."
Late-onset Alzheimer's disease represents by far the majority of cases—perhaps 95 percent. Symptoms first appear in a person's mid-60s or later. The NIA says, "The causes of late-onset Alzheimer's are not yet completely understood, but they likely include a combination of genetic, environmental and lifestyle factors that affect a person's risk for developing the disease." At this time, researchers have not found a specific gene that causes late-onset Alzheimer's disease, but having a certain form of a particular gene (the APOE) raises the risk. A blood test can determine whether a person has this form of the gene—but it doesn't predict whether a person will actually develop Alzheimer's disease.
If your loved one has Alzheimer's and you are worried about your risk, talk to your healthcare provider—not only about your genetic risk, but also if you have noticed troublesome signs in your own memory and thinking. Stress causes many annoying but harmless memory and thinking glitches, and Alzheimer's caregivers can be some of the most stressed people around! Worrying about these stress-related symptoms can raise your stress level all the more.
Which raises perhaps the most important point: Whether you are related genetically to the person you're caring for or not (the latter in the case of spouses, for example), studies show that if you don't take care of yourself, your own risk of dementia rises.
Luckily, this is a risk factor we can do something about. Here are lifestyle choices that have been found to lower the risk of dementia. The challenge for Alzheimer's caregivers is to find the time and energy to do them!
Eat a healthy diet. Choose a balanced diet that includes healthy fats (no trans fats), fruits, vegetables and whole grains—essentially, the same diet that is commonly recommended for heart health.
Get enough exercise. Physical activity is the No. 1 way to protect your brain, say many researchers. Take an exercise class, go to the gym or go for a walk with friends. Exercise is good for people with Alzheimer's as well, so even though a walk with your loved one won't be vigorous, every little bit helps.
Give your brain a workout, too. Take a class, learn an instrument or play brain-teaser video games. Numerous studies show that mental stimulation helps protect against cognitive decline as we grow older.
Get enough sleep. Sophisticated brain imagery is helping experts understand how important sleep is for warding off dementia. Sleep strengthens the memories we form during the day, and sleep is the time when the brain cleanses itself of unhealthy substances. Unfortunately, the sleep disturbances that are typical of Alzheimer's disease also interrupt the sleep of caregivers.
Quit smoking. If you're having trouble giving up the habit, ask your doctor about a smoking cessation program.
Wear your seatbelt and fall-proof your home. Traumatic brain injury is a leading cause of cognitive impairment in people of every age; even if a head injury seems to heal successfully, it can raise the risk of dementia in later years.
Talk to a counselor. Many caregivers find it difficult to express their mixed emotions with family and friends. A counselor who has experience with the needs of dementia caregivers can help treat depression, anxiety and stress—all very common in Alzheimer's caregivers, and all raising the risk of memory loss.
Stay socially connected. Loneliness and isolation are stressful for humans, leading to inflammation that's bad for our brains. If you find yourself spending little time with anyone but your loved one, make an effort to branch out. For example, many caregivers find that a support group is a great source of human warmth, and lifelong friendships have formed in these groups.
The first step: get help.
It's not an exaggeration to say that most Alzheimer's caregivers simply can't care for their loved one alone without endangering their own health. Enlist the help of other family members; they may need you to take the lead in educating them about your loved one's needs. Contact your local senior services agency and the local chapter of the Alzheimer's Association. Look into adult day centers for people with dementia. In some cases, a residential facility is the best choice; be sure to select one that offers memory care. Most people with Alzheimer's prefer to remain in their familiar surroundings, and in-home care can provide the support families need to keep their loved ones safe at home while protecting their own health and well-being—day or night.
Whatever support you arrange for, remember that by helping yourself, you're ensuring better care for your loved one.
Talk to your doctor if you are concerned about your risk of Alzheimer's disease, and if you've noticed troubling symptoms in your own memory and thinking. Early detection of Alzheimer's disease and other dementia allows for early treatment and planning. Your doctor also may wish to rule out treatable conditions that affect memory—and, most likely, will be able to help you avoid more stress by putting your mind at ease in this way.
The National Institute on Aging’s Alzheimer’s Disease Education and Referral Center offers a consumer-friendly fact sheet on the genetics of Alzheimer's disease.