Leading researcher discusses Alzheimer’s disease and dementia

Alexandra Touroutoglou, PhD, a neurology scientist, explains why more women than men are living with Alzheimer’s disease (AD) and how to recognize early symptoms of the ailment.

In the United States, almost 2 in 3 people with Alzheimer’s disease are female. But that number is somewhat misleading, Dr. Touroutoglou says. As people get older, their risk of AD goes up. Since women live longer than men, there are also more older women living with AD.

When you look at men and women of the same age, it’s not clear that women are at greater risk. “The research on this has been inconclusive,” she says. Some studies suggest that there might be differences between men and women in the risk for developing AD because of biology—such as genetic differences or the role of female hormones like estrogen. Scientists are still exploring those possibilities, however.

It’s clear, though, that three main factors increase the risk of Alzheimer’s dementia, regardless of gender:

  • Age: Aging is the most important risk factor for AD. Although there is a form of AD that affects people younger than 65, most people with the disease are older. AD affects 17% of people ages 75 to 84, and 32% of people 85 and older.
  • Genetics: Researchers have found a few genes linked to an increased risk. The most important gene identified so far is called APOE-e4.
  • Family health history: People with a parent or sibling with AD are more likely to develop the disease themselves.

“If you or a loved one are experiencing these signs, the best thing to do is to talk to your doctor and make an appointment to see a specialist,” said Touroutoglou.

Early signs of Alzheimer’s disease

Most people experience some changes in their memory as they get older. “Forgetfulness is a normal part of aging. You might forget someone’s name, for example, or go into a room and say to yourself, ‘What was I coming in here to do?’,” Dr. Touroutoglou says. “If you can retrace your steps to remember what you were doing, or recall something later with a reminder, that’s normal forgetting.”

Normal forgetting doesn’t interfere with your ability to live independently. “In Alzheimer’s disease, the forgetting begins to disrupt a person’s independence and daily life and sometimes even their safety,” she adds.

Common early signs of AD include:

  • Asking the same questions over short period of time
  • Frequently misplacing things
  • Word-finding difficulties (trouble remembering words when speaking and writing)
  • Difficulty with planning and problem-solving
  • Forgetting to pay the bills or forgetting that you bought something and buying it again
  • Withdrawal from social activities
  • Changes in mood and personality, such as developing depression or anxiety

These changes are common in people of all genders who develop AD. “If you or a loved one are experiencing these signs, the best thing to do is to talk to your doctor and make an appointment to see a specialist,” says Touroutoglou.

Touroutoglou and her colleagues study older adults who maintain excellent memory and brain function well into late life. These older adults are called “superagers,” and they may hold clues to preventing dementia. “Memory decline may be a normal part of aging, but it’s not inevitable. Some older adults avoid the brain shrinkage and memory loss that typically go along with aging,” she explains. “Their brains remain youthful—imagine a 25-year-old brain in a 75-year-old body.”

Alzheimer’s disease is thought to be mainly caused by two proteins in the brain, tau and beta amyloid. Interestingly, the superagers Dr. Touroutoglou studies have beta amyloid in their brains, but it doesn’t seem to cause trouble. “They somehow manage to not get AD, despite the fact that they have the same level of amyloid in their brains as typical older adults,” she says.

Superagers, she found, seem to have more connections between brain cells than do other older adults. That finding led to an ongoing Alzheimer’s clinical trial at Mass General. Dr. Touroutoglou and her colleagues are treating people with early AD using transcranial magnetic stimulation (TMS).

TMS uses magnetic fields to stimulate brain cells. Her goal is to improve connections between brain cells—and, hopefully, reduce memory loss and other symptoms of AD. “Studying superagers may lead us to discover new ways to prevent or treat dementia,” she says.

Preventing Alzheimer’s dementia

Dr. Touroutoglou and her colleagues continue to study new ways to prevent AD. But already, science has pointed toward behaviors that can protect against the disease.

These activities may help reduce your risk of dementia:

  • Cognitive training: “It is unclear if playing brain games on your phone or computer will help,” Dr. Touroutoglou says. “But you can increase the odds of a healthy brain by engaging in activities such as reading, socializing, and learning a new skill,” she says.
  • Heart health: Heart disease is a risk factor for dementia. Controlling blood pressure and taking other steps to keep your heart healthy may also protect your brain.
  • Eat well: A healthy diet has been linked to a lower risk of dementia. “A heart-healthy diet is also a brain-healthy diet,” Dr. Touroutoglou says.
  • Exercise: Regular physical activity can improve your brain health. “You don’t have to start running a marathon. But you want to make sure you remain physically active. You should talk to your doctor to see what makes sense for you,” she says.

The thought of memory loss can be troubling for aging adults, especially in people with an increased genetic risk of Alzheimer’s. But people can continue to live meaningful lives after a dementia diagnosis. When you recognize the early signs of the disease, you can get a timely diagnosis and begin to make plans for managing symptoms.

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