When talking about Alzheimer’s, it’s important to look at the risk factors:

• Age—This is the strongest risk factor, with most people being diagnosed after age 65.
• Genetics—There are genetic links associated with the disease, meaning it can run in families.
• Environment—The most studied environmental factors include aluminum, zinc, food-borne poisons, and viruses, but there has been no clear evidence of cause and effect.
• Related medical conditions—These include high blood pressure, obesity, diabetes and cardiovascular disease.

It’s also important to note that having many family members with Alzheimer’s does increase an individual’s risk, but it’s not necessarily tied to genes per se. Instead, it can be tied to a genetic mutation or other medical conditions (such as diabetes and obesity) that may run in the family.

As doctors, we are learning more and more about how diabetes, heart disease, obesity and dementia are all tied together.

These medical conditions all involve blood vessels—specifically how healthy or unhealthy the vessels are.

A healthy blood vessel has a smooth inside lining, flexible walls and no plaque build-up. In contrast, an unhealthy blood vessel has a sticky lining, stiff walls and plaque build-up, possibly even buried in the vessel wall. This can result in decreased blood flow to important cells in brain tissue, impacting function and clearance of certain proteins.

This build-up is associated with dementia and Alzheimer’s.

We also know that Alzheimer’s disease is associated with certain acquired risk factors—especially when they start in midlife. The greatest risk factors include smoking, obesity, high cholesterol, type 2 diabetes and high blood pressure.

Taking control of your future self

What’s the bottom line? Midlife is the time to consider life goals and make important choices.

When I talk about Alzheimer’s and risk factors, I think about a patient of mine I’ll call Tania who came into the menopause clinic with some serious concerns.

Tania, 53, complained of forgetting things, feeling anxious, having night sweats and simply not feeling like herself. She was worried she had dementia—and for good reason.

Tania’s grandmother moved from Mexico to live with Tania’s family when Tania was 12. By the time Tania entered high school, her grandmother suffered from Alzheimer’s disease. Concerned she had the same thing, Tania needed answers.

We began by talking about her current stage in life—early perimenopause. This was clear because of her irregular periods, and symptoms of hot flashes and mood changes around the time of her period. Next, we went over her medical history, which included diabetes during pregnancy and lifelong issues with mild obesity.

Tania’s family history revealed some real concerns: Her mom, aunts and grandmother suffered from diabetes, high blood pressure and obesity; and her father had high blood pressure. When I took Tania’s vitals that day, her blood pressure was 150/75 and her BMI was 31. Both of those numbers were too high.

After gathering this information, I asked Tania what she wanted, and she said she wanted to be healthy—without diabetes or high blood pressure. She also wanted to maintain a healthy weight, be active, and not have to take all the meds her family did. And, most importantly, Tania did not want to get Alzheimer’s disease.

When I explained to her that diabetes, high blood pressure, high cholesterol and obesity in midlife were all significant risk factors for Alzheimer’s, she wanted to know what she needed to do. We ran her labs, and the results showed she had pre-diabetes and mildly elevated cholesterol.

We then put together a plan. And our plan paid off.

After three months, Tania walked for 45 minutes every day and had changed her diet. She had lost 8 pounds and, even better, her blood pressure was down to 140/70 and her blood sugar was lower—almost in the normal range. Her periods were regular again and she slept better.

Tania felt great and addressed her health issues in time to meet her goals and make a difference.