Young African Americans With Poor Heart Health At Risk of Alzheimer's

Risk factors for Alzheimer's dementia could be apparent even in teenagers and people in their 20s, according to research recently presented at the Alzheimer's Association International Conference. The risk of Alzheimer's is disproportionately apparent in African Americans, largely due to cardiovascular health and societal issues.

Alzheimer's development has been linked to a number of health issues that can be present even in young people, including:

• High blood pressure
• Diabetes
• High cholesterol
• Higher body mass index (BMI)

Having two more of these factors in adolescence, young adulthood, or midlife is associated with statistically significant risk of cognition issues later in life, including Alzheimer's.

Race as a Factor

African Americans have higher rates of heart health factors like high blood pressure, high cholesterol, and diabetes, which are all associated with more risk of dementia and Alzheimer's.

The Alzheimer's Association notes in its report that older African Americans are about twice as likely to have dementia compared to white people in the same age categories.

Addressing health inequities and providing more resources to Black communities is an important part of changing these numbers, according to Madeline Sutton, MD, a medical epidemiologist and faculty member at Morehouse School of Medicine.

"We are now having these conversations about racial disparities in healthcare and outcomes, but obviously we have a long way to go," she says. "Recognizing issues like these is a step in the right direction, of course, but we need to keep moving toward action on what it will take to address these inequities."

In the recent study, researchers also emphasized the need to promote heart- and brain-healthy lifestyles for younger adults and adolescents, particularly African Americans who are susceptible to the negative impact of poor vascular health on the brain.

Focus on Weight

Another major factor is BMI, and the study noted that dementia risk is increased with early adulthood BMI in the overweight or obese categories, especially for women.

Compared to women with normal BMI in early adulthood, dementia risk was 1.8 times higher among those who were overweight, and 2.5 times higher among those with obesity.

Detecting Alzheimer's

Although Alzheimer's doesn't have a cure yet, early detection can be incredibly important for slowing progression of the disease, says Scott Kaiser, MD, geriatrician and director of geriatric cognitive health for Pacific Neuroscience Institute at Providence Saint John's Health Center in Santa Monica, CA. He notes that no matter what age someone might be, these are some major signs to consider:

• Emotional changes: Alzheimer's usually first affects the hippocampus, a part of the brain associated with memory, but also with emotional regulation. Even in early Alzheimer's, people may have sudden shifts toward being fearful, irritable, or angry. In later stages, emotions tend to shift more toward anxiety, paranoia, and sadness.
• Confusion or difficulty with organizing tasks: Because the hippocampus allows you to form new memories, even minor loss in that function can be disorienting. You might lose track of time, or become challenged by organizational tasks.
• Mobility problems: Since the hippocampus also plays a key role in how you navigate and orient your body, this sense may be affected, leading to bumping into objects, stumbling, or dropping things.
• Language challenges: Alzheimer's affects each person differently, and some may not have communication issues at all, while another may have them early on. Kaiser says this can take the form of being unable to recall common words, jumbling word order in sentences, or struggling with pronunciation.

Next Steps

No matter what age you or a loved one might be, issues like these should prompt a cognitive screening, according to Jasmeer Chhatwal, MD, PhD, a neurologist at Massachusetts General Hospital and assistant professor of neurology at Harvard Medical School. Even in young adults, this can provide a helpful baseline that can be compared to later screens if symptoms should worsen, he says.

Also, prevention is key—especially for those who might be predisposed to Alzheimer's due to family history. Chhatwal says significant research indicates lifestyle can be a major factor for delaying onset and slowing progression. These include:

• Regular exercise
• Quality sleep
• Nutrition diet
• Meaningful social interaction
• Cultivating a sense of purpose

"Even modest improvements in habits like exercise can be substantial for your brain," says Chhatwal. "That isn't applicable only to Alzheimer's, but to brain function in general, and it applies to people of all ages."