February 12, 1996
Media Contact: Michael Purdy
Phone: (410) 955-8725

The best defense against Alzheimer's Disease may be to look for a variety of risk factors and change them in a way that minimizes a patient's chance of getting the disease, according to Claudia Kawas, M.D., an associate professor of neurology at Johns Hopkins Medical Institutions.

"It's important to realize that there's no single cause of Alzheimer's Disease," says Kawas. "There's no single treatment, and there will probably never be one prevention. To most effectively decrease the chances of getting Alzheimer's, a customized approach will be necessary for each person."

Kawas is chairing a symposium on Alzheimer's Disease at the meetings of the American Association for the Advancement of Science in February in Baltimore. For the symposium, she will present an overview of suspected risk factors for Alzheimer's.

Among the most well-known of these factors is a gene, APOE4, tentatively linked to coronary artery disease and Alzheimer's.

"Before we go out and start screening people for this gene, we need to know more about how the protein it produces may be involved in Alzheimer's Disease," she says.

Other researchers are investigating a possible link between Alzheimer's and head trauma. One study by researchers at another institution of young head-trauma victims found that changes in their brains over several years resembled changes in the brains of Alzheimer's patients.

At least three epidemiological studies have found a link between Alzheimer's and head trauma, but Kawas cautions that doctors typically can't rely on Alzheimer's patients to report if they have had a head trauma after onset of the disease. Relatives of Alzheimer's patients searching for an explanation may "remember" events inaccurately.

Education also seems to play a role in Alzheimer's--the less educated a person is, the more likely he or she is to develop Alzheimer's, she says.

"If you're at school when you're young, you may be developing more synaptic connections. It's possible that symptoms of Alzheimer's that occur later are less apparent as a result of this synaptic reserve," Kawas says. "However, it could be something that correlates with access to education, such as nutritional intake. If you're better educated, you may also more likely to be well-nourished as a child, and this could account for the change in risk."

Well-educated people may also have more effective strategies for compensating for Alzheimer's Disease, Kawas notes. The most definite risk factor is still age, according to Kawas.

"In every country, studies show the risk of Alzheimer's disease doubles every five years after the age of 65, and the doubling does not appear to level off. A ninety-year-old person has a very high risk.

"Some people take this as an indication that Alzheimer's is inevitable, a normal consequence of the aging process," Kawas says. "Even if it is normal,' though, it's still worth preventing. We will probably never be able to say, This person will definitely get it.' But we will be able to identify high-risk groups of people reliably, and make a difference for a lot of people by intervening to minimize their risk."

-- JHMI --
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