allisong wrote:Hello all! I'm Allie, 30 years old, married 8 months and hoping to start a family soon. This information has thrown me for a loop and made me question if it is responsible for me to have biological children knowing that I'd pass on at least one copy. I should add that I deal with pretty significant anxiety and OCD daily so that is probably partially at play here. My husband is not concerned and doesn't even think we need to meet with a genetic counselor - I can't tell whether my own issues are playing into my extreme emotions over this news. I don't have any family history of AD. Is this unusual? Sorry for the rambling post! Happy to have found this community and interested to learn all I can from you guys!
As Theresa said, I think most 4/4s are glad that our parents were brave enough to have kids! My own parents each lost a parent while young--one to stomach cancer, the other to a stroke. They lived through the Depression and WWII and in my dad's case, survived dangerous runs on the North Atlantic. They started having kids around the same time that "drop and cover" drills for nuclear bomb attacks started in schools. And yet they chose to have 4 kids, and none of us has mild cognitive impairment or Alzheimer's at ages 66-70, or heart disease or any cancer more serious than skin cancer from our Scots/English skin. My three adult children, all in their 30's, are doing just fine with ApoE 3/4 in challenging careers and my two grandchildren (who may have inherited a 4) also are great examples of why people have kids.
Here's what my parents' generation (and maybe your grandparents) didn't have that my generation (I'm 67) has learned as adults and your generation grew up knowing: Awareness and tools to prevent, diagnose early, treat and in many cases reverse diabetes, high blood pressure and cardio-vascular disease, sleep apnea, smoking-related disease, air and water pollution, and sedentary lifestyle-related illness. Many also didn't have opportunities for continued education and challenging, fulfilling occupations.
I know that my own children have lived far healthier lives than I did in my first 30 years (think bologna and Velveeta cheese sandwiches as a staple in the 1950's) so their risks and yours should prove to be far lower than mine--and at 67 with a healthy brain, I think I have a good likelihood of turning 80 with that same healthy brain!
The fact that there is no history of AD in your family suggests that you also inherited strong protective factors--which is why scientists are now studying "resistance" to neuropathology (i.e. never having it occur) and "resilience" (having amyloid plaques or tau tangles without showing corresponding cognitive impairment) using stem cells drawn from healthy ApoE 4/4s in their 70's and 80's. I got to meet one of these scientists last year. He's in his early 40's and got into the field because 3 grandparents died with dementia. He now uses machine learning to test 1000's of substances against stem cells of healthy and unhealthy brains, and expects that within 10 years we will have a range of interventions (lifestyle, gene therapy, preventative medications, etc.) based on highly personalized risk assessments. So if someone with 3 grandparents with dementia is hopeful, I think you can be also!!
I would strongly encourage you to avoid suspect sources of information on your own risk--lots of those use articles written 20+ years ago based on small samples of people who showed up at Alzheimer's clinics. Here's a quote from a 2017 meta-analysis of four large population-based cohorts on the statistical (not personalized) risk of someone MY AGE (60-75) to have a diagnosis of either Mild Cognitive Impairment or Alzheimer's by the age of 85:
APOE-related risk of mild cognitive impairment and dementia for prevention trials: An analysis of four cohorts
The Generation Study elected to disclose the following “lifetime” risks of MCI or dementia to its potential participants: 30%–55% for individuals with APOE-e4/e4; 20%–25% for individuals with APOE-e3/e4 and -e2/e4 (with a note that risk might be lower for those with APOE-e2/e4); and 10%–15% for individuals with APOE-e3/e3, -e3/e2, and -e2/e2 (with a note that risk might be lower for those with APOE-e2/e3 and -e2/e2). These values are consistent with our findings, but use round numbers for intelligibility, and broader ranges to reflect statistical and other sources of uncertainty.
If you want to read some great strategies endorsed by a healthy, smart, active, world-traveling doctor who is in her late 50's and has ApoE 4/4, browse our Primer
And to find out how to quote people so they see your response, how to search, how to find unread posts and how to "subscribe" to posts to get updates on a topic or thread, check out "How-To" Get the most out of the ApoE4.info website
Hugs from a genetic 4/4 "mom" who wants you to life life large!