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RISK FACTORS

GENERAL INFORMATION
    You are probably wondering what the word "risk factor" means. A risk factor increases or decreases the likelihood of getting alzheimer's disease; risk factors are separate from the cause of the disease. For example, age is a risk factor for alzheimer's disease. At age 65, 2% of the population will have alzheimer's disease, but by age 85, more than 30% of the population will have the disease. Aging increases the likelihood of having the disease, but aging is not the cause of alzheimer's disease.
    Risk factors can be positive or negative. Positive risk factors increase the risk of getting the disease. For example, age is a positive risk factor. Education, on the other hand is a negative risk factor. Education decreases the risk of getting alzheimer's disease. I have designed a fun, informative test which you can take here online. Get a pencil and paper. Record your answers to the questions. Then score the test. I also show you what the total test score means. I also explain why each question increases or decreases your risk. So get your pencils and paper ready.

ARE YOU AT RISK FOR ALZHEIMER'S DISEASE?

Note:This test is copyrighted and may not be used for commercial or research purposes without express permission from the author.

1. Are you male or female?
[Score 0 if male, +2 if female.]

2. What grade level did you achieve?
[Score +2 if less than high school education.Score 0 if you completed high school only. Score -1 if you started or completed college. Score -2 if you have any education beyond college.]

3. How often do you exercise weekly?
[Score +1 if none. Score 0 if once. Score -1 if twice. Score -2 if more than twice weekly.]

4. How many relatives, including mother, father,grandfather,grandmother,brothers, or sisters have had alzheimer's disease?
[Score 0 if none,+2 if one relative,+4 for two relatives,and +6 if three or more relatives.]

5. Have you ever had any kind of cancer?
[Score -1 if yes, and 0 if no.]

6. Do you currently have diabetes?
[Score -1 if yes, and 0 if no.]

7. Do you recall your dreams easily?
[Score 0 if yes, and +1 if no.]

8. What is your age?
[Score 0 if 50 or under;score +1 if 51 to 60;score +2 if 61-70; score +3 if 71 or older.]

9. How often do you eat meat weekly?
[Score -1 if never;score 0 if once;score +1 if once;score +2 if three or more.]

10. How often do you eat fish weekly?
[Score 0 if never;score -1 if once; score -2 if twice; score -3 if twice or more.]

11. How often do you get cold sores yearly?
[Score 0 if never; score +1 if once or twice; score +2 if more than twice.]

12. How many cigarettes do you smoke daily?
[Score 0 if none; score -1 if 1 pack or less; score +1 if more than l pack.

13. Have you ever had a stroke or transient ischemic attack?
[Score +2 if yes; score 0 if no].

14. How often do you drink red wine weekly?
[Score 0 if none; score -1 if one or two glasses; score -2 if three glasses; score +1 if three glasses or more.]

15. How many times weekly do you take aspirin, ibuprofen, or similar over the counter pain medicines?
[Score 0 if never; score -1 if once or twice weekly; score -2 if three or more weekly.]

The next step is to total all plus scores. Then total all minus scores. Then add the net results. For example, if the total plus score is +7 and the total minus score is -9, the net score is -2. On the other hand, if the total plus score is +9 and the total minus score is -7, the net score is +2.

WHAT THE TEST RESULTS MEAN

    A score of +4 or more means that you have more total risk factors for alzheimer's disease in your background than do the majority of people who take this test. On the other hand, if you have a score of -4 or less, it means that you have less total risk factors in your background than do the majority of people who take this test. Having a high risk score does not mean you will get alzheimer's disease. Many people, at high risk for the disease,never get the disease. On the other hand, having a low risk profile does not mean you will avoid alzheimer's disease. The test is useful, because it alerts you to risk factors that can be modified. For example, eating more fish in your diet may delay alzheimer's disease. This is a risk factor that you can do something about today. Many other risk factors can be modified. To learn about them, please read the material that follows.

    Question 1  asks whether you are male or female. Being female is a risk factor for alzheimer's disease. For every male with alzheimer's disease, there are two females with the disease. Females probably get alzheimer's more often because they live longer than men. Women live an average of 5 years beyond men, and, as I already mentioned, the incidence of dementia increases with age. Thus, women probably have a greater incidence not because of their gender, but because they live longer.

    Question 2  asks what level of schooling you completed. Education decreases the risk of getting alzheimer's disease. Those with grade school educations only are more prone to the disease; whereas, those with post-college training have markedly less risk. Education can be life- long enrichment too. If, as you age, you take an active interest in hobbies and activities, this can help ward off alzheimer's. Taking courses, travel, and learning new things causes your brain to grow more connections between brain cells, even in old age. It is never too late to learn, and new learning is an excellent way to shape your mind and defend against alzheimer's disease.

    Question 3 asks how often you exercise weekly. The more you exercise, the less risk for alzheimer's disease. Studies have shown repeatedly, that people who exercise regularly and are active physically, have less alzheimer's risk. I have a theory why this may be so,but this idea is not yet proven. One of the earliest effects of alzheimer's disease is a reduced blood flow to the brain. Maybe some of the effects of alzheimer's might be blocked by increasing brain blood flow. Exercise increases blood flow, and this may be how it reduces risk. Ginkgo biloba, an herbal compound that improves memory and mood in alzheimer patients, may also work by increasing blood flow.

    Question 4  asks how many relatives in your family have had alzheimer's disease. Genetics is a strong risk factor for alzheimer's disease. Statistically, the more relatives who have had alzheimer's disease in your family, the stronger is your personal risk.

    Question 5  asks whether or not you have had cancer. Studies have found that alzheimer patients do not get cancer as often as the general elderly population does. Why is this so? The reason is not clear, but some biochemical abnormality, found in alzheimer patients ,may prevent the development of various cancers. Another possibility is that patients with cancer have some blood factor that prevents the development of alzheimer's disease. In any case, if you have had cancer, it reduces your risk of developing alzheimer's disease.

    Question 6  asks whether or not you havve had diabetes. If you have diabetes,or have had diabetes in the past, you may be at reduced risk for alzheimer's disease. Why is this? Studies have found that alzheimer patients have a below normal incidence of diabetes. It is possible that some factor in the blood stream of alzheimer patients prevents the development of alzheimer's disease. It is also possible that high blood sugar levels, found in diabetics may actually help prevent the development of alzheimer's disease. Why? Well for one reason, when alzheimer patients are given foods that raise their blood sugar to diabetic levels, these patients have improved thinking, memory, and behavior. Further, it is well known that many alzheimer patients, early in their illness, develop abnormal cravings for sweets. In such patients, an increased sweet craving may reflect a real need for more sugar.

    Question 7  asks whether or not you recall dreams easily. One study found that an inability to recall dreams increases the risk of developing alzheimer's disease. Why should dream recall be a risk factor? Dreams are controlled by an area of the brain rich in cholinergic brain cells, the kind of brain cells destroyed by alzheimer's disease. Thus, early loss of cells in the dream area of the brain could lead to lack of dream recall. Further, it is well known that most alzheimer patients have both less dream recall and time spent dreaming.

    Question 8  asks your age. As mentioned before, age increases alzheimer risk. Risk begins to increase after age 50. The incidence of alzheimer's disease is 3 to 5 percent at age 65, but by age 85, 30 to 50 percent of the population is affected by the disease.

    Question 9  asks how often you eat meat weekly. Eating red meat often has been associated with high blood cholesterol levels. High blood cholesterol levels may be a risk factor for alzheimer's disease. Why? The apolipoprotein E4 gene, which helps control cholesterol levels, has been shown to increase the risk of alzheimer's disease after age 65. And recently, several studies have found that persons who take cholesterol-lowering drugs have a reduced risk for alzheimer's disease. One such drug, simvastatin,can actually reduce formation of amyloid beta protein, which is the protein believed repsonsible for alzheimer's disease. Thus, the more red meat you eat, and the higher your blood cholesterol levels, the higher your risk for alzheimer's disease.

    Question 10  asks how often you eat fish weekly. Studies have shown that high fish consumption lowers the risk for alzheimer's disease. For example, Nigeria has one of the lowest rates of alzheimer's in the world. Nigerians, coincidentally, consume large quantities of fish. Why should fish lower risk? Well, as we have seen before, high blood cholesterol can increase risk. It turns out that omega 3 fatty acids, found abundantly in fish, can actually lower blood cholesterol levels and help prevent the formation of cholesterol plaques. Thus, eating more fish and less red meat, will lower blood cholesterol, which in turn, will decrease your risk of getting alzheimer's disease.

    Question 11  asks how often you get cold sores yearly. This is a minor risk factor for alzheimer's disease. The herpes simplex type 1 virus, which causes cold sores, increases the risk of alzheimer's disease later in life, after age 65. But ther virus does this only if you happen to have an apolipoprotein E4 allele. As mentioned before, this protein controls the transport of cholesterol. The E2 and E3 forms of the apolipoprotein E gene do not seem to alter risk in those who have high exposure to the herpes simplex 1 virus, but the E4 form does. Thus, the more often you get cold sores, the higher is your presumed risk.

    Question 12  asks how often you smoke. Many studies have found the light smoking, less than 1 pack daily, seems to reduce the risk of alzheimer's disease. On the other hand, heavy smoking seems to increase risk. Why? Cigarettes contain nicotine, which may actually stimulate the same brain cells damaged by alzheimer's disease. Heavy smoking, on the other hand, creates large quantities of dangerous free radicals, which may help destroy brain cells. If you don't smoke now, don't start. Light cigarette smoking may reduce alzheimer risk, but it may lead to a host of other diseases, such as cancer, heart disease, and emphysema.

    Question 13  asks whether or not you have ever had a stroke. Stroke is a risk factor for alzheimer's disease. Why? Stroke and alzheimer's are not easily separated. For example, some stroke patients show amyloid deposits in their brains, as do alzheimer patients. Further, many alzheimer patients show evidence of brain infarcts, as do stroke patients. The blood vessels in the brains of alzheimer patients may actually be damaged by amyloid beta protein, the protein believed responsible for alzheimer's disease. Amyloid beta protein actually kills endothelial cells, which line the brain vessel walls. That is why amyloid beta deposits are often found near brain blood vessels. Thus, the line between stroke and alzheimer's disease is not as clear as it might be, and stroke risk increases alzheimer risk. Part of the reason may be that blood cholesterol tends to be high in both alzheimer patients and stroke patients. Alzheimer patients tend to show high blood cholesterol before they develop alzheimer's disease, but once they actually develop the disease, blood cholesterol and triglycerides tend to fall. The reason for this is unclear.

    Question 14  asks how often you drink red wine. Studies have shown that people who drink red wine regularly have less incidence of alzheimer's disease. Why? Red wine is rich in antioxidant compounds, and these antioxidants may prevent or reduce the onset of alzheimer's disease. Numerous studies have shown that alzheimer patients lack a good antioxidant defense system in their blood. If you take blood from an alzheimer patient, and compare it with blood from a non-demented elderly person, the blood of the alzheimer patient will not trap damaging free radicals as well. Free radicals are highly energetic electrons that hook on to proteins. Free radicals have been linked to cancer, alzheimer's disease, aging, and many other diseases. So drinking red wine in moderation may help reduce risk.

    Question 15  asks how often you take over the counter pain medications such as aspirin, ibuprofen, and indomethacin. Such medicines, known as non-steroidal antiinflammatory agents, greatly reduce the risk of alzheimer's disease. It was interesting how this fact was discovered. Early studies had found that persons with rheumatoid arthritis had a lower than normal incidence of alzheimer's disease. Researchers at first wondered if arthritis somehow made one immune to alzheimer's disease. Later on, someone theorized that the medications that arthritics take may actually lower alzheimer risk. Thus, numerous studies were done, and most studies seem to find that regular users of anti-inflammatory drugs does really lower the risk of alzheimer's disease. One clinical study actually showed that anti-inflammatory drugs actually did slow the progression of alzheimer's disease in living alzheimer patients. Why do these drugs reduce risk? The reason may be their anti-inflammatory action. Studies have made it abundantly clear that the brains of alzheimer patients are in a state of inflammation. There is an abundance of free radicals. Microglia, which are activated during states of inflammation, become increasingly abundant. And inflammatory compounds, such as interleukin 6 and tumor necrosis factor alpha, are found to increase in the brains of patients. Anti-inflammatory drugs may reduce that cycle of events, but this is speculation, and has not yet been proved.