Welcome to another edition of the Dementia Care Partner Talk Show.
Now here's dementia care expert Teepa Snow and your host, Greg Phelps.
Hello and welcome to the Dementia Care Partner's podcast series
brought to you by Positive Approach to Care.
I'm your host, Greg Phelps, along with Teepa Snow
and our topic today is one that we've touched on previously, but today,
perhaps we can go a little more in-depth.
The question is, which dementia risks
can I take and do genetics play a role?
So let's answer the first one first and then look at reducing risk factors.
So, no, let's OK, the last one first.
Let's let's go with genetics first.
I'll get it straight. First one first. Last or last?
Second one in the middle.
OK, so whichever one
we go with, we got to know both is what I hear you saying. Sure.
So what role does genetics play in which dementias?
Is that one of the two that you would like to go with? Yea let's go with that
Yeah. Oh, OK. All right.
So four different kinds of Alzheimer's.
Oh, did you just hear me say four different kinds of Alzheimer's?
Oh, yeah, I did.
Yeah, I just sort of scratched my head on that one.
Yeah, because Alzheimer's is not all one form or type or
I mean, it does have characteristics that make it Alzheimer's.
In other words, you got
beta amyloid plaque and you got tau pathologies, both of them.
How you got them, though, can vary.
And so there's one form of Alzheimer's called Presenilin.
And it's a type where if you get one gene from either parent
you will get young onset Alzheimer's.
It's a dominant gene.
It is a gene that triggers the onset
of the development of the beta amyloid plaque and some other things.
So you start to develop your tau
pathologies and your bado amyloid and your glial cell activity.
So if you get one of those presenile genes.
Ouch. But. If you didn't, then you don't.
So, you know, the tricky part there is historically
we didn't know about presenilin genes, and so people would have children.
And it wasn't until after they had their children.
And then some people had it, some didn't.
So we didn't realize that, oh, well, you had to get the one gene
from the one parent, because they only had to have one.
And then they then developed their dementia.
So what we now know is we can identify those families who have that
presenilin gene. And we do have them fairly well identified.
You can double check and see if you're one of those people.
If so, then we now know that, oh, that's not a good gene to have.
But it's also a fairly rare.
I mean, that is not a very common form of Alzheimer's.
It just isn't. Now, there's another thing that
is and it's called APOE.
And then you can have one of three variations, two, three, or four.
So if you have fours and you get a four from mom and a four from dad,
oh, your risk of getting Alzheimer's is pretty good.
If you get a four from one and a three from the other,
yeah well, your risk is up some.
If you get two twos, not going to happen.
If you get two threes, not going to get it,
except you still could get it, but not because you carry that gene.
So it's a risk gene.
There are other problems in the medical world that are sort of
similar, aren't they, where it takes two really to tangle generally.
Yeah, it's called a recessive gene.
And so or you have to have two of them to really for sure have the impact
if you only have one.
Your risk goes up, but it doesn't necessarily mean it's going to happen.
So, you know, within Alzheimer's, there's those variations
and then there are other reasons.
It's called a spontaneous mutation, which means it doesn't have anything to do
with genetics, really.
Your just, your system spontaneously mutated and you hit the jackpot.
So these are these are things that we really can't worry about.
They're beyond our control.
Let's look at some things that we can control, because that's
that's sort of our great hope isn't it, for most of us, we want to eat it.
Greg, I've got to go back to it, because I only talked about Alzheimer's.
This is this tricky part now, Down Syndrome, Trisomy 20, 21.
Well, they they have those genetic codes only they get an extra copy.
So the risk goes up now differently, like Lewy Body or FTDs.
There are some of those, again, just like Alzheimer's,
that would be genetically linked, but a lot of it is not, its lifestyle
and other things.
So now let's talk about the risks, because just like Alzheimer's.
Alzheimer's is not unique. Some of the other dementias are in that same boat
where, you know, you have a primary gene and then you have other related genes.
Alzheimer's, we have at least five.
Now, have you ever thought of going into politics?
Because I always have a hard time getting a straight answer from,
you know, if there were straight answers.
We have we have a cure for this condition.
That's true. Yeah. Yeah. Yeah.
So now let's really change course
and let's talk about risk factors we can do something about.
Because I can't affect my gene pool.
I truly can't. I mean, if I know my gene pool, it gives me some
either solace perhaps or it gives me alert
or it makes me wonder, OK, now I need to be extra careful
on my other risk factors because I do have risk there.
So let me see what I can do with these others.
So some risk factors, blood pressure,
blood sugar. Oh, that's a biggie.
Managing blood sugars, making sure you, if at all possible, do not get into
insulin intolerance issues, whether hyper or hypoglycemic.
Same thing with the blood pressure.
Hypo or hyper, too high or too low, not good.
We also know that sort of like cholesterol
levels and lipid levels, those are risk factors.
So the things you can do, what you take in, what you put in,
what you put through is sort of important to understand,
because our brains and our bodies in our guts and our brains
are actually more connected than we used to think they were.
And we also know that
that our stress level matters.
So if we allow ourselves to have high cortisol levels
over periods of time where we just put out cortisol, which is that stress hormone,
when we feel threatened and it happens, and it happens, and it happens.
We're actually predisposing our brain.
We're increasing the risk that we're going to find
that we start developing abnormal stuff going on in our brain,
sleep, not being able to stay asleep at night more than anything.
So you go to sleep, but then you wake up in the middle of the night
and you can't get back to sleep.
So it's an insomnia, but it's that difficulty of staying asleep.
That's a risk factor for developing dementia.
We can also look at social isolation.
The more isolated we are socially.
Oh, that's a risk factor for developing dementia
and nobody noticing it, because if you don't use skills, you lose skills.
And what we don't know
is what happens to people if they maintain social connections.
Now, the tricky part, Greg, is you have to pick somebody
you like to be with to socialize.
If you're around people you don't like, guess what it tends to do?
Well, you know, if you throw an extrovert into a room full of introverts, it's
kind of like throwing a cat in amongst the dogs.
Yeah, well actually it's a dog in amongst the cats in that case, I think
because the dog's the extrovert, hey, let's have a party.
And all the cats are like, tear you apart.
No, you can go the other way.
But what we're saying is it increases your cortisol level
because you're not getting what you like out of a social interaction.
So matching the social needs
and preferences of somebody is really sort of important to reduce risk.
And then it turns out.
Let me think. Oh, yeah.
Exercise.
Diet and exercise, oh, you're a bummer. I know, it's an everyday thing,
and hydration counts.
Mm hmm. So, you know, drinking enough fluids.
But the fluid that's best for you is,
I know you don't want to hear it.
Beer? No, no, water.
And so this idea of, you know,
what we do matters, what we do matters
living under threat for a long period of time,
being isolated, being shoved in with people you don't like,
not getting, not getting good sleep, not exercising,
not eating well, not not drinking effectively.
I mean you can only abuse the system so long before it goes, Unlce.
What did I read about lifelong learning being helpful?
Oh, yeah. So when we talk about exercise, it's not just exercising your body,
it's exercising your brain.
So when we talk about exercise, just like social exercise, being with somebody
is a social exercise, brain activity, doing something different and unique
so you build more pathways, fire some synapses.
But physically doing the same kind of thing, it's about being well, essentially.
Spiritually well, physically well, socially well, mentally well,
it adds up, apparently.
Teepa, thank you very much.
You're welcome I think. You've been listening to the Dementia
Care Partners podcast brought to you by Positive Approach to Care.
If you'd like more information relating to dementia, simply go to
TeepaSnow.com