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Risk factors
By Mayo Clinic staff
Age
Increasing age is the greatest known risk factor for Alzheimer's. Alzheimer's is not a part of normal aging, but your risk increases greatly as you grow older. After you reach age 65, your risk of developing the disease doubles about every five years. Nearly half of those over age 85 have Alzheimer's.
People with rare genetic changes that guarantee they'll develop Alzheimer's often begin experiencing symptoms in their 40s or 50s.
Family history and genetics
Your risk of developing Alzheimer's appears to be somewhat higher if a first-degree relative — your parent, sibling or child — has the disease. Scientists have identified rare changes (mutations) in three genes that guarantee a person who inherits them will develop Alzheimer's. But these mutations account for less than 5 percent of Alzheimer's disease. Most genetic mechanisms of Alzheimer's among families remain largely unexplained. The strongest risk gene researchers have found so far is apolipoprotein e4 (APOE-e4). Other risk genes have been identified but not conclusively confirmed.
Sex
Women may be more likely than are men to develop Alzheimer's disease, in part because they live longer.
Mild cognitive impairment
People with mild cognitive impairment (MCI) have memory problems or other symptoms of cognitive decline that are worse than might be expected for their age, but not severe enough to be diagnosed as dementia. Those with MCI have an increased risk — but not a certainty — of later developing dementia.
Lifestyle and heart health
There's no lifestyle factor that's been conclusively shown to reduce your risk of Alzheimer's disease.
However, some evidence suggests that the same factors that put you at risk of heart disease may also increase the chance that you'll develop Alzheimer's. Examples include:
- Lack of exercise
- Smoking
- High blood pressure
- High cholesterol
- Poorly controlled diabetes
These risk factors are also linked to vascular dementia, a type of cognitive decline caused by damaged blood vessels in the brain. Many people with cognitive decline have brain changes characteristic of both Alzheimer's disease and vascular dementia. Some researchers think that each condition helps fuel the damage caused by the other.
Working with your health care team on a plan to control these factors will help protect your heart — and may also help reduce your risk of dementia.
Lifelong learning and social engagement
Studies have found an association between lifelong involvement in mentally and socially stimulating activities and reduced risk of Alzheimer's disease.
Factors that may reduce your risk of Alzheimer's include:
- Higher levels of formal education
- A stimulating job
- Mentally challenging leisure activities, such as reading, playing games or playing a musical instrument
- Frequent social interactions
Scientists can't yet explain this link. One theory is that using your brain develops more cell-to-cell connections, which protects your brain against the impact of Alzheimer-related changes. Another theory is that it may be harder to measure cognitive decline in people who exercise their minds frequently or who have more education. Still another explanation is that people with Alzheimer's disease may be less inclined to seek out stimulating activities years before their disease can be diagnosed.
- Middleton LE, et al. Promising strategies for prevention of dementia. Archives of Neurology. 2009;66:1210.
- Preventing Alzheimer's disease and cognitive decline. National Institutes of Health State-of-the-Science Conference Statement. April 26-28, 2010. http://consensus.nih.gov/2010/docs/alz/ALZ_Final_Statement.pdf. Accessed Oct. 28, 2010.
- Rusanen M, et al. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Archives of Internal Medicine. In press. Accessed Oct. 28, 2010.
- Alternative treatments. Alzheimer's Association. http://www.alz.org/alzheimers_disease_alternative_treatments.asp Accessed Nov. 5, 2010.
- Scarmeas N, et al. Physical activity, diet, and risk of Alzheimer disease. JAMA. 2009;302:627.
- Alzheimer's disease fact sheet. National Institute on Aging. http://www.nia.nih.gov/NR/rdonlyres/7DCA00DB-1362-4755-9E87-96DF669EAE20/13991/ADFactSheetFINAL2510.pdf. Accessed Oct. 29, 2010.
- Grabowski TJ. Clinical manifestations and diagnosis of Alzheimer's disease http://www.uptodate.com/home/index.html. Accessed Oct. 30, 2010.
- Press D, et al. Treatment of dementia. http://www.uptodate.com/home/index.html. Accessed Oct. 30, 2010.
- Shadlen M-F, et al. Risk factors for dementia. http://www.uptodate.com/home/index.html. Accessed Oct. 30, 2010.
- What is Alzheimer's? Alzheimer's Association. http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp. Accessed Nov. 4, 2010.
- Prevention. Alzheimer's Association. http://www.alz.org/research/science/alzheimers_prevention_and_risk.asp. Accessed Oct. 31, 2010.
- Essentials of a diagnostic workup. Alzheimer's Association. http://www.alz.org/professionals_and_researchers_14902.asp. Accessed Oct. 31, 2010.
- Basics of Alzheimer's disease. Alzheimer's Association. http://www.alz.org/national/documents/brochure_basicsofalz_low.pdf. Accessed October 31, 2010.
- Late stage care. Alzheimer's Association. http://www.alz.org/national/documents/brochure_latestage.pdf. Accessed Nov. 2, 2010.
- Strobel, G. Noisy response greets revised diagnostic criteria for AD. Alzheimer Research Forum. http://www.alzforum.org/new/detail.asp?id=2522. Accessed Nov. 3, 2010.
- Neurological tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Nov. 3, 2010.
- Caring for a person with Alzheimer's disease. National Institute on Aging. http://www.nia.nih.gov/NR/rdonlyres/E0F45395-A473-4B26-8F7E-86F4314405CE/0/CaringGuide.pdf. Accessed Nov. 4, 2010.
- Medical foods. Alzheimer's Association. http://www.alz.org/national/documents/statements_medicalfoods.pdf. Accessed Nov. 19, 2010.
- Is it really approved? Food and Drug Administration. http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM143301.pdf. Accessed Nov. 19, 2010.
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