54 year old APOE 4/4. What can I do to delay dementia at my age?

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54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by fkleeber »

I've never been in bad shape I think but I started really taking care of myself when I was in my late 40s. I changed to a mediterranean diet, started working out like an animal and lost about 50 lbs. I feel great and at my age I'm dumbfounded at the muscle I've put on. My lipids, BP, A1C, etc are all near perfect.I feel terrific..physically anyway.

After mom died of Alzheimers I used a 23andme DNA kit to see if I carry the APOE4 variant and of course I'm a 4/4. I panicked at first but then learned about the risk factors that I can control which made me feel a bit empowered, like I'm not completely at the mercy of me genes.

As I continued reading about APOE4, I began to see that as the blood brain barrier becomes compromised with age, the ability to delay cognitive decline through lifestyle choices becomes less realistic. In fact, I've read some sources that suggest that nourishing the brain with nutrients like Omega-3 after 50 probably isnt even possible for APOE4 carriers.

With the image of moms deteriorating body fresh in my mind, I've become increasingly depressed over everything I've learned about my genetics. I've lost interest in things that I was once passionate about and I feel a bit hopeless. I'm fully aware that having APOE4 does not mean you're destined to get Alzheimers. It's not deterministic I know but the statics surrounding APOE4/4 carriers are depressing. Realistically what things can I do at my age to postpone dementia for as long as possible?
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by floramaria »

fkleeber wrote: Sat Mar 16, 2024 4:57 pm I've never been in bad shape I think but I started really taking care of myself when I was in my late 40s. I changed to a mediterranean diet, started working out like an animal and lost about 50 lbs. I feel great and at my age I'm dumbfounded at the muscle I've put on. My lipids, BP, A1C, etc are all near perfect.I feel terrific..physically anyway.

After mom died of Alzheimers I used a 23andme DNA kit to see if I carry the APOE4 variant and of course I'm a 4/4. I panicked at first but then learned about the risk factors that I can control which made me feel a bit empowered, like I'm not completely at the mercy of me genes.

As I continued reading about APOE4, I began to see that as the blood brain barrier becomes compromised with age, the ability to delay cognitive decline through lifestyle choices becomes less realistic. In fact, I've read some sources that suggest that nourishing the brain with nutrients like Omega-3 after 50 probably isnt even possible for APOE4 carriers.

With the image of moms deteriorating body fresh in my mind, I've become increasingly depressed over everything I've learned about my genetics. I've lost interest in things that I was once passionate about and I feel a bit hopeless. I'm fully aware that having APOE4 does not mean you're destined to get Alzheimers. It's not deterministic I know but the statics surrounding APOE4/4 carriers are depressing. Realistically what things can I do at my age to postpone dementia for as long as possible?
Hello, and welcome, fkleeber,
I’m so sorry that you lost your mom to Alzheimer’s and understand how devastating it is to watch someone you love deteriorate. I lost my mom in the same way so my heart goes out to you. It is frightening to learn that you carry 2 copies of ApoE4, especially coming soon after your mom’s death.
As you become more familiar with this website and read through more of the posts, I believe you will find the hope and encouragement that may help to lift your depression and restore your sense of empowerment. There are many 4/4’s in this community who doing well in their 70’s and 80’s. Having upped your health routine in your late 40’s, you are off to a great start. You’ve got your BP, lipids and HbA1c at Healthy levels and you’ve been able to gain muscle and lose weight with your exercise program. These are all major wins that will help to sustain your cognitive health long term.
The Primer is a great place to begin to learn more about other steps you can take to reduce your risk of dementia.
You’ll find that here: Primer
We don’t want you to just “delay dementia for as long as possible”, but rather, to avoid it altogether.
As you said , you are not at the mercy of your genes.
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by NF52 »

fkleeber wrote: Sat Mar 16, 2024 4:57 pm I've never been in bad shape I think but I started really taking care of myself when I was in my late 40s. I changed to a mediterranean diet, started working out like an animal and lost about 50 lbs. I feel great and at my age I'm dumbfounded at the muscle I've put on. My lipids, BP, A1C, etc are all near perfect.I feel terrific..physically anyway.

After mom died of Alzheimers I used a 23andme DNA kit to see if I carry the APOE4 variant and of course I'm a 4/4. I panicked at first but then learned about the risk factors that I can control which made me feel a bit empowered, like I'm not completely at the mercy of me genes.

As I continued reading about APOE4, I began to see that as the blood brain barrier becomes compromised with age, the ability to delay cognitive decline through lifestyle choices becomes less realistic. In fact, I've read some sources that suggest that nourishing the brain with nutrients like Omega-3 after 50 probably isnt even possible for APOE4 carriers.

With the image of moms deteriorating body fresh in my mind, I've become increasingly depressed over everything I've learned about my genetics. I've lost interest in things that I was once passionate about and I feel a bit hopeless. I'm fully aware that having APOE4 does not mean you're destined to get Alzheimers. It's not deterministic I know but the statics surrounding APOE4/4 carriers are depressing. Realistically what things can I do at my age to postpone dementia for as long as possible?
Welcome to our community of people who "get it".

We really and truly understand the emotions you're feeling right now. I took the liberty of putting your optimistic statements in blue and your pessimistic statements in green. BOTH are completely valid and normal right now--you got on a rollercoaster you didn't expect right after the trauma of watching your mom's slow decline. Please believe that how you feel is normal-- and that it will get better as you circle back to that feeling of being empowered by this knowledge and ready to slay the dragon of bad news.

Much of that news is not current and/or not applicable to you as someone 20-40 years younger than the people studied for those findings. Most epidemiology studies look back at birth cohorts born in the 1930's and 40's, or at lab samples from people identified 10-20 years ago who were then in their 70's.

I recently heard two different top researchers, recognized internationally, say "We will keep millions of people from getting Alzheimer's with what we are learning." Their goal is that Alzheimer's becomes, at most, a disease that is found in its earliest stages--like pre-diabetes, or colon polyps, or early risks for heart disease--and will be managed through the same lifestyle strategies you have already mastered--and maybe for some people safe and effective prevention treatments.

I took a 23&me test 10 years ago and had the same results. At that time, 23&me wasn't required to show any warning before seeing the results--which also contained a link to an outdated article saying that the average age of diagnosis of Alzheimer's was 68--and I was about to turn 62. I took felt pretty hopeless--until I remembered that like you, I had a lot going for me. Not the midlife improvements in diet, exercise and biomarkers you achieved through hard work in your 40's--but a good level of education, occupational challenge, social networks and an optimistic outlook that left me wanting to be "empowered"--a word you used and strengths I bet you also have.

I will be 72 in a few months and I still feel empowered and purposeful and far more confident that we are not our mother's clones when it comes to Alzheimer's risk. My husband and I took a two-week trip to Spain and Portugal last fall that I planned out to the last detail, using cognitive skills I thought 10 years ago would be long gone!

Here's what I've found from spending the last 7 years or so finding good sources to track developments, being in two clinical trials for people with normal cognition, serving on a research participant advisory board that gives me access to the most cutting-edge research in virtual and in-person conferences and being on this forum:
  • Research on Alzheimer's prevention, upstream causes, lifestyle interventions and possible treatments before or after changes in cognition is exponentially growing and improving, with access to current long-term population studies in people who stay healthy--not just those who come to memory clinics for testing
  • Exercise, diet and control of lipids, AiC and blood pressure are now known to be among the best prevention tools, with exercise having benefits for our hearts, brains and emotions--so hold onto that part of your life during the dark times and it will help you get through to better days.
  • "Cognitive reserve" and "cognitive resilience" are now recognized at significant factors in prevention of dementia, which is why the overall incidence (how many people out of 100, for example) is dropping rapidly in first-world countries, as more people have access to higher education and occupational challenge--which can occur regardless of how much your paycheck is!
  • Alzheimer's is not like some diseases that occur with little to no warning; it's now known that intervention can happen for a full 20 years to change the trajectory. You're already doing EVERY SINGLE THING that would be recommended by the best evidence of current research at your age. If you want to prove it to yourself, ask you doctor for a prescription for a coronary artery scan, which is a quick, painless CT to check for plaque. It usually isn't covered by insurance, but at about $150., I was able to learn that at the same age (67) that my dad died of cardiac arrest after quadruple bypass, I had zero plaque and a cardiac age of 39, per the report. A healthy heart is able to nourish a healthy brain--and knowing that may give you one more reason to again feel "great" and "terrific".
  • This 2021 article is co-authored by the founder and former director of the Alzheimer's Prevention Program at NewYork-Presbyterian--and a nationally recognized authority on prevention, and offers reassurance that it is not too late for Omega 3 and lots of other great strategies.
    Precision Nutrition for Alzheimer’s Prevention in ApoE4 Carriers
Here's a post from Friday by "FC" who is a healthy, active 82 year old with Apoe 4/4 viewtopic.php?p=92056#p92056. He has previously posted about working into his mid-70's as a state-appointed ombudsman for assisted living facilities in Virginia and was tested several years in a row at Stanford during that time, until they told him he didn't need to come back any more because his cognition was just fine!

Keep posting; we're here for you!

Nancy
4/4 and still an optimist!
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by AnnieV »

I read your post. I highly recommend you please read Dr. Bredesen's book, ESPECIALLY for you, specifically pages 119-121.

Your concern for breakdown of the BBB is merited. To that specific end test for your homocysteine. Dr. Bredesen shows how that can be lowered if it is high (which I will only presume for you is too high), but Dr. Bredesen (IMO, and per my own testing results) focuses on the active supplement path described in those pages. However, there is a parallel path, possibly a synergistic one. That path reduces homocysteine dramatically via fermented milk products made from real/raw milk (NOT, repeat NOT commercial store-bought milk products that are destructively homogenized and pasteurized). My own blood tests (4 tests in a row over 2 years now) showed I reduced Hcy (homocysteine) by about 40% by consuming fermented milk products made (ONLY) from real/raw milk daily. I tested and proved that theory by reading an NIH report to that effect and showed it was in fact valid.
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by floramaria »

AnnieV wrote: Wed Mar 20, 2024 10:52 am I read your post. I highly recommend you please read Dr. Bredesen's book, ESPECIALLY for you, specifically pages 119-121.

Your concern for breakdown of the BBB is merited. To that specific end test for your homocysteine. Dr. Bredesen shows how that can be lowered if it is high (which I will only presume for you is too high), but Dr. Bredesen (IMO, and per my own testing results) focuses on the active supplement path described in those pages. However, there is a parallel path, possibly a synergistic one. That path reduces homocysteine dramatically via fermented milk products made from real/raw milk (NOT, repeat NOT commercial store-bought milk products that are destructively homogenized and pasteurized). My own blood tests (4 tests in a row over 2 years now) showed I reduced Hcy (homocysteine) by about 40% by consuming fermented milk products made (ONLY) from real/raw milk daily. I tested and proved that theory by reading an NIH report to that effect and showed it was in fact valid.
Hi AnnieV, Thanks for posting about your experience bringing down your homocysteine with fermented raw milk products. Congratulations! Were you just consuming things like kefir and yogurt or did you included cheese in the fermented milk products category? If you happen to have kept the NIH report you refer to, I'd be very interested in reading it if you can post the link.
I did a quick search and found a few interesting things about fermented milk and homocysteine but did not find one specifically about raw milk. I try to get fermented raw milk products when possible but might make more of an effort after reading your post!
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by AnnieV »

Kefir and Caspian Sea yogurt. I give both to my mom and me daily. Much less than a pint total. Can even be mixed into a green smoothie if the other ingredients don't neutralize the milks' essential bacteria.

You can find cultures online to buy. I make both kefir and Caspian Sea yogurt but recently have found a top quality real/raw kefir at Sprouts that comes from California. It's fantastic and highly recommended. Those are the key, most important fermented milk products because those have the specific lactic acid bacteria that are demonstrated to allow the body itself to produce the active version of folate that in turn neutralizes/stabilizes the body's homocysteine levels. Remember, (1) homocysteine itself is produced by the body for a purpose but if it's too high it damages the hippocampus (as Bredesen clearly says), (2) humanity consumed fermented milk products over its entire time on earth, tens of thousands of years, all the way up to the Industrial Revolution (starting roughly 1870) so ALZ in general was NOT pervasive as it is today. Humanity has been omitting fermented milk over only the last 150 years or so. It thus appears the corruption of milk (and bread) products post Industrial Revolution is a primary factor for society’s insidious cognitive decline in general. That theory is at least supported by my normalized Hcy levels without supplementation.

As to cheeses you want to stick to real/raw milk made cheeses which are primarily French and Swiss cheeses. Camembert, Gruyere, Swiss, etc. are examples. The French generally refuse to make cheese with homogenized/pasteurized (corrupted) milk because they well understand the taste of the final product severely suffers. Any cheeses that are not made from real/raw milk will be insidiously destructive (not neutral, destructive) to the body because the homogenization process (high pressure application) itself destroys the milk fat globule membrane (MFGM) that contains the polar lipids (fats) and phospholipids (fats) the body wants for optimized health. Recall, that the job the APOE gene has is to regulate the body's lipids (fats), sounds familiar right...? So, some real cheeses can be fine but they are not substitutes for kefir and/or real yogurts like Caspian Sea, Bulgarian, etc. I have not tested my Hcy just for cheese products (while omitting kefir, Caspian Sea yogurt) and have no intention to do so. The reason I followed what I have is because both Bredesen and dozens of NIH reports attest to kefir and real yogurt efficacies far above any other means.

You have to query using boolean methods when doing research. Use the term "fermented milk" for starters. You typically won't find all that much on "raw milk" specifically (but you will find some, just keep going they are out there) because the NIH itself is unduly influenced by corporate interests that corrupt some of their analysis. Sad but true. I have come to believe through research and testing the food and drug industry is a business model first and a health model second. Those priorities appear firmly fixed at the potential prevention detriment of many.
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by floramaria »

AnnieV wrote: Wed Mar 20, 2024 3:22 pm
You can find cultures online to buy. I make both kefir and Caspian Sea yogurt but recently have found a top quality real/raw kefir at Sprouts that comes from California. It's fantastic and highly recommended.
Thanks for the great information, AnnieV. Every time I am in California I purchasethat Raw Farms Raw Milk Kefir from Sprouts. I agree that it is fantastic! Unfortunately it is not available in NM. For a while one of my neighbors was selling goats’ milk yogurt she made from raw milk from her goats, but she stopped selling it after a bureaucratic crack down. If I can find raw milk, I may try to make my own kefir again. You seem to be very well informed in this area. Is there a culture you particularly like?
Thanks!
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by AnnieV »

FloraMaria,

Yes, exactly Raw Farms brand! I can get it at Sprouts in Florida! If you can't get in NM, then look for "low temperature pasteurized", NON-homogenized milk. There are a couple brands (MilkKing, etc.) that sell it at Whole Foods I have found online. I still haven't seen such milk though in Florida Whole Food stores, yet. Maybe its in NM. Look hard for it. If you can get that Low Temp pasteurized, NON-homogenized milk (BOTH are key attributes and BOTH distinguish such milk from fully corrupted store milk that is high temp pasteurized and homogenized), THEN you can use that milk (again, ONLY that kind of milk beside real/raw milk) to make kefir and/or Caspian Sea Yogurt. You can find many sources online to buy kefir grains sent to you with instructions and you can find many online sources for yogurt cultures too. I have used a few and all I have found are good. I cannot overstate the importance of what dozens of NIH reports show and what my own results show with respect to the benefit of consuming real ("raw") fermented milk products (and trust me, I had NO intention of consuming milk at all, the research itself drove me to do it). (I put "raw" in quotes because its absurd--no one calls store milk "cooked milk" but that's exactly what it is. The nutrients are literally cooked out of it. Adding back in lab-made vitamins via a "fortification" process isn't the same at all, its Frankenmilk. The proper term for "raw" milk is real milk, it's what human beings consumed for tens of thousands of years for heaven's sake until only the last 100 or so year when government dictated supposed "safety" standards and in the process legitimized the theft of cream via the homogenization process (that destroys the milk fat polar and phospholipids, breaking them into such small particles the body does not recognize them, causing inflammation).
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Re: 54 year old APOE 4/4. What can I do to delay dementia at my age?

Post by floramaria »

AnnieV wrote: Thu Mar 21, 2024 5:56 pm FloraMaria,

Yes, exactly Raw Farms brand! I can get it at Sprouts in Florida! If you can't get in NM, then look for "low temperature pasteurized", NON-homogenized milk. There are a couple brands (MilkKing, etc.) that sell it at Whole Foods I have found online. I still haven't seen such milk though in Florida Whole Food stores, yet. Maybe its in NM. Look hard for it. If you can get that Low Temp pasteurized, NON-homogenized milk (BOTH are key attributes and BOTH distinguish such milk from fully corrupted store milk that is high temp pasteurized and homogenized), THEN you can use that milk (again, ONLY that kind of milk beside real/raw milk) to make kefir and/or Caspian Sea Yogurt. You can find many sources online to buy kefir grains sent to you with instructions and you can find many online sources for yogurt cultures too. I have used a few and all I have found are good. I cannot overstate the importance of what dozens of NIH reports show and what my own results show with respect to the benefit of consuming real ("raw") fermented milk products (and trust me, I had NO intention of consuming milk at all, the research itself drove me to do it). (I put "raw" in quotes because its absurd--no one calls store milk "cooked milk" but that's exactly what it is. The nutrients are literally cooked out of it. Adding back in lab-made vitamins via a "fortification" process isn't the same at all, its Frankenmilk. The proper term for "raw" milk is real milk, it's what human beings consumed for tens of thousands of years for heaven's sake until only the last 100 or so year when government dictated supposed "safety" standards and in the process legitimized the theft of cream via the homogenization process (that destroys the milk fat polar and phospholipids, breaking them into such small particles the body does not recognize them, causing inflammation).
Thanks, AnnieV! If I can’t find genuine RAW milk (aka real milk !) I will try for Low temp pasteurized/non-homogenized next time I’m grocery shopping.
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