2023-09-11 10:57:00
By Tony Poland and Melanie Hoffmann, medical editors | September 11, 2023, 12:57 p.m
One of the biggest risk factors for an Alzheimer’s diagnosis is age. If you also have a genetic predisposition in your family, the risk increases even further. A team of researchers has now discovered which measures can at least offset the risk.
Not only is Alzheimer’s incurable – it is also not yet fully understood what triggers the disease, determines how quickly it progresses and how it can be effectively prevented. It is clear that genetic factors can play a major role. According to current research, four genes are associated with an increased risk of developing illnesses in middle or old age. Now a study gives hope to genetically predisposed people: Apparently, education can counteract their increased risk of Alzheimer’s.
Die „Alzheimer-Gene“
APP and presenilin
The genes that are associated with the pathological accumulation of the proteins beta-amyloid and tau are colloquially known as “Alzheimer genes”. These are amyloid precursor protein (APP), presenilin 1 (PSEN1) and presenilin 2 (PSEN2). They are associated with early illness between the ages of 30 and 65.1
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Variants of the ApoE gene
There is also the gene apolipoprotein E (ApoE), which comes in three variants: ApoE2, ApoE3 and ApoE4. Which variant of ApoE a person carries determines their individual risk of developing Alzheimer’s disease in old age (symptoms from 65 years of age).
ApoE3 is the gene variant that is most common in the population and is therefore referred to as the “normal” variant. According to current knowledge, it plays a neutral role in Alzheimer’s disease. This means that this variant neither increases nor reduces the risk of the disease.
ApoE4 is considered the most important genetic risk factor for Alzheimer’s disease. In contrast to the normal gene variant (ApoE3), this variant increases the risk of the disease twelvefold. According to research, a mutation plays an important role in this context. For example, one study came to the conclusion that people with the PSEN1 E280A mutation who were also ApoE4 carriers tended to develop Alzheimer’s disease earlier.2
ApoE2 is relatively rare and appears to offer some protection once morest the disease. Alzheimer’s disease usually occurs later in life in people with this allele than in a person with ApoE4.3,4
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Can other factors counteract the genetic predisposition?
Even though it has been proven that genes play an important role in the development, many questions still remain unanswered. For example: Why do carriers of the same genes develop the disease at different times in their lives? A guess: Other factors, such as environmental and lifestyle factors, have an influence.
One such factor is education. Studies have shown that the level of education or the duration of learning (measured by time spent at school, training, university, etc.) can have a protective effect once morest Alzheimer’s.5
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Study on the influence of education and genes
Scientists at Massachusetts General Hospital and Harvard Medical School have now investigated what influence the above-mentioned ApoE genotypes have on the cognitive functions of carriers of the PSEN1 E280A mutation. In the second step, they investigated whether the level of education has a protective effect and weakens the connection between ApoE and cognitive functions.
For this purpose, they analyzed data from a total of 675 people over 18 years of age with different levels of education (370 women, 305 men) with the genetic mutation PSEN1 E280A. In comparison, 594 people (over 18 years of age) who did not carry this mutation were analyzed (332 women, 262 men).6
Can education protect once morest Alzheimer’s?
On the one hand, the US researchers were able to confirm that the joint occurrence of PSEN1 E280A and ApoE4 increases the risk of early Alzheimer’s disease. In contrast, the combination of PSEN1 E280A and ApoE2 resulted in Alzheimer’s only appearing later in the subjects’ lives.
The analysis of the data also provided evidence that education – more precisely, a high level of education or more time in educational institutions – can have a protective effect. People with higher educational qualifications had better cognitive function compared to study participants with less educational qualifications. This was particularly noticeable in the people with the highest genetic risk (i.e. with the combination of PSEN1 E280A and ApoE4). Accordingly, the researchers conclude that higher education or more years of education can mitigate the effects of ApoE on the brains of PSEN1 carriers.
Study author Dr. Yakeel T. Quiroz stated in a report by “Medical News Today“: “Our results suggest that higher levels of education may be a way to preserve cognitive function in people at risk of Alzheimer’s disease.”
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Limitations of the study
The study therefore provides arguments that a high level of education is not only desirable for professional and social reasons, but also has an impact on health. However, it cannot explain how exactly education or learning influences the brain so that it appears to be protected to a certain extent from Alzheimer’s. Furthermore, it cannot be ruled out that other environmental and/or lifestyle factors besides education did not play a role in the results of the study.
Sources
1. Competence instead of dementia. Genetic. (accessed on September 11, 2023)
2. Pastor, P., Roe, C.M., Villegas, A. et al. (2003). Apolipoprotein Eepsilon4 modifies Alzheimer’s disease onset in an E280A PS1 kindred. Annals of Neurology.
3. Alzheimer Research Initiative eV Inheritance of Alzheimer’s dementia: Genetic basis. (accessed on September 11, 2023)
4. Max Delbrück Center. What makes ApoE4 dangerous for the brain. (accessed on September 11, 2023)
5. Wada, M., Noda, Y., Shinagawa, S. et al. (2018). Effect of Education on Alzheimer’s Disease-Related Neuroimaging Biomarkers in Healthy Controls, and Participants with Mild Cognitive Impairment and Alzheimer’s Disease: A Cross-Sectional Study. Journal of Alzheimer’s Disease.
6. Langella, S., Barksdale NG, Quiroz, YT et al. (2023). Effect of apolipoprotein genotype and educational attainment on cognitive function in autosomal dominant Alzheimer’s disease. Nature.
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