Potential role of ENRICH® in assessing risk for late-onset Alzheimer's Disease

Alzheimer’s Disease (AD) is a condition with a devastating and growing impact on individuals, families, and society as a whole. As the population ages, more people are developing the disease – one every 66 seconds. And as prevalence increases, the conversation around genetic testing is becoming more mainstream, with doctors, ethicists, and public figures debating the benefits and harms of knowing one’s AD risk decades before onset.

Yet, this debate misses a key point: lifestyle habits are just as important as genetics in determining AD risk.  Having one particular form of a gene (APOE ε4) does increase your risk of developing AD. That said, having one or even two APOE ε4 alleles does not mean that the development of AD is a foregone conclusion. AD is a matter of nature AND nurture, genetics AND environment. Factors like exercise, diet, and smoking, can actually alter the expression of genes, switching them on or off, so to speak. And while there is a test to determine if a person has the gene that causes early-onset familial AD, or eFAD, at this time there is no way to look at a person’s genome and say for certain whether that person will develop late-onset AD.

Given the limitations of genetic testing for late-onset AD, as well as the potential psychological impact of “positive” test results, leaders in the fields of AD research and policy generally take a cautious stance, recommending it only under very specific conditions. Instead, the National Institute on Aging (NIA) recommends that people who are worried about changes in their memory or other problems with thinking seek a physician consultation.

For families, it’s critical to be well-prepared for this consultation. Physicians require information on lifestyle habits, and ENRICH® is an ideal way to collect this information. ENRICH® is an all-in-one brain health package that includes a cognitive assessment tool, a report that serves as a launching point for conversations with providers, and a guide to brain-healthy behaviors and cognitive exercises. Bringing your ENRICH® report with your family history information will help your provider exercise more accurate clinical judgment to assess your dementia risk and recommend interventions.

While there is currently no cure for AD, knowledge and information are power. And information about lifestyle habits is just as important as information about genetic risk. Consider the following analogy: You are a train with “Dementia” as a potential destination. After onset, the train is on the tracks and headed toward “Dementia” with no way to stop it or reverse the direction. However, you can slow the train down or prevent the tracks from being laid in the first place by adopting the habits encompassed by ENRICH®. Doing so could have a profoundly positive impact on your future, your family, and society as a whole.

Madeleine Boudreau