If a Relative Has Alzheimer’s Disease, Am I at Risk?

They are right to consider this. Studies demonstrate that a family history of Alzheimer’s raises the risk of the disease. The most common inherited risk factor is a variety of a certain gene, commonly called the APOE4. It is not rare—about 25% of the world’s population has this gene.

It’s understandable that a person with this or other genetic risk of Alzheimer’s would be concerned. But there’s good news: According to a May 2022 study published by the American Academy of Neurology, certain lifestyle factors are just as important, maybe more important, than heredity.

This study examined 30 years of data on the genetic and lifestyle factors of more than 11,000 people of European and African ancestry in the U.S. While neurologists have known for a long time that lifestyle choices can protect against dementia, this study is one of a growing number demonstrating that the protective benefits apply to everyone. “The good news is that even people who are at the highest genetic risk who live by this same healthier lifestyle are likely to have a lower risk of dementia,” said study author Adrienne Tin, Ph.D., of the University of Mississippi Medical Center.

Tin’s study and previous research have revealed specific steps we can take to protect brain health:

Manage health conditions that affect the brain. Through a number of processes, heart disease, hypertension, diabetes, high cholesterol, depression and other conditions can damage the brain. Have regular health care appointments, take medications correctly, and follow the doctor’s recommendations to help control those conditions.

Get plenty of exercise. Studies show that inactivity raises the risk of dementia to a degree comparable to genetic risk. Exercise stimulates brain activity, building a more resilient brain. Increasing our level of exercise could slow or delay the progression of dementia. Ask your doctor to recommend an appropriate exercise program, and add extra physical activity to your life whenever you can.

Choose a brain-friendly diet. Fill your plate with vegetables, fruits, berries, whole grains, nuts, fish, poultry, olive oil and other healthy fats. Limit your intake of red meat, unhealthy fats, refined sugars and carbohydrates, and other processed foods. Many studies have demonstrated the effectiveness of this type of diet in lowering the risk of dementia. Talk to your doctor or a dietitian about a meal plan that’s right for you.

Sleep well. Good quality sleep protects the brain. It is during sleep that the brain is able to remove harmful substances that cause memory loss. Seek treatment right away for sleep disorders, and practice good sleep habits—for example, set aside enough time for sleep, create a quiet, dark sleep environment, and avoid the use of light-emitting devices, such as smartphones, at bedtime. Report sleep problems to your doctor.

Quit smoking, and limit alcohol intake. Drinking too much alcohol, and smoking any amount, are bad for the brain. Studies show smoking raises the risk of Alzheimer’s by 157%. Overusing alcohol causes shrinkage of the brain and raises the risk of head injuries. If you’re having problems controlling your drinking or quitting smoking, talk to your doctor.

Get plenty of mental stimulation. The brain isn’t a muscle, but it needs exercise. Mental stimulation helps build connections between brain cells that allow memories to be accessed via different paths—a big plus when a person has early Alzheimer’s disease. Formal education is protective, and it’s never too late to give your brain a workout by learning something new. Spending time with other people is also great brain stimulation.

Control stress. Prolonged stress releases an excess of the hormone cortisol into our bodies, which over time can harm the brain. If you feel that your stress is out of control, talk to your health care provider. Stress management techniques and counseling can help.

Here’s one more thing family caregivers should know: Caregiving is hard work, and may make it difficult to follow a brain-friendly lifestyle. This can raise the risk of dementia even for caregivers who do not have a genetic risk. Talk to your doctor about the topics above, and learn about resources to help you care for your loved one, which might include help from family, friends and senior services agencies, an aging life care professional (geriatric care manager), and a memory care or other senior living community.

The information in this article is not intended to replace the advice of your health care provider. Talk to your doctor about your risk factors for memory loss.