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6.7 Million Seniors Hit with Alzheimer’s in ’23, Set to Double by 2060! Here’s Your Risk Playbook.

Staff

      As of 2023, over 6.7 million people in the United States over 65 years have received an Alzheimer’s diagnosis, and an estimated 14 million people may receive their diagnosis by 2060. Alzheimer’s disease impacts a significant portion of the American population, with nearly two-thirds of diagnosed individuals being women. As the U.S. elderly population continues to expand rapidly, Alzheimer’s disease poses a major and increasing public health challenge. 

      Currently, Alzheimer’s disease ranks as the sixth leading cause of death in the United States, with one in three seniors dying with this condition or another form of dementia. As African Americans are disproportionately burdened with the highest percentage of Alzheimer’s disease and are roughly 1.5 to two times as likely as whites to develop dementia, it is vital that they understand the risk factors and not dismiss early signs of the disease as a natural part of the aging process. 

      Most Alzheimer’s cases do not have a clearly identified cause, although the risk of developing the disease increases with age. However, the fact that more women are affected than men cannot be solely attributed to their longer life expectancy. Several factors, including hypertension, high cholesterol, and vitamin D deficiency, have been identified as predictive indicators, and some may find some other key factors surprising. For men specifically, erectile dysfunction and an enlarged prostate are significant predictors, while osteoporosis is a critical factor for women.

      A study by Duke and Columbia Universities revealed that older, non-white adults with mild cognitive decline are more likely than their peers to live in areas with higher air pollution and near toxic disposal sites. These findings contribute to a growing body of research exploring the links between environmental factors and brain health. The study suggests that a patient’s address may be just as crucial for care providers as traditional medical evaluations. 

      In 2020, the Minority Aging Research Study found that changes in body mass index (or BMI instability) were related to faster cognitive decline among African American older adults. Another study found that the more stressful events a person was subjected to in early life, the more impaired their cognition became in later life. Stressful experiences considered in the study included losing one’s job, facing financial insecurity, being raised by a parent with substance abuse issues, surviving the death of a child, and engaging in military combat. The study further found that each stressful experience accounted for the equivalent of four years of cognitive decline.

      Racism, too, has been identified as a factor. 

      “Chronic exposure to racism and interpersonal discrimination among marginalized communities leads to stress that affects the body and influences physiological health, and likely contributes to the development of cognitive decline,” said Jennifer Manly, Ph.D., professor of neuropsychology at Columbia University Irving Medical Center. “Overall, our findings indicate that racism impacts brain health.”

      But as with a number of studies, UC San Francisco scientists developing a method to predict Alzheimer’s disease up to seven years before symptoms appear utilizing AI, the most influential conditions for the prediction were high cholesterol and osteoporosis in women. 

      Early-onset Alzheimer’s disease can be genetically determined, including cases linked to early-onset Alzheimer’s. Individuals with these genetic variants often develop symptoms between the ages of 40 and 60. People with two copies of the APOE4 gene variant—the gene known to increase the incidence of Alzheimer’s and to be associated with an earlier age of onset— are almost certain to develop Alzheimer’s, and researchers are proposing frameworks for early diagnosis. 

      “There have not been a lot of studies following this community from middle age into late life. But understanding the risk and protective factors throughout someone’s life is key to improving brain health and reducing disparities,” said Rachel Whitmer, co-director of the UC Davis Alzheimer’s Disease Research Center.

      Alzheimer’s disease has two main types in terms of family traits: one is inherited in an autosomal dominant fashion, and the other has some hereditary influence. While having first-degree relatives with Alzheimer’s increases one’s risk, it doesn’t mean that everyone will develop the disease. Engaging in intellectual activities, maintaining social interactions, following a healthy diet, getting rest, and reducing stress may improve quality of life and potentially postpone cognitive impairment. 

      Research from France has shown that a combination of lifestyle and other modifiable risk factors can lower the risk of dementia, regardless of genetic susceptibility. According to the research, up to 40% of dementia cases may be delayed or slowed by addressing 12 modifiable risk factors such as a healthy diet, regular exercise, cardiometabolic and renal factors, cognitive activities, smoking, alcohol consumption, and depression.

      Various studies highlight the importance of early identification and treatment, particularly within minority populations who might experience disparities in healthcare access. Black Americans, for instance, are often diagnosed later in the disease process. Research underscores the necessity for targeted dementia prevention efforts tailored to specific risk factors among different ethnic groups. Awareness and management of modifiable risk factors can significantly impact the onset and progression of Alzheimer’s. 

      What it all boiled down to for Dr. Angela Allen with Banner Alzheimer’s Institute was this: “African Americans need to get involved so that we can make sure we’re addressing the concerns within ourselves, and possibly our family members, too.”

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