alveatch50 wrote:I have 4/4. I'm 53 with recently diagnosed heart disease. Both parents died of dementia. Happy to be here and soak it in.
alveatch50 wrote:Thank you for this post. I too am 53. I have 4/4. I have cardiac disease diagnosed without symptoms just this past year. I have 6 blockages on screening calcium cardiac CT. I exercise, I am vegan, I dont smoke, I dont drink. Despite this, my stress test was very positive with ST depression 3 mm, and chest pain. CT angiogram showed non obstructive disease, meaning I dont need intervention like a stent or bypass but the blockages are real. I had been concerned about alzheimers since I received my 23andme results 7 years ago. The urgency has heightened now and I am researching and anxious about how best to manage my health. In addition to this, my anxiety has increased as I feel my cognition may be slipping. I do have the book by Dr. Breseden and have been reviewing this. I am a physician myself and am selective regarding my health care providers. I live in Tacoma, Washington and I am not able to locate or accessReCODE/APOE4 knowledgeable doctors in my area that can guide me. My cardiologist and internist are well meaning but are not familiar with the significance of my genes. I am willing to travel if it is going to make a difference. Thanks so much for this website and for all of you. I was referred here by the facebook page apoe4.
Welcome again, Andrea!
I hope you don't mind that I took the liberty of copying over your detailed post from our Practitioner Review of Dr. Jessica Pena in NYC Re: Jessica Peña, MD / New York City, NY
to add to your first post. Since you already have a post, it seems like a happy idea to bring these two together!
As someone with a sky-high Lp(a) level and family history of strokes and heart disease, I get your anxiety about both heart disease and AD. Anxiety is a thief who comes at odd moments to steal our confidence and toss us in what I have come to think of as "funkdom"--a place where we have to battle our learned pessimism that problems are pervasive, personal and permanent, and instead seek to reframe them as temporary (maybe), specific and open to external interventions. (I credit Dr. Martin Seligman of the Learned Optimism and Positive Psychology movement for that wisdom.)
So I won't begin to second-guess your choices as a physician. I will offer some possible examples of good outcomes for similar people though. I knows of several ApoE 4/4 women around my age (almost 68) and years older who have similar histories of "everyone died of heart disease before they could get Alzheimer'rs" or "everyone got dementia in their 60's" who are cognitively healthy (and have proved it on repeated studies in preventative clinical trials), working in demanding professions and finding time for advocacy of important issues, travel with friends and family and time with grandchildren--including regular care of up to five at once! My assumption, which seems to be supported by the Finnish FINGER study and some of the meta-analysis done for the Generations Trials (of which I was a participant) is that we don't share the same environmental, dietary, health-monitoring and pollution risks of our parents. My risk, according to this study https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002254
is about 35-55% for a diagnosis of MCI or AD by age 85. At 67, I expect to sail past the gloomy assertion that I would be diagnosed with Alzheimer's at age 68, and believe you will also in 15 years.
If I could go back to age 53, I would do what Stavia, the doctor with ApoE 4/4 and a history of 2 severe TBIs who wrote the Primer
chooses to do: Follow the strategies she recommends, find purpose and joy in life, travel as often as possible (and eat the local pastries when in Portugal--a day of those won't doom us). As the Stoics advise, we cannot control the outcome of our journey; we can seek to be well-prepared for possible adventures and choose to surround ourselves with those who make they journey easier.
I hope your local cardiologist is informed about ApoE 4 and can offer you some specific suggestions. Others here are likely to share their experiences and suggestions.