Imagine, if you knew in advance that you would definitely develop Alzheimer's disease in the future, what would you do? Actually, what can we do after knowing such a thing? This is a big problem that many doctors and researchers face today. Recently, a group of researchers found that about 20% of people who develop Alzheimer's disease can be identified early just by looking at their genes. That's why it's so important to talk about this.
What is this APOE4? Why is it linked to Alzheimer's disease?
Simply put, this `APOE` is a gene in our body. Its main function is to help transport fats such as cholesterol in our blood. There are different variants of this `APOE` gene. We get this gene, one from our mother and the other from our father.
Most people have the variant called `APOE3`, but some people may have the variant called `APOE4`.
- On average, about 20% of the population has one copy of the `APOE4` gene.
- However, about 2% of the population inherits two copies of the `APOE4` gene (from both the mother and the father). In medical terms, we call these people `(APOE4 homozygotes)`.
It has long been known that people with both copies of the APOE4 gene have a very high risk of developing Alzheimer 's disease .
What does the latest research say?
A recent study published in the prestigious medical journal Nature Medicine explored this in more depth. They analyzed the health data of 3,300 donated brains and 10,000 individuals.
There they found something surprising: 95% of people with both copies of the APOE4 gene had changes (biomarkers) related to Alzheimer's disease in their brains or body fluids.
These changes usually began around the age of 55. Symptoms began around the age of 65. Finally, dementia , a severe decline in memory and thinking ability, was diagnosed around the age of 74.
Simply put, researchers say that having two copies of APOE4 is more deterministic than it is 'increasing risk.' If this is true, Alzheimer's disease could become the most common hereditary disease in the world.
The best thing about this is that in the future, there may be an opportunity to identify and treat people with brain disease before symptoms appear.
So, does everyone have to take this test?
Here's the most important question. The answer is, no! Given the current situation, medical associations do not recommend this test for everyone, regardless of symptoms. There are several reasons for that.
Understand the limitations of this research
- Ethnicity: This research was conducted mostly on white people of European descent. So it is not yet clear to what extent these results apply to people in our country, that is, Asians.
- Nature of the sample: The data was collected from people who participated in Alzheimer's research, so they may have a slightly different predisposition to the disease than the general population.
Not everyone gets symptoms.
This is the most important comforting thing. The research itself says that not everyone who has both copies of `APOE4` has developed symptoms . Some people have lived well into their 80s without any signs of dementia. Also, the age at which symptoms begin can vary greatly from person to person.
| Pros of taking the test | Cons & Risks of Taking the Test |
|---|---|
| You can be aware of the risk in advance. | There may be severe stress and anxiety. |
| There is a great temptation to change lifestyle (eating, drinking, exercise). | The results are not 100% certain. It is not possible to say for sure whether the disease will develop or at what age it will develop. |
| You may be eligible for new treatments or research in the future. | There is currently no permanent treatment that can prevent the disease. |
| Families can also get some idea of their risk. | Things like insurance and employment may be affected in the future (ethical issues). |
If you are thinking about this test, what should you do?
Imagine that someone in your family has Alzheimer's and you are worried about it. If you are thinking about this `APOE4` test, here are some things to keep in mind.
1. Don't just take the test: Don't take this kind of test just out of curiosity. Be especially careful with tests ordered online.
2. Talk to your doctor: First, talk to your family doctor or a neurologist about this. Be open about your family history and your fears.
3. Genetic Counseling is essential : If you are going to have a test like this, it shouldn't be just a matter of getting the report. It is essential to talk to a genetic counselor or a doctor who specializes in this before and after. You need to explain what the result means, how it will affect your life, and how to cope with the psychological impact it will have.
4. Think about things you can control: We can't change our genes. But there are many things we can control. The best thing we can do is adopt a lifestyle that is good for brain health .
- Eat a balanced diet.
- Exercise regularly .
- Get a good night's sleep.
- Control blood pressure, diabetes, and cholesterol levels.
- Do things that challenge the brain (reading books, solving puzzles, learning something new).
- Be social.
One veteran doctor says, "I've even changed the language I speak to patients now. I never say that someone is 'suffering from a disease.' I say that they are 'living with neurocognitive changes.'" This shows how important hope and a positive attitude are.
Take-Home Message
- The `APOE4` gene is a major risk factor for Alzheimer's disease, especially if you have two copies of it, which greatly increases your risk.
- Although recent research further confirms this connection, further study is needed to determine the extent to which its results are relevant to our population.
- Not everyone who has this gene will develop the disease. There are people who age without symptoms.
- Currently, it is not recommended to routinely test for APOE4 in asymptomatic individuals.
- If you have any concerns or questions about this, the best thing to do is to discuss genetic counseling with your doctor.
- Rather than worrying about genes, you can reduce your risk by adopting a brain-friendly lifestyle that we can control.
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