welcome to the organic green doctor blog

i am a family physician who was diagnosed with
early mild cognitive impairment(mci) amnestic type on december 21, 2010
this is a precursor to alzheimers disease
because of this diagnosis i have opted to stop practicing medicine
this blog will be about my journey with this disease
please feel free to follow me along this path
i will continue blogging on organic gardening, green living,
solar power, rainwater collection, and healthy living
i will blog on these plus other things noted to be interesting

Friday, August 9, 2019

alzheimers news-should a young person be tested

Image result for organicgreendoctor
thats a question i have been asked several times over the last 9 years
my answer
maybe not

then this last week a former patient and nurse lh asked me to post something for her age group
let say she is 40
is a nurse
has 5 kids

here is her excellent question

You say the best time to change would have been 20 years ago. I'd love it if you were to write a blog with recommendations for the rest of us. When should (the collective) we start screening for any of this? I know we cannot just March into an office and ask for screenings without certain symptoms. But, are there any screening that could/should be done by certain ages? Similar to mammograms and colonoscopies...age related screenings. Or is it only symptom based as this point? What treatment should one seek and when? Any other recommendations?

today there is not a test that will tell you that you have alzheimers disease at your age except a genetic test for the early onset gene which is rare
if it the early onset is in your family you will know it as there will be a lot of relatives diagnosed in their late 40s and 50s who died from it in their 50s and early 60s
i eg personally dont know anyone with this type of alzheimers disease but ive have met families that have it

there is the test for the late onset alzheimers gene called apoe 4
if you carry one version your chances are increased 2-3 times that you might get alzheimers disease
if you carry two versions like i have then your chances are increased 10-20 times that you will get alzheimers disease
14% of yall have this gene
less than 3% of yall have the double version
way less than 1% have the early onset gene

if you have the early onset gene you will get alzheimers at a young age
if you have the late onset gene you may not get alzheimers disease if you take real good care of your health

should you have this test
if i was your age i would have it
thats me
others including my siblings have chosen not to have it done

its not quite like being tested for huntingtons where if you are positive then you know you will 100% get huntingtons
if you are positive for the apoe 4 it means your risks are increased
how you live your life may determine if it causes you to get alzheimers disease

there is a blood test that may be available in europe in over a year that will 100% tell you if you have alzheimers disease
so if 30 years before symptoms start if the process has started up in your brain then this test will be positive
if its positive then you know you are getting alzheimers disease
this test measures rna that programs proteins that show up in patients with alzheimers disease
so at your age had the test been available then my blood test would have been positive for this rna
so they could have told me at 30 or 40 or 50
dr nash you have the beginnings of alzheimers
i could then plan my life accordingly

this test very likely will be in the us in 2021 or 2022

another test that may become available is 94% accurate for diagnosing alzheimers disease

so right now there is no test except for the early onset gene
but probably in 2 years the new alzheimers test will be available here

the question is do you want to know
its similar to other diseases like huntingtons that folks have to make a decision on whether to be tested

for me
im a i wanna know person
tell me
then ill attack the problem the best i can

ill live right eat right exercise right
look for clinical studies
talk to others about it
thats what i do
had i known at your age lh i would be much better for me had i really known 29 years ago
doing all the right things would have probably pared down my risks by as much as 40+%

now back to your question
memory testing is now recommended at the welcome to medicare wellness exam and the annual medicare physical visit so most get screened at 65
but these memory screens dont pick folks up early
eventually 65 will be too old to screen as it should have been done younger like your age

now no matter what the age if there are memory issues an evaluation needs to be done

is there issues with lack of exercise obesity sleep disturbances mental health issues like anxiety depression alcohol or drug abuse medication side effects high blood pressure cholesterol diabetes other health issues
i would say most memory issues in your age group are related to medicines drug alcohol abuse hormones like thyroid mental health issues stress sleep issues

if like in my family there is a real strong family history of alzheimers disease
i would say for example if you are genetically kin to me then you will probably get alzheimers disease one day
you dont really need a blood test to know that unless you are like me where you want to really know

you might consider an apoe 4 gene test but you really need to put a lot of thought into it
some folks cant handle the results
as my historian brother who does a lot of ancestry dna research says
if you cant handle the results of what you may find then dont do the test

i have the double apoe 4 apoe4 gene
that means both my sons have at least the  apoe 4 gene
the same is probably true of my younger brothers kids and probably my other siblings kids and most of my cousins and their kids
they dont really need to be tested they basically already know
they should be living their lives accordingly

should they get the alzheimers blood test when it becomes available
well since they and their cousins are around your age i would say yes if and only if they truly understand the results and feel like they can handle definitely knowing the results

right now the workup is based on symptoms in most medical offices
no symptoms no workup
i prefer a more aggressive approach
ask the question about memory maybe like in folks over 50
these folks may not have alzheimers but may have treatable causes of memory issues

now in your lifetime and definitely in your kids lifetimes there will be treatment but as we are finding out it will need to be started at a younger age
eg in me had i known in my 40s and treatment to stop or prevent it was available then i would have to start the treatment and stay on if forever
like someone who has rheumatoid arthritis or ulcrerative colitis or lupus etc does now

there may one day be a genetic treatment likes whats happening with huntingtons and with sickle cell disease where the patients dna is being alter to normal dna
thus ending the disease

maybe some versions of alzheimers can be treated this way one day

so what to do today

its been proven in several research studies that if you are risk for late onset alzheimers disease that you can markedly lower that risk by as much as 50% by living a good life style
to include

eating right eg the mind diet most of what one likes to eat is on there just maybe not as much as we americans consume
the red belts of the most alzheimer disease rates correlates with the red belts of obesity diabetes poor diets poverty poor health care etc

exercise you dont have to go to a gym or kill your self exercising just live an active physical life
ive never done gyms i hike walk i use to jog i use to bike play sports i garden take care of grandkids man thats exercise

dont smoke dont drink too much thats 1 wine glass for females 1-2 for males

if you are obese you should eat right and exercise to lose weight

control any mental health issues like anxiety depression sleep issues stress

control you weight your blood pressure your cholesterol your diabetes

stay active socially and mentally and phyically all your life

if you do have memory issues have an evaluation done
many things that cause memory issues are treatable

so lh
i hope that answers your question
stay tuned
the alzheimers story will be changing a lot in the next 10 years

live a good healthy life is my final answer

the organicgreen doctor

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