Mom's Alzheimer's May Raise Children's Risk

If your mother had late-onset Alzheimer's disease, you may be
more likely to undergo brain metabolism changes that might
lead to Alzheimer's, a new study shows.

But that doesn't mean that Alzheimer's disease is definitely in your future,
notes researcher Lisa Mosconi, PhD, assistant professor of psychiatry at
NYU Langone Medical Center in New
York.

Her advice: "If you're at risk of Alzheimer's because your mother had
the disease, you need to make sure that you take special care of your
health" to try to prevent or delay Alzheimer's disease.

Here's a look at Mosconi's findings -- presented in Chicago at the
Alzheimer's Association International Conference on Alzheimer's Disease 2008 --
and reaction from experts.

Maternal History of Alzheimer's

Having a parent or sibling with Alzheimer's disease is a known risk factor
for Alzheimer's. The new study is about figuring out how that happens.

Mosconi's team studied 66 healthy adults (average age: 64) with no signs of Alzheimer's , dementia , or milder mental
problems.

Some participants' moms had had late-onset Alzheimer's disease, the most
common form of Alzheimer's, which starts after age 65. Others had a father, but
not a mother, with late-onset Alzheimer's. A third group had no parents with
Alzheimer's.

Participants got positron emission tomography (PET) scans every year for two
years to see how effectively their brain used sugar (glucose).

Throughout the study, all participants had normal mental skills. But those
with a maternal history of Alzheimer's had a sharp decline in how well brain
regions linked to memory and attention used glucose. Having a father with
Alzheimer's didn't affect the PET scan findings.

It's too early to know if the drop in brain glucose metabolism will predict
Alzheimer's. Mosconi's team will follow participants to check on that.

The researchers are also studying mitochondria, energy-making structures in
cells, because mitochondria DNA are handed down maternally. Flawed mitochondria
might be one piece of the Alzheimer's puzzle, but that isn't certain, Mosconi
notes.

Clue to Alzheimer's?

The findings are "intriguing," Samuel E. Gandy, MD, PhD, and John R.
Gilbert, PhD, tell WebMD.

Gandy, who chairs the medical and scientific advisory council of the
Alzheimer's Association, points out that brain's glucose metabolism can fall
decades before Alzheimer's starts.

"If you had a baseline [brain] scan and then a follow-up five years
later and it showed that your glucose utilization was falling off rapidly and
in a pattern consistent with Alzheimer's disease, that would be of
concern," says Gandy. He also says "it's certainly plausible that if
one inherits faulty mitochondria, that might put you at increased risk for
Alzheimer's," though more work is needed to confirm that.

Gilbert -- a professor of human genetics who directs the Center for Genome
Technology at the University of Miami Miller School of Medicine's Miami
Institute for Human Genomics -- agrees.

"It may be that decreased glucose utilization doesn't necessarily mean
you're going to get Alzheimer's disease but that, in conjunction with the wrong
type of environment or some other genes that might give you a slight risk,
would combine to give it to you," says Gilbert.

For some people, slowing glucose metabolism in the brain might be the
tipping point. "But in a lot of people, it probably is just another insult
... another hit in a biological boxing match," says Gilbert.

But family history or not, you can pack some punches of your own against
Alzheimer's risk.

What You Can Do

What if your mother has, or had, late-onset Alzheimer's? Here's advice from
Mosconi and Gandy:

• First, get a thorough medical checkup.


• Next, get any problems like blood pressure , high cholesteol , and diabetes under control.


• Upgrade your lifestyle with exercise and a healthy diet . If you smoke, quit. And
  find ways to exercise your brain by challenging your memory and attention.

What About Dad?

Though Mosconi's findings are all about mothers, don't jump to the
conclusion that dads don't affect Alzheimer's risk. "That's too far of a
jump," says Mosconi. "There could be a paternal transmission factor but
we don't really know what it is."

Gandy and Gilbert agree. Several Alzheimer's genes can come from either
parent, notes Gilbert. And Gandy predicts that "there will be risk factors
throughout the genome and some may be paternally transmitted. ... I think it
would be too soon to exclude that."

By Miranda Hitti
Reviewed by Louise Chang
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