ADD/ADHD and APOE4

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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kayakmac08
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ADD/ADHD and APOE4

Post by kayakmac08 »

I'm curious if people think there's a correlation.

I doubt there is any scientific evidence for a relationship one way or the other, and haven't taken the time to look. But maybe folks here have opinions or anecdotal evidence? If you have an opinion or personal experience to share, I'd love to hear from you. And if you know of any relevant research, please let me know!

I'm wondering because I can't help but notice that four out of the six E4 carriers who I know personally have been diagnosed with ADD/ADHD, and the fifth would probably have been diagnosed if she'd been born a few decades later. Additionally, I've begun to wonder if my own ADD (diagnosed at 19, but have been off meds for years), which is characterized by some significant executive functioning deficits that seem to be tied to working memory (especially retrieval and application of newly encoded information), might be related to me being a 4/4. It might just be a coincidence, but I can't help wondering.
  • 4/4 male, born 1989
  • Status discovery: 2020
  • Regimen: 14+ hr. fast/day; 200-300 min of mod-vig exercise/week; Med-esque diet; Supplementing with Trig DHA, B vits, D3
circular
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Re: ADD/ADHD and APOE4

Post by circular »

kayakmac08 wrote:I'm curious if people think there's a correlation.

I doubt there is any scientific evidence for a relationship one way or the other, and haven't taken the time to look. But maybe folks here have opinions or anecdotal evidence? If you have an opinion or personal experience to share, I'd love to hear from you. And if you know of any relevant research, please let me know!

I'm wondering because I can't help but notice that four out of the six E4 carriers who I know personally have been diagnosed with ADD/ADHD, and the fifth would probably have been diagnosed if she'd been born a few decades later. Additionally, I've begun to wonder if my own ADD (diagnosed at 19, but have been off meds for years), which is characterized by some significant executive functioning deficits that seem to be tied to working memory (especially retrieval and application of newly encoded information), might be related to me being a 4/4. It might just be a coincidence, but I can't help wondering.
I don't know of any research (and haven't looked), but what I'd be thinking about is whether the ADD symptoms, including executive functioning, might be related to mold or toxin exposure, sinus issues, and the like. I have had ADD symptoms, sometimes for long periods, but they come and go and fluctuate over time. They have been far less prounounced since taking steps to offset the influence of ApoE4, but that's not to say that ApoE4 means was the cause. It seems that as the ancestral allele, ApoE4 can be more susceptible to inflammatory triggers, leading to inflammation that can easily be experienced the brain as 'brain fog' or ADD-like symptoms. Meanwhile, our modern, more ApoE3-suited environments are replete with inflammatory triggers. So I see the ills of neolithic civilization as the 'cause.' Well, I could take that back even further to the cause being those aspects of human nature that, when uncontrolled by the apprehension of oneness among all living things, have a tendency to hoard and control resources, putting others at the mercy of the ones with the resources. I'll refrain from trying to figure out where human natures come from :lol:
ApoE 3/4 > Thanks in advance for any responses made to my posts.
MattCo
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Re: ADD/ADHD and APOE4

Post by MattCo »

kayakmac08 wrote:I'm curious if people think there's a correlation.
In my case, yes. At least I think so. I've been diagnosed with ADHD-inattentive. There are two classes of medications and they both have horrible side effects for me. I've found that what works best for me is what I like to do and am able to do. The surprise is that this is nearly identical to what I have to do for dealing with my apoe4 gene. Diet, exercise, meditation, it's nearly the same. Also, ADHD and PTSD share a lot of similarities. I'm also dyslexic and lets just say that grade school in the 60's was not kind to dyslexics. But dyslexia is a very common comorbidity with ADHD. So I don't know which might be more of what I have. I don't believe there's a good genetic test for ADHD but current understanding is that ADHD does not "come and go." You're born with it and never get rid of it. What comes and goes is how one adapts to it.

That all said, look at the MTHFR mutation and among all the things that this can cause, ADHD is one possibility. What's really been a challenge for me is that ADHD comes with a dopamine addiction. Anything from meth, being a perfectionist or, my favorite, carbs!
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kayakmac08
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Re: ADD/ADHD and APOE4

Post by kayakmac08 »

circular wrote:I don't know of any research (and haven't looked), but what I'd be thinking about is whether the ADD symptoms, including executive functioning, might be related to mold or toxin exposure, sinus issues, and the like. I have had ADD symptoms, sometimes for long periods, but they come and go and fluctuate over time. They have been far less prounounced since taking steps to offset the influence of ApoE4, but that's not to say that ApoE4 means was the cause.
That's fascinating that you've seen a decrease in ADHD symptoms as you've "plugged the holes", so to speak. It makes me wonder if there might be a connection between diet and ADHD symptoms that might account for some of the rapid rise in diagnoses over the last ten years. Obviously, even if that's the case, there are many other factors probably contributing (living in a digital age chief among them, I'm sure).

I've got many more holes to plug, but so far it seems like I'm more resilient against distraction when in a ketogenic state, which I'm guessing is related to my brain running on ketones rather than glucose?
MattCo wrote:In my case, yes. At least I think so. I've been diagnosed with ADHD-inattentive....That all said, look at the MTHFR mutation and among all the things that this can cause, ADHD is one possibility.
I'm an "inattentive", too! It was never problematic in school, but seriously affects me in day-to-day life. I'm basically either laser focused or borderline incapable, as I have an almost comically severe issue with keeping important-yet-"uninteresting" information at the front of my brain; it just immediately gets displaced by a preferred topic (fortunately, school was a "preferred" topic lol) and won't return until I'm prompted by an external source, like an angry and bewildered boss, teammate, wife, or--worst of all--my own student.

And I'm heterozygous for the MTHFR defect, and tend to have low B12 and B6, but thankfully, I've been responding well to multivitamins lol, so I guess that's been easy to address.
  • 4/4 male, born 1989
  • Status discovery: 2020
  • Regimen: 14+ hr. fast/day; 200-300 min of mod-vig exercise/week; Med-esque diet; Supplementing with Trig DHA, B vits, D3
circular
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Re: ADD/ADHD and APOE4

Post by circular »

This paper doesn't mention ApoE4, but it does point to shared familial risk for ADHD and Alzheimer's:

Attention-deficit/hyperactivity disorder and Alzheimer's disease and any dementia: A multi-generation cohort study in Sweden
Abstract
Introduction

We examined the extent to which attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental disorder, is linked with Alzheimer's disease (AD) and any dementia, neurodegenerative diseases, across generations.

Methods

A nationwide cohort born between 1980 and 2001 (index persons) were linked to their biological relatives (parents, grandparents, uncles/aunts) using Swedish national registers. We used Cox models to examine the cross-generation associations.

Results

Among relatives of 2,132,929 index persons, 3042 parents, 171,732 grandparents, and 1369 uncles/aunts had a diagnosis of AD. Parents of individuals with ADHD had an increased risk of AD (hazard ratio 1.55, 95% confidence interval 1.26–1.89). The associations attenuated but remained elevated in grandparents and uncles/aunts. The association for early-onset AD was stronger than late-onset AD. Similar results were observed for any dementia.

Discussion

ADHD is associated with AD and any dementia across generations. The associations attenuated with decreasing genetic relatedness, suggesting shared familial risk between ADHD and AD. [Emphasis added]
ApoE 3/4 > Thanks in advance for any responses made to my posts.
circular
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Re: ADD/ADHD and APOE4

Post by circular »

There was another article published in AARP Bulletin called:

'ATTENTION, PLEASE! If memory and focus problems are plaguing you at midlife, it could be undiagnosed ADHD. Here’s how to tell'

I see it in Apple News app but not at the AARP bulletin website. I think it's member only at the bulletin site, while I'm reading it for free at Apple News with a teaser to spend my retirement money on a monthly subscription for more access to tons of interesting stuff I don't have time to read …. but I digress …

For women,
Plunging estrogen levels affect short-term memory and the ability to focus, and contribute to the brain fog so many women going through menopause describe,” says psychologist Kathleen Nadeau, author of Still Distracted After All These Years: Help and Support for Older Adults With ADHD.

When estrogen drops at menopause, even ADHD stimulants may lose their efficacy, says Bill Dodson, M.D., a Denver psychiatrist who specializes in adults with ADHD. But the issue seems to affect women specifically. “The level of male hormones such as testosterone seems to have no effect on either the impairments of ADHD or the effects of ADHD medications in males,” he notes.

DOCTORS IN THE DARK

ADHD is seldom taken into consideration when assessing older people with cognitive complaints. Only 1 in 5 memory disorder clinics actively screen for ADHD. “People can have ADHD their whole life and they are now developing dementia,” Goodman says. “At that point, you have two processes contributing to cognitive difficulty.”
Menopausal women experiencing cognitive decline should be screened for ADHD, Goodman says, even if they have never been diagnosed with the disorder.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
evapearl57
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Re: ADD/ADHD and APOE4

Post by evapearl57 »

(I'm a 66yo female, 3/4).

I recently searched for information on this topic. I was considering seeking a diagnosis and treatment for my own ADHD (inattentive type), and wanted to see whether or not the medications used to treat it were what Bredesen calls "dementagens," drugs that increase the risk of AD, or not, before considering taking them.
I'd known I had ADHD for a long time, having learned enough about it through my career as a teacher to recognize all the symptoms in myself, but didn't feel like I needed medication to cope with it. Recently, various factors made me reconsider that, so I got a psychological assessment for it, and was indeed diagnosed as ADHD. In researching the safety of the ADHD meds for AD risk, I came across the following information.

According to a recent study, reported in this JAMA Open Network article in October 2023:
https://jamanetwork.com/journals/jamane ... le/2810766

and discussed in detail in the Washington Post article of the same month:
https://www.washingtonpost.com/wellness ... ntia-risk/

--adult ADHD does appear to increase the risk of dementia. The study, done in Israel, analyzed the heath records of over 109,000 participants ages 51-70, none of which had existing diagnosis of either ADHD or dementia. They followed up on them 17 years later, and found the following results:

"Of the participants, 730 adults (0.7 percent) had received a diagnosis of ADHD and 7,726 adults (7.1 percent) had received a diagnosis of dementia. Notably, of the 730 participants with adult ADHD, 13.2 percent (96 participants) were diagnosed with dementia. In contrast, of the 108,388 participants without adult ADHD, just 7 percent (7,630 participants) developed dementia." (Washington Post).

So, the rate of dementia among those with ADHD was almost twice that of those without ADHD.

The research took into account 18 other confounding factors, in their analysis. Even after adjusting for other known AD risks, the increased risk of AD for ADHD participants remained.

The GOOD NEWS, though, was this:

"There was, however, no clear increase in the risk of dementia associated with adult ADHD among those who received psychostimulant medication. (JAMA Open Network)

Or, as rephrased in the Washington Post article:
"Intriguingly, adults with ADHD who were taking a psychostimulant medication such as Ritalin or Adderall did not have an increased risk of developing dementia compared with those not taking medication."

In other words, for those with adult ADHD, taking the prescription psychostimulant medications for it appears to do away with any increased dementia risk associated with untreated ADHD.

For me, that was enough to seal my own decision to get the prescription. (And just speaking for myself, the medication has proved to be so helpful in alleviating my ADHD symptoms, and made such an improvement in my quality of life, I wish I had sought it years ago.)

(Unfortunately, the study didn't include any information on the participants' APOE status, so it doesn't help answer the question of whether ADHD was more prevalent in APOE4 carriers.)
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