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Carrie Steckl, Ph.D.Carrie Steckl, Ph.D.
Finding Meaning Through the Many Windows of Wellness

Can "Nurture" Temper "Nature"? Environment, Genes, and Alzheimer's Disease

Carrie Steckl, Ph.D. Updated: Aug 16th 2012

In a recent post, I described how I turned my anger about Alzheimer's into a vehicle for advocacy. Finding a cure for this disease is a long-term dream with immediate urgency. And while researchers have made significant strides in unraveling the causes and processes of Alzheimer's, so many questions remain.

older adults lifting weightsOne question I've been asked a lot is whether there is anything we can really do to prevent the onset of Alzheimer's. We know that genes play a role in a person's risk; we also know that some people with no genetic factors develop the disease. When our chance of developing a serious illness seems like a crapshoot, motivation to practice prevention runs thin. I feel quite helpless when a person tells me, "What's the use in taking care of myself? If I'm going to get it, I'm going to get it. I have no choice in the matter."

This may be true to a very minimal extent. A few genetic mutations tied to Alzheimer's are deterministic - that is, inheriting the gene is a guarantee that the disease will develop. But according to the Alzheimer's Association, deterministic genes account for less than 5% of Alzheimer's cases, and they only occur in a few hundred families in the world.

On the other hand, risk genes increase the odds that a disease will develop, but carrying a risk gene is not a guarantee that the disease will ensue. The risk gene with the strongest influence on developing Alzheimer's disease is APOE-e4, which is thought to play a role in 20 - 25% of Alzheimer's cases.

Already, we can see that genes most likely account for no more than 30% of all cases of Alzheimer's - which leaves a high percentage of cases not tied to any known genetic cause. Moreover, there are people who carry the APOE-e4 gene but do not develop the disease. Why do some people who carry a genetic risk not develop Alzheimer's? This is the million dollar question.

It's also the question asked by researchers at Stockholm University and the Aging Research Center of the Karolinska Institute in Sweden. They recently studied 932 people aged 75 and older over a 9-year period. Their findings included:

  • Those carrying the APOE-e4 gene had a higher risk of developing Alzheimer's than non-carriers.
  • Carriers with more than 8 years of education had a lower risk of developing the disease than carriers with less than 8 years of education.
  • Carriers with a high level of leisure activity (including physical, mental, and social factors) had a lower risk of developing Alzheimer's than carriers with a low level of leisure activity.
  • Carriers with no vascular risk factors (obesity, diabetes, high blood pressure, high cholesterol, and smoking) had a lower risk of developing Alzheimer's than carriers with any of these vascular risk factors.

The researchers' also found that having all three "protective factors" (education, leisure activities, no vascular risks) significantly reduced the chances of Alzheimer's or any other kind of dementia among those carrying the APOE-e4 gene.

This is not the only study indicating there is something we can do to reduce our risk of Alzheimer's. Note that I said reduce our risk, not prevent the disease. In the fight between nature and nurture, perhaps nurture can temper nature while not wholly overcoming it.

So stretch your mind, exercise your body, and stay connected. Eat a healthy diet, keep tabs on your vascular numbers, and for heaven's sake, please don't smoke. These are all wise practices regardless of whether or not we carry the APOE-e4 gene, and now there is evidence that they might be protective practices, too.

It would be too bold to purport that our actions could actually guarantee an Alzheimer's-free future. But hell, why wouldn't we do something that could reduce our risk, especially if it is good for us anyway?


Carrie Steckl, Ph.D.

Its a true blessing to have you visit my blog on mental health and wellness. I also write blogs on faith and caregiving in addition to teaching part-time for Columbia College of Missouri. For more information about my background and writing, visit my webpage at

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