In a rabbit hole

[shawnF]

Hi all,
I am new here. A brief history about me:

49 yrs old male with a family history of AD on the fathers side. Grandmother developed symptoms at around 99 and died at 102. One of the aunts developed symptoms at 89 and died at 91. My father developed symptoms at 70 and he is now 81. I would say for him at this stage he is 50% there as he can shower himself, shave and carryout phone conversations with people but the normal memory issues are there.

As for me i have ADD and GAD but other than that no physical issues (Regular exercise and a clean diet). I don't know my APOE status but i am going to safely assume either 3/4 or 4/4.
My issues started about 6 month ago when one of my employees mentioned a conversation that we had two month prior and i had no recollection of that. This issue repeated itself few times whereby i would not remember certain aspects of conversations which happened a while back. I have done all metabolic/hormone panel blood tests and all seem fine except for elevated homocysteine and vit B12 which i don't think are relevant. I am trying to come off of low dose clonazepam (0.375mg nightly) which i have been taking for four years for sleep and its really worsening my anxiety as well.
Overall i don't find problems functioning at my job or day to day activities (well not yet at least) but a few days ago i took this ReCode cognitive test and actually scored low average on the memory test (above average on the other two). This put me in a rabbit hole of spending the entire weekend searching on the internet. The anxiety of it is actually interfering my job.
Unfortunately i live in the middle-east at the moment and don't really trust the medical professionals here. Suggestions or tips would be appreciated.

[abalboa]

Hi all,
I am new here. A brief history about me:

49 yrs old male with a family history of AD on the fathers side. Grandmother developed symptoms at around 99 and died at 102. One of the aunts developed symptoms at 89 and died at 91. My father developed symptoms at 70 and he is now 81. I would say for him at this stage he is 50% there as he can shower himself, shave and carryout phone conversations with people but the normal memory issues are there.

As for me i have ADD and GAD but other than that no physical issues (Regular exercise and a clean diet). I don't know my APOE status but i am going to safely assume either 3/4 or 4/4.
My issues started about 6 month ago when one of my employees mentioned a conversation that we had two month prior and i had no recollection of that. This issue repeated itself few times whereby i would not remember certain aspects of conversations which happened a while back. I have done all metabolic/hormone panel blood tests and all seem fine except for elevated homocysteine and vit B12 which i don't think are relevant. I am trying to come off of low dose clonazepam (0.375mg nightly) which i have been taking for four years for sleep and its really worsening my anxiety as well.
Overall i don't find problems functioning at my job or day to day activities (well not yet at least) but a few days ago i took this ReCode cognitive test and actually scored low average on the memory test (above average on the other two). This put me in a rabbit hole of spending the entire weekend searching on the internet. The anxiety of it is actually interfering my job.
Unfortunately i live in the middle-east at the moment and don't really trust the medical professionals here. Suggestions or tips would be appreciated.

Welcome shawnF,
Thank you for joining our site and posting in the forum! It sounds like there could be a few factors happening for you that you feel are affecting your cognition. From my own personal experience, going into the "rabbit hole" can be overwhelming and possibly consulting with a APOE4 practitioner could help you to identify or prioritize where you may want to focus to help improve the slight memory issues you are referring to. We have a great list of APOE4 aware practitioners that could be a resource and many offices now do take virtual appts. APOE4 aware healthcare practitioners Additionally, there is quite a bit of information available on the role of homocysteine & the B complex in relation to dementia. Please see link to a NIH article addressing this subject: Homocysteine and Dementia: An International Consensus Statement

Additionally, as a Support Team Intern, I can share several tools & resources to help you get the most out of your experience if you would like to explore the site in more detail. The Primer is a detailed and informative resource written by a practicing M.D. with ApoE4/4. It includes information about the biochemistry of the ApoE4 gene and offers a variety of research-based prevention strategies.

Some helpful tips to navigate the site include the How-To Guide. It includes topics such as navigating the forum, private messaging, and searching. For example- you may enter "homocysteine" in the search bar and get quite a bit of member information regarding this particular issue. Another great tip is using the quote (") button when replying to a post. Using the button will automatically alert the member of your response.

If you are interested in learning more about other members check out Our Stories.

Again, I am so glad you joined our forum. I look forward to hearing from you in the future. Please feel free to reach out anytime.

Warmly,
Angie

[shawnF]

Thank you kindly for your response.

With APOE4 is cholesterol metabolism compromised? I seem to have this problem that despite a very clean diet (No red meat, Lots of fish /olive oil and vegetables) my cholesterol (Total and LDL) is always high.

Regards
SF

[abalboa]

Thank you kindly for your response.

With APOE4 is cholesterol metabolism compromised? I seem to have this problem that despite a very clean diet (No red meat, Lots of fish /olive oil and vegetables) my cholesterol (Total and LDL) is always high.

Regards
SF

There is a correlation to cholesterol dysregulation and APOE4 and I have included a link to one articleApoE4-Induced Cholesterol Dysregulation and Its Brain Cell Type-Specific Implications in the Pathogenesis of Alzheimer’s Disease but there is alot of additional information you can find online or in the forum and an educated practitioner can give you further insights.

[shawnF]

Interesting. This paper suggests that taking a statin that crosses the BBB is beneficial to reduce the LDL load in the barin whereas i have also read that these types of statins have associated side effects such as brain fog which in this context sounds counter intuitive.

[abalboa]

Interesting. This paper suggests that taking a statin that crosses the BBB is beneficial to reduce the LDL load in the barin whereas i have also read that these types of statins have associated side effects such as brain fog which in this context sounds counter intuitive.

Yes.. I have seen that as well and you ultimately have to make those choices based on your individual situation and set of risks. You certainly would want to consider input from a knowledgeable practitioner prior to making any choices regarding Rx medication and there is a lot to be done from a lifestyle and diet perspective that can help with blood lipid levels as well. My father has AD and is 3/4. When trying to get his lipid panels in line.. our practitioner recommended Red Yeast Rice supplement as a natural option. However, I am not a doctor and cannot give you medical advice regarding your choices. I do highly suggest you browse some of the information available here around lowering cholesterol and if you feel like you need medical advice... you have the link to browse apoe4 aware practitioners. I also found Dr Dale Bredesens book very helpful The End of Alzheimer's Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age

[NF52]

...49 yrs old male with a family history of AD on the fathers side. Grandmother developed symptoms at around 99 and died at 102. One of the aunts developed symptoms at 89 and died at 91. My father developed symptoms at 70 and he is now 81. I would say for him at this stage he is 50% there as he can shower himself, shave and carryout phone conversations with people but the normal memory issues are there.

As for me i have ADD and GAD but other than that no physical issues (Regular exercise and a clean diet). I don't know my APOE status but i am going to safely assume either 3/4 or 4/4.
My issues started about 6 month ago when one of my employees mentioned a conversation that we had two month prior and i had no recollection of that. This issue repeated itself few times whereby i would not remember certain aspects of conversations which happened a while back. I have done all metabolic/hormone panel blood tests and all seem fine except for elevated homocysteine and vit B12 which i don't think are relevant....This put me in a rabbit hole of spending the entire weekend searching on the internet. The anxiety of it is actually interfering my job.
Unfortunately i live in the middle-east at the moment and don't really trust the medical professionals here. Suggestions or tips would be appreciated.

Welcome shawnf,

Your post resonated with me, not because we're the same, but because I was where you are now 20 years ago. I also know now that I am ApoE 4/4, although my family history would suggest that much more so than yours. My dad died of cardiac arrest with severe coronary artery disease at age 67; my mother and most of her 10 siblings developed vascular and Alzheimer's dementia in their 70's or early 80's. Your grandmother and aunt almost certainly did not die of Alzheimer's--it simply doesn't show up in 99 year olds. Instead, they likely had "senescent" brain cells and synapses that got worn out after almost a century. And they outlived their expected lifespan at birth by about 50 years! Your exercise, diet, occupational skills, ability to navigate living in a different country all are viewed by credible epidemiologists at adding about 7-8 years to your brain's "cognitive reserve".

At age 71, with a worse family history and ApoE4/4, I had zero on a coronary calcium scan, am still cognitively and physically active and have come to terms with the long-term quirks of my memory--spelling, dates and lists are easy; faces and plots of movies are fair and my drawing ability plateaued at a 6 year old level.

At your age, as a school administrator supervising about several dozen people and with responsibility for about 750 kids, I often had people reminding me of conversations or incidents that had been very important to them, but were long off my "urgent/important" radar. They would say something like "Remember that kid that did X; well he did Y now and it's driving me crazy." It was okay to say "Sorry, I forgot about that, but it sounds like it's still an issue for you. What do you think are some options for us?" My guess is your employees won't mind if you own up to saying "Tell me more about that conversation; it's slipped from my dashboard."

I was lucky enough to work with brilliant people who had studied memory as part of working with people with traumatic brain injury (TBI). So I learned that some of us struggle more with episodic memory (conversations, movie plots, events in our past) if they don't have high emotional "salience" or connections with other events. (I asked a graduate class about 30 years ago if they remembered where they were during the OJ Simpson car chase. Every one did; none of them could tell me what they had done two months ago on a specific day.)

ADD and generalized anxiety disorder (GAD) can both interfere with memory, which requires 2 things: Having focused and sustained attention to a particular event, face, pattern, date, etc. and having the emotional bandwidth to deal with it in the moment. It's also okay to share with people that "sometimes my ADD may drop some important things you've said. It's okay if you want to summarize what your key issues are in an email after this."

And if you are looking for some folks with skills in functional medicine in the Middle East, feel free to look at our Searching for a Healthcare Practitioner wiki. Many practitioners allow for tele-medicine and there may be people in European countries or the UK that you could consult with, if you want to get some more direct support.
Nancy