Can Alzheimer Disease be Prevented?

 Bret S. Stetka, MD

Background and Biomarkers

AD is an epidemic, affecting over 5 million Americans and nearly 40 million people worldwide. AD afflicts 1 in 8 people aged 65 years or older and nearly half of those 85 years and older.^[2] The reason for the staggering prevalence is simply that we’re living longer. “The major risk factor for AD is advanced age,” noted Small. According to the Centers for Disease Control and Prevention, life expectancy in 1900 in the United States was around 47 years; in 2013, it’s nearly 80 years.^[3,4]

“So what is Alzheimer’s disease?” asked Small rhetorically, before a brief history lesson. In 1906, German psychiatrist and neuropathologist Alois Alzheimer presented the first case of the condition that would bear his name. His initial patient died 4 years after her symptoms began, and on autopsy her brain contained the waxy protein fragments and twisted fibers now known to be amyloid plaque and tau tangle protein accumulations. Assumed to be a rare form of dementia, it wasn’t until decades later that more progress was made. A 1968 paper^[5] by Blessed, Tomlinson, and Roth correlated plaques and tangles with “senility,” pathologizing cognitive dysfunction previously thought to be a normal part of aging and igniting AD awareness.

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