Podcast Summary
A personal journey with Alzheimer's and prevention measures: Actress Lauren Miller Rogan shares her family's experience with Alzheimer's and emphasizes the importance of prevention through expert advice and research.
Alzheimer's disease has a profound impact on individuals and families, and prevention is key. Lauren Miller Rogan, an actress, screenwriter, director, and co-founder of Hilarity for Charity, shares her personal journey with Alzheimer's in her family. Her grandfather and grandmother both had the disease, and she saw its effects from a young age. Despite finding it amusing as a child, she later came to understand the devastating consequences of Alzheimer's. Lauren's experiences led her to seek out preventative measures and connect with experts like Dr. Richard Isaacson, the director of the Alzheimer's Prevention Clinic at Weill Cornell and assistant dean at the Weill Cornell Medicine faculty office. Together, they discuss the latest research on Alzheimer's prevention and the importance of taking steps to modify risk. Their conversation is both touching and enlightening for anyone interested in the prevention of Alzheimer's disease.
A young woman's journey through her family's Alzheimer's experience: Alzheimer's disease can impact families at a young age, leaving fear, uncertainty, and sadness. Discussing concerns with loved ones can provide support and understanding.
Alzheimer's disease can significantly impact the lives of individuals and their families at a young age. The speaker's grandmother and mother both experienced the disease, leaving the speaker with a sense of fear and uncertainty about her own family history. The speaker's mother, a vibrant and intelligent woman, began showing signs of Alzheimer's during the speaker's college years. The family struggled with denial, fear, anger, and depression as they came to terms with her diagnosis. Despite her own fears, the speaker didn't openly discuss her concerns with her boyfriend at the time, as she felt he didn't fully understand her mother's personality and the changes she was experiencing. Over time, the speaker's mother's condition worsened, and she was eventually unable to teach or care for herself. The experience left the speaker in a "very dark place," as she watched her mother's identity fade away. The speaker's mother's retirement from teaching was a difficult transition, as she likely wasn't fully aware of the reasons for the change. The experience highlighted the sad reality of Alzheimer's disease and its impact on families.
A mother's Alzheimer's diagnosis affects her family deeply: Early onset Alzheimer's is a devastating condition that affects not only the diagnosed individual but also their family, and research is crucial to understanding and preventing it.
Alzheimer's disease, particularly when it's familial and has early onset, is a devastating condition that not only affects the person diagnosed but also their entire family. The speaker's mother was diagnosed when she was in her 50s, and the speaker was just starting to form a close relationship with her. The mother was scared not for herself but for her children and husband, as she had experienced the disease in her own parents. The speaker felt helpless and angry, searching for a cure but finding none. As a neurologist, Richard hates Alzheimer's disease for its insidious nature and the way it robs people of their memories and their lives. He believes that Alzheimer's starts in the brain decades before symptoms appear, and when he hears of a case like this, he wonders what was happening in the person's 30s and why it's affecting their family. The first thought is always genetic, and the question of early onset arises. Most people associate Alzheimer's with older individuals, but this type of diagnosis is a heartbreaking reminder of the disease's cruelty and the importance of research and awareness.
Understanding the causes of Alzheimer's: Genetics and environment: The most common genetic risk factor for Alzheimer's is the ApoE4 gene, but most cases involve a combination of genetics and environment. Precision medicine aims to provide personalized recommendations based on individual genes and environmental factors to prevent or delay the disease.
Alzheimer's disease can affect people at different ages, and while some cases may be caused by rare genetic mutations, most early onset cases involve a combination of genetics and environmental factors. The most common genetic risk factor is the ApoE4 gene, but having this gene does not guarantee that a person will develop Alzheimer's. Instead, it increases their risk. The future of Alzheimer's research lies in precision medicine, which aims to understand the individual genes and environmental factors that contribute to a person's risk and provide personalized recommendations to prevent or delay the disease. The discussion also touched upon the rarity of early onset Alzheimer's cases caused by specific genes like presenilin 1, presenilin 2, and the amyloid precursor protein gene mutation. These cases represent less than 1% of all Alzheimer's cases, and most people with early onset Alzheimer's have a complex mix of genetic and environmental risk factors. The term epigenetics was mentioned as a key concept in understanding the environmental impact on gene expression and the role of multiple genes working together (polygenic risk) in Alzheimer's disease.
APOE4 gene increases Alzheimer's risk, but lifestyle modifications can help: Having the APOE4 gene increases the risk of Alzheimer's, but lifestyle modifications, managing cholesterol, and personalized care can help delay or prevent the disease. Every person's journey is unique, and understanding genetic factors provides valuable insights for personalized care.
Having the APOE4 gene variant increases the risk of developing Alzheimer's disease due to its role in increasing vascular risk and accelerating the accumulation of amyloid protein in the brain. However, having this gene does not mean it's a death sentence. Lifestyle modifications, managing cholesterol, and personalized care can help delay or even prevent the onset of the disease. For those without the E4 variant, it may be more challenging to identify and address potential risks. The speaker emphasizes that every person's journey with Alzheimer's disease is unique, and understanding the role of genes like APOE4 can provide valuable insights for personalized care. Lauren's story highlights the emotional and practical challenges of dealing with a loved one's Alzheimer's disease, particularly when it comes to accessing effective medical care. As the disease progresses, individuals may lose their ability to perform daily tasks, and planning significant life events like weddings can become more complicated. Despite these challenges, the speaker emphasizes the importance of finding ways to support and care for loved ones with Alzheimer's disease, even as the disease takes its toll.
Caring for a loved one with Alzheimer's: Unexpected Presence: Supporting families dealing with Alzheimer's is crucial as it affects more than just memory; behavioral and emotional symptoms are common and unpredictable.
Caring for a loved one with Alzheimer's disease can be challenging and unpredictable. The speaker shared her experience of her mother's behavior during her wedding, which was initially difficult due to her mother's confusion and fear in a new environment. However, on the wedding day itself, her mother managed to be present and engaged, despite the progression of the disease. The speaker emphasized the importance of supporting families affected by Alzheimer's, as the disease not only affects the memory of the patient but also causes deeper emotional and behavioral symptoms. The speaker also highlighted the need for understanding that Alzheimer's is a progressive and heterogeneous disease, meaning that the symptoms depend on where the disease progresses in the brain. This can lead to a wide range of symptoms beyond memory loss, including fear, confusion, and loss of control over bodily functions.
Understanding Different Forms of Alzheimer's: Alzheimer's is a group of disorders affecting cognitive decline differently, with executive function impacted in some forms and primary memory loss in others. Prevention and treatment may target the preclinical phase.
Alzheimer's disease is not a single condition but rather an umbrella term for various brain disorders that affect different areas and manifestations of cognitive decline. Executive function, which involves judgment, planning, and decision-making, can be impacted in some forms of Alzheimer's, such as frontotemporal dementia, while primary age-related taupathy primarily affects short-term memory due to pathology in memory centers. Additionally, Alzheimer's can be divided into three stages: the preclinical phase, where the disease begins but no symptoms are present; mild cognitive impairment, characterized by memory glitches and other cognitive changes; and dementia, where significant cognitive decline occurs. Prevention and treatment efforts may focus on the preclinical phase to delay or even prevent the onset of symptoms.
From Mild Cognitive Impairment to Alzheimer's Disease: 12-16% of MCI cases progress to Alzheimer's annually. Different Alzheimer's variants exist, including the lipid and potentially infectious. Personal experiences can lead to advocacy and raising awareness.
Alzheimer's disease can affect people at different stages and ages, with mild cognitive impairment (MCI) being a potential precursor. The transition from MCI to dementia occurs in roughly 12-16% of cases per year. Lauren's mother is an example of someone who was diagnosed with symptoms in her 50s but was still able to attend her daughter's wedding years later. The discussion also touched upon the possibility of different variants of Alzheimer's disease, such as the lipid variant or potentially an infectious variant. Lauren shared her personal story of how she became an Alzheimer's advocate after organizing a community event in 2012, which led her to meet various experts and advocates in the field. Tragically, her uncle, who was five years older than her mother, also began showing symptoms and passed away in 2020, allowing his story to be shared publicly to potentially help others.
Making unconventional connections leads to valuable insights: Determination and persistence can lead to valuable connections and potential solutions, even in the context of dealing with Alzheimer's disease. Seek help and information unconventionally and trust your instincts for a better outcome.
Determination and persistence can lead to valuable connections and potential solutions, even in the context of dealing with Alzheimer's disease. The speaker, Lauren, shares her experience of reaching out to a renowned Alzheimer's doctor, Richard, for her uncle's care. She was able to make the connection through unconventional means and discovered that they had a mutual connection. Once she met Richard, she was impressed and decided to become a patient herself to prevent Alzheimer's. The speaker also mentions a pivotal moment where she saw a video of Lauren's mom from years ago, which gave her a sense of urgency and made her trust her instincts. Overall, this story highlights the importance of taking action and being proactive in seeking help and information, especially when dealing with complex and challenging health issues.
Considering genetics and environment in neurological diagnoses: Genetics and environment can influence neurological conditions like Alzheimer's, and considering multiple pieces of information can lead to more accurate diagnoses. Handwriting may also offer clues about neurological health, and Alzheimer's could begin in the brain decades before symptoms appear.
Genetics and environmental factors can interact in complex ways to influence the development and expression of neurological conditions like Alzheimer's disease. The speaker's observation of similarities and differences in family members' behaviors, mannerisms, and handwriting, combined with their clinical history and genetic testing, led them to suspect a more complicated diagnosis than Alzheimer's for one family member. This case highlights the importance of considering multiple pieces of information when making a diagnosis and the potential role of genetics in the development of neurological conditions over a person's lifetime. Additionally, research suggests that handwriting can provide clues about a person's neurological health and that Alzheimer's may be a lifelong disease that begins in the brain decades before symptoms appear.
Genetics, Lifestyle, and Hormones: Alzheimer's Risk Factors for Women: Genetic predisposition, sedentary lifestyle, high sugar intake, and hormonal changes, especially after hysterectomy, can increase Alzheimer's risk for women with the E4 variant. Preventative measures include regular exercise, healthy diet, and good sleep habits.
The combination of genetic predisposition, lifestyle factors, and hormonal changes can significantly increase the risk of developing Alzheimer's disease, especially for women with the E4 variant. The speaker shared the story of Lauren, whose mother had a hysterectomy in her late 40s and developed Alzheimer's disease. The mother's sedentary lifestyle, high sugar intake, and lack of cardio exercise, combined with her family history and hormonal changes after the hysterectomy, may have contributed to her early onset of the disease. The speaker emphasized the importance of awareness about the increased risk for women with the E4 variant and the need for preventative measures, including regular exercise, healthy diet, and good sleep habits. The speaker also mentioned that the mother, despite not being unhealthy by typical standards, could have benefited from more proactive steps to reduce her risk based on current knowledge.
Physical activity and exercise impact cognitive function, especially for APOE4 gene carriers: Cardiovascular and strength training, including high intensity interval training, are essential for cognitive health. Women's unique biological changes during perimenopause may accelerate Alzheimer's pathology, making interventions during this time crucial.
Physical activity and exercise play crucial roles in cognitive function, particularly for those with the APOE4 gene variant. The difference between physical activity and exercise is key, with cardiovascular and strength training being essential. High intensity interval training is particularly beneficial. The importance of optimizing physical activity was not fully understood even a few years ago. Additionally, women are disproportionately affected by Alzheimer's disease, and it's not solely due to their longer lifespans. During the perimenopause transition, women experience bioenergetic shifts in the brain that can accelerate Alzheimer's pathology. Intervening during this time with the right approach could potentially mitigate some of the negative effects of estrogen loss, which is believed to be neuroprotective.
Perimenopause as a Brain Disease: Women with perimenopause face cognitive risks due to hormonal shifts, with individual risk factors like genetics, waist size, and widowhood playing a role. Hormonal interventions and ongoing research on sex differences in brain aging offer potential solutions.
Perimenopause is not just a stage of life, but a brain disease with significant implications for cognitive health. Symptoms like brain fog, irritability, and sleep disturbances are not merely side effects, but manifestations of hormonal shifts in the brain. Women with certain risk factors, such as the APOE4 gene, enlarged waist circumference, and a history of widowhood, are at an increased risk for cognitive decline and dementia during this transition. It's essential to pay attention to individual sex-specific risk factors, such as body fat distribution, and consider hormonal interventions in consultation with healthcare professionals. The ongoing research on sex differences in brain aging, including the role of muscle mass and glucose disposal, promises to shed more light on this complex issue.
Genetic Information: Empowerment, Not Fear: Genetic testing can provide valuable insights for health management, but it's crucial to consult healthcare professionals and stay informed about the latest research and recommendations.
Having access to genetic information, such as the APOE gene related to Alzheimer's risk, can be empowering rather than scary. The speaker in this conversation shares her experience of receiving her genetic results and how she used it as an opportunity to take control of her health. She emphasizes that science provides tools to help modify risks, and not using them seems worse than living in the dark. The conversation also touches upon the importance of starting conversations about genetic testing and potential lifestyle modifications at an early age, even for children. However, it's important to note that the interpretation and application of genetic information should be done in consultation with healthcare professionals. The conversation also highlights the importance of ongoing education and updating one's understanding of the latest research and recommendations.
Genes and Alzheimer's: Personalized Care and Risk Reduction: Understanding genes like APOE4, Tom40, and FTO influences Alzheimer's risk and progression through inflammation, lipids, and longevity. Personalized care and risk reduction come from genetic knowledge.
Understanding the role of genes, such as APOE4, Tom40, and others, in the development of Alzheimer's disease is crucial for personalized care and risk reduction. While some genes, like APOE4, have received more attention, there are other important genes, such as Tom40 and FTO, that influence the risk and progression of Alzheimer's. These genes can impact the disease through various pathways, including inflammation, lipids, and longevity. As our knowledge of these genes grows, so will our ability to provide targeted, personalized care for individuals at risk for Alzheimer's disease. It's important to note that most doctors may not be aware of this genetic information, making it essential for patients to educate themselves and advocate for their health. Overall, the future of Alzheimer's care lies in the integration of genetics and personalized medicine.
Alzheimer's risk: Complex interplay of genes and lifestyle: Genes and lifestyle choices interact to influence Alzheimer's risk. Carrying certain genes like APOE4 and TNF alpha increases risk, but healthy habits can help mitigate it. Each person's response to genetic factors varies.
Alzheimer's disease risk is not determined by a single gene or factor, but rather a complex interplay of multiple genes and lifestyle choices. For instance, the presence of both the APOE4 and TNF alpha genes increases the risk of developing Alzheimer's. Exercise, while beneficial, does not guarantee prevention. Each person's response to genetic factors can vary, similar to how LP little A gene affects heart disease risk differently. Therefore, adopting a comprehensive approach to risk reduction, including healthy lifestyle choices, can be crucial in mitigating the risk of Alzheimer's disease. It's essential to remember that even if you don't carry the APOE4 gene, you're still not completely risk-free, and supporting loved ones in their journey towards risk reduction can make a significant difference.
Personalized care for Alzheimer's risk involves tailored interventions: Individuals at Alzheimer's risk receive personalized care with various interventions including lifestyle modifications, supplements, and regular assessments tailored to their genetic markers and individual needs.
Personalized care is essential for individuals at high risk for Alzheimer's disease. This was highlighted in a recent clinical trial, in which participants, including Lauren, received an average of 21 different interventions. These interventions ranged from lifestyle modifications like regular follow-ups, exercise, and nutrition, to supplements like omega-3 fatty acids and specific vitamins. For individuals with certain genetic markers, like the APOE4 gene, more targeted interventions, such as higher doses of omega-3s and specific supplements, may be necessary. Regular assessments and tracking of various biomarkers, such as body composition, blood-based markers, and cognitive function, help healthcare providers fine-tune interventions and optimize care. Overall, personalized care is an iterative process that requires close monitoring and adjustment to effectively manage the risk of Alzheimer's disease.
Maintaining optimal vitamin D levels and taking adequate Omega-3 fatty acids can help reduce Alzheimer's disease risk for those with APOE4 gene variant: Individuals with APOE4 gene variant should maintain vitamin D levels around 40-50 ng/mL, take adequate Omega-3 fatty acids, consider therapeutic interventions, and engage in regular exercise to reduce Alzheimer's disease risk
Maintaining optimal vitamin D levels, ideally around 40-50 ng/mL, is crucial for individuals with the APOE4 gene variant to reduce their Alzheimer's disease risk. Vitamin D can be taken with meals and a little fat for better absorption. Additionally, Omega-3 fatty acids, particularly DHA, are essential for brain health, and individuals with APOE4 may require higher doses. The use of therapeutic human nanoparticles, which can cross the blood-brain barrier, is a promising approach for those at higher risk for Alzheimer's disease due to their ability to reduce amyloid accumulation. Regular exercise, like Lauren's, may also reduce the need for additional supplementation. Overall, a comprehensive approach that includes maintaining optimal vitamin D levels, taking adequate Omega-3 fatty acids, and considering therapeutic interventions can help reduce the risk of Alzheimer's disease for those with the APOE4 gene variant.
Magnesium L3 and 8 for MCI and Alzheimer's prevention: Magnesium L3 and 8 may improve symptoms of MCI and delay its progression. Exercise is crucial for brain health, especially for E4 carriers due to increased susceptibility to Alzheimer's. Lifestyle factors, including alcohol consumption and diet, require special consideration for E4 carriers.
Magnesium L3 and 8, a supplement that helps transport magnesium into the brain more effectively, shows promise in improving symptoms of Mild Cognitive Impairment (MCI) and may even delay its progression. However, its use in Alzheimer's prevention is not as well-established as other interventions, such as exercise, which is particularly beneficial for individuals with the APOE E4 variant. Exercise, which is crucial for brain health, is even more important for E4 carriers due to their increased susceptibility to Alzheimer's pathology. Other lifestyle factors, such as tobacco use, alcohol consumption, and cognitive engagement, also require special consideration for individuals with the E4 variant. While light to moderate alcohol consumption may be beneficial for non-carriers, E4 carriers may benefit more from reducing or abstaining from alcohol. The role of specific diets, including omega-3 fatty acids and MCTs, is also worth exploring further for individuals with the E4 variant. Overall, a personalized approach, taking into account individual risk factors and genetic makeup, is crucial for effective Alzheimer's prevention.
Personalized approach to THC and CBD use: Speaker suggests individuals conduct 'N of one studies' to objectively measure effects on cognitive function and sleep metrics, advocating for personalized approach to using THC and CBD due to conflicting study results and potential biases in epidemiological studies.
The use of THC and CBD, particularly in the form of edibles, for health benefits such as stress reduction and sleep improvement, is a complex issue with inconclusive scientific evidence. The speaker acknowledges the potential benefits but expresses uncertainty due to conflicting study results and the bias in epidemiological studies. They suggest that individuals should conduct their own "N of one studies" to objectively measure the effects on cognitive function and sleep metrics. The discussion also touches upon the importance of cognitive testing for Alzheimer's prevention and the limitations of current testing methods. The speaker shares a personal experience of underperforming on a cognitive test due to stress and distraction, raising questions about the test's ability to distinguish between effort and external factors. Overall, the speaker advocates for a personalized approach to using THC and CBD, emphasizing the need for more research and objective data to inform decisions.
Factors affecting cognitive performance differently based on cognitive domains: Cognitive tests results can be influenced by various factors including homocysteine, vitamin D, cholesterol levels, emotional state, stress, practice effects, individual differences, and underlying cognitive domains. A comprehensive understanding of cognitive health requires considering all these factors.
Certain factors, such as homocysteine, vitamin D, and cholesterol levels, can impact cognitive performance differently based on underlying cognitive domains. For instance, early Alzheimer's symptoms may affect memory tasks, while vascular risk factors may impact executive function measures. Stress and emotional factors can also influence cognitive test results. However, consistent cognitive decline warrants further investigation. During a specific testing session, a person's emotional state and external stressors might impact their performance, but over time, their cognitive function can be assessed more accurately. The presence of practice effects and individual differences, such as genetic factors and gender, should also be considered when interpreting cognitive test results. Odor identification, as a part of cognitive assessments, can provide valuable insights into potential cognitive impairments. The importance of subjective cognitive assessments, such as odor identification, lies in their ability to complement more objective measures and offer a more comprehensive understanding of an individual's cognitive health.
Changes in temperature sensitivity and smell can indicate early signs of neurodegenerative diseases: Aging-related shifts in temperature regulation and smell abilities may signal potential health issues like Parkinson's and Alzheimer's. Hearing loss is also a risk factor for dementia, and early intervention could help reduce cases.
Changes in temperature sensitivity and loss of smell can be early indicators for neurodegenerative diseases, such as Parkinson's and Alzheimer's. As people age, their temperature regulation and smell abilities can shift, and these changes may signal potential health issues. Additionally, hearing loss has emerged as a modifiable risk factor for dementia, and early recognition and intervention could potentially reduce the number of dementia cases. However, the exact reasons why these conditions are linked to neurodegenerative diseases are not fully understood and require further research.
Prioritizing Hearing Health and Regular Evaluations: Regular hearing evaluations and hearing protection are crucial for overall health and well-being, even in younger individuals. Despite imperfections in medical data and tests, prioritizing hearing health can lead to emotional benefits and improved quality of life.
Regular hearing evaluations and protecting hearing should be prioritized, even if it means identifying and addressing hearing loss in younger individuals. While there may be concerns about compliance and the desire to use noise cancellation technology instead, the precautionary principle suggests that there is no downside to protecting hearing. Doctors could do a better job of incorporating hearing evaluations into routine health checks. Additionally, subjectivity and learning effects can impact even objective tests, such as odor identification. Despite the imperfections and imprecisions in medical data and tests, it's important to focus on the overall improvement in health and well-being. Emotional benefits, such as reduced fear and increased hope, can also be significant. On a lighter note, the discussion touched upon Hilarity for Charity, a mission to raise awareness and funds for Alzheimer's disease research through comedy. The decision to focus on comedy was based on the belief that laughter can help alleviate stress and improve overall well-being, making it a powerful tool in the fight against Alzheimer's.
Supporting Individuals and Families Affected by Alzheimer's: The Horan Family Foundation supports individuals and families affected by Alzheimer's through personalized care, support groups, and research, inspiring early brain health education and caregiver training.
The Horan Family Foundation (HFC) is dedicated to supporting individuals and families affected by Alzheimer's disease through personalized care, support groups, and research. The founder's personal experience with Alzheimer's in her family inspired her to create HFC, which aims to provide care and relief for caregivers, as well as educate young people about brain health and the importance of taking care of it from an early age. HFC offers various ways for people to get involved, including donations, sharing personal stories, and hosting fundraisers. Due to the challenges of fundraising during the pandemic, HFC encourages people to find ways to give back that align with their personal interests and abilities. The foundation also partners with organizations to provide caregiver training and support. Overall, HFC's mission is to help people today with Alzheimer's and inspire them to take care of their brains for tomorrow.
Supporting caregivers through Alzheimer's journey: Hilarity for Charity offers tools and resources to help navigate caregiving for Alzheimer's, emphasizing hope, control, and prevention through open dialogue and education.
While there's no formal training to be a caregiver, organizations like Hilarity for Charity aim to provide tools and resources to help navigate the unexpected journey of caregiving. Through a mix of comedy and serious information, HFC encourages hope and control for those dealing with Alzheimer's. Recently, research shows that up to 40% of Alzheimer's cases may be preventable, making open conversations about the disease even more crucial. HFC's membership program offers in-depth content and resources to further support those on this journey. Overall, HFC emphasizes the importance of addressing the challenges of Alzheimer's through open dialogue and education.
Importance of consulting healthcare professionals: Always consult with healthcare professionals for medical conditions and don't rely solely on podcast information. Disclose potential conflicts of interest for transparency.
While listening to health-related podcasts, including this one, can provide valuable information, it should not replace professional medical advice. Users should always consult with their healthcare professionals for any medical conditions they have and should not disregard or delay seeking medical advice based on podcast content. Additionally, it's important for transparency and trust that I disclose any potential conflicts of interest, which can be found on my website at peteratiamd.com/about. There, you can find an up-to-date and active list of the companies I invest in or advise. It's crucial to prioritize your health and well-being, and combining professional medical advice with the knowledge gained from podcasts can lead to the best possible outcomes.
