Doctors in Singapore, Kuala Lumpur, Bangkok and South East Asia

[Dr.KevinTran]

Hi,
I recently discovered that I was a ApoE e4/e4 and I have been looking for a doctor to support me in fighting the gene.

Doctors I have spoken to are all more or less telling me to wait until I get diagnosed with ADS, because they can't do much before. Obviously "preventive" methods exists and I'd like a doctor who can help me do all the blood tests and prescribe medication when necessary (e.g. statins and so on)

I am already on a protocol I built covering diet, sports, cognitive training, removing bad habits and sleep, but I can only do so much without someone to help me fine tune everything with blood tests + medications and see if there is any blind spots I havent covered.

Any recommendations would be great. As I am living in Singapore, I can travel to Kuala Lumpur or Bangkok quite easily for lower costs of treatments.

Thank you!

[NF52]

Hi,
I recently discovered that I was a ApoE e4/e4 and I have been looking for a doctor to support me in fighting the gene.

Doctors I have spoken to are all more or less telling me to wait until I get diagnosed with ADS, because they can't do much before. Obviously "preventive" methods exists and I'd like a doctor who can help me do all the blood tests and prescribe medication when necessary (e.g. statins and so on)

I am already on a protocol I built covering diet, sports, cognitive training, removing bad habits and sleep, but I can only do so much without someone to help me fine tune everything with blood tests + medications and see if there is any blind spots I havent covered.

Any recommendations would be great. As I am living in Singapore, I can travel to Kuala Lumpur or Bangkok quite easily for lower costs of treatments.

Thank you!

Hi Dr. Tran,

Your personal protocol is already addressing the factors known to be associated with ApoE 4 in mid-life, which is where I'm guessing you would place yourself. Apologies if you're 27 and still years away from "mid-life'! I sympathize with your discovery that practicing neurologists are puzzled and/or dismissive of what you want from them, although I hope they told you that you are already adding to your "health span" and lifespan.

Here are some suggestions from this 72 year old with ApoE 4/4, who also doesn't want to wait for a diagnosis:

• Remember that statistical models are based on past epidemiological data, much of which is incomplete or inaccurate. Now that blood-based biomarkers are available, studies of bio-repositories from early AD trials have shown that about 30% of people deemed to have Alzheimer’s disease by clinical symptoms had NO biomarkers of the disease (amyloid or tau) Many had other preventable diseases: vascular disease, neuroinflammation, etc. I tend to take results from before 2010 with some skepticism.

• Prevalence of Alzheimer’s is dropping worldwide, even while incidence is rising because my "Baby Boomer" generation is moving through late life years. The biggest factors are ones you have: early high levels of education; occupational challenge, social connections. Others shown to add up to 7 years in health span include continuing learning and problem-solving and an optimistic and purpose-focused mindset, which I "diagnose" you as having!

• You can find doctors who specialize in functional medicine, who may have limited familiarity with ApoE 4, but do support mid-life health and have access to blood tests, on the website of the Institute for Functional Medicine. Here are links to results of two "advanced searches", using the Find A Practitioner link in the top right of the home page, and using Singapore and Thailand as the locations:Thailand and Singapore

• I've found that going to conferences and talking to people doing research opens doors to meeting other people doing great research in prevention and gives me confidence that prevention of Alzheimer’s in ApoE 4/4 carriers is doable and will be realized within the next few decades. You may want to join one of these groups, with access to lots of online content on biomarker development, novel drug therapies, non-pharmacological interventions and research in under-represented groups including Asian and Pacific Island populations (some of that is US-focused)

Here are some options:

• ISTAART:Alzheimer's Association International Society to Advance Alzheimer's Research and TreatmentThis is from their website:

  ISTAART has grown into a diverse global network of scientists, clinicians, and professionals who share common goals: the pursuit of knowledge, collaborations and breakthroughs in order to find more effective ways to detect, treat and prevent Alzheimer's and other dementias.

  I have gone to ISTAART sessions and found them lively and informative, with many students, young clinicians and researchers eager to change the story on Alzheimer’s. They also provide reduced rates for attendance at professional conferences and most webinars are later posted online for members.

• Asian and Pacific Islander American Health Forum

• Dementia Research Centre Singapore

A clinical trial of anti-amyloid drugs at a small dose in "primary prevention" for people in their 40's or 50's seems to be realistic within 10 years or less, possibly using low doses of a BACE inhibitor. Gene therapy using a vector virus (if I have my science right) to deliver one copy of ApoE2, may be further out but is being studied now in people with ApoE 4/4 and mild AD dementia. Keep working to increase awareness in Singapore of the needs of people with ApoE 4/4. You can be the one to bring about change!

Nancy

[Dr.KevinTran]

Hi Nancy,

Thank you so much for the detailed (and full of hope) answer!
I am 34 and I do consider myself in midlife

You mention an interesting topic about the diversity of ethnicities and groups and how it would influence interventions. I have been reading about it and it seems like the East Asian population I am part of (which is actually a very mixed group) has even higher risk with e4/e4, I wonder if there are other specificities.. Will reach out to those research centers in Asia and try to get an answer.

I appreciate all the ressources you have shared, and have joined ISTAART.
Thank you again!