Is Dementia Hereditary?
While the majority of dementias are not thought to be hereditary, some rare forms can be passed on genetically. Here, we’ll give a brief overview of what dementia is along with common symptoms and treatment options for symptom mitigation. Then, we’ll address which types of dementia may have a heritable component.
What is dementia?
According to the US Department of Health and Human Services, dementia is a term that describes a group of neurological conditions that affect the brain. Dementia can impact an individual’s cognition, memory, and reasoning abilities as well as their emotions and behaviors.
Several different diseases and conditions can cause dementia, such as:
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Dementia signs and symptoms
The signs and symptoms of dementia can vary depending on the specific disease a person is experiencing and the stage of their condition. For example, the National Institute on Aging lists the signs and symptoms of Alzheimer’s based on whether an individual is experiencing a mild, moderate, or severe case.
Mild symptoms of Alzheimer’s can include things like trouble remembering information and navigating familiar places along with mood swings and personality changes. As the disease progresses, the person might experience increased memory loss and confusion plus agitation, impulsivity, trouble recognizing loved ones, hallucinations, and paranoia. Severe Alzheimer’s can bring symptoms like seizures, difficulty swallowing, inability to speak, incontinence, and lack of awareness of surroundings.
Progression of symptoms
So, while symptoms of other forms of dementia can vary, most types involve progressive memory loss, confusion, mood and personality changes, and, eventually, severe physical decline and death. This progression can be very difficult for those affected by the condition and their loved ones as well. It can also lead to questions about whether dementia is hereditary and what risks may apply to those with a family history of this type of disease.
Genetic testing and risk factors: Is dementia hereditary?
Early-onset Alzheimer’s—which develops before age 60—is one of these rarer types. It’s tied to certain genes and is therefore considered heritable. Another example is vascular dementia. The disease itself is unlikely to be directly inherited except in very rare cases. However, the health conditions that may contribute to the development of vascular dementia, such as diabetes and high blood pressure, can be inherited.
One form of dementia that is known to have a higher likelihood of heritability is frontotemporal dementia, or FTD, though this condition is less common in general than Alzheimer’s or vascular dementia. The Alzheimer’s Society estimates that approximately 40% of people with a close relative with certain types of dementia (including frontotemporal dementia, amyotrophic lateral sclerosis (ALS), or Alzheimer’s disease) will develop FTD. In addition, those with a greater number of relatives who have experienced dementia (especially ALS or FTD) may have a higher risk of developing FTD themselves.
If you’re concerned about your genetic risk for a health condition like dementia, you might benefit from speaking to your doctor about it. In some cases, there are healthy lifestyle changes you can make that may decrease your risk of developing certain inherited diseases.
Is there a cure for dementia?
There is currently no cure for dementia. In some cases, doctors may recommend certain treatments that may reduce some symptoms and help an individual with dementia experience a better quality of life as the disease progresses.
Dementia medications
There is currently no way to halt or reverse the progression of most types of dementia. However, the United States Food and Drug Administration (FDA) has approved a few medications that may help slow the disease’s progression in individuals living with certain types of dementia as well as other medications that may help mitigate symptoms.
- Disease progression medications. The FDA has approved two types of anti-amyloid medications that work to remove beta-amyloid plaques in the brain. While one treatment, aducanumab, is being discontinued by its manufacturer, another anti-amyloid treatment known as lecanemab may be recommended in some cases. This treatment might help reduce signs of functional and cognitive decline for those in the earlier stages of Alzheimer’s. However, there may be side effects, like infusion-related reactions and temporary swelling of the brain.
- Symptom mitigation medications. The FDA has also approved several medications that may help reduce brain cell damage and decrease cognitive symptom severity. These include cholinesterase inhibitors, which can help prevent the breakdown of acetylcholine and improve communication between nerve cells, and glutamate regulators to improve a person’s memory, reasoning, and language capabilities. Side effects may include headaches, constipation, vomiting, nausea, confusion, dizziness, and increased frequency of bowel movements.
Medication is not right for every person with dementia, and whether it is prescribed depends on many factors. It’s important for individuals with dementia or their caregivers to speak with a doctor before starting, stopping, or changing any medication.
Talk therapy for dementias
Certain types of talk therapy may be helpful for individuals in the early to moderate stages of dementia. A licensed therapist can provide a safe space to discuss the challenges of dementia and help the individual find healthy ways to cope with their symptoms and the emotions that may arise as a result. In general, sessions may be completed one-on-one or in groups and may be conducted in person or online.
Some types of talk therapy that may be helpful for individuals with dementia can include:
- Interpersonal therapy (IPT). IPT is often used to address relationship challenges that may negatively impact the mood or well-being of either a person with dementia or their loved ones.
- Family therapy. Family therapy often involves addressing challenges between a person experiencing dementia and their family members. These sessions typically require the family members to attend and openly discuss the struggles they may be experiencing.
- Psychodynamic therapy. Psychodynamic therapy typically focuses on the way that unconscious thought patterns and past experiences may impact current behavior and relationships.
- Humanistic therapy. This type of therapy often emphasizes personal growth, giving people a way to discuss their thoughts, behavior, personal values, and how they find meaning in life.
- Cognitive behavioral therapy (CBT). CBT is a type of psychotherapy that can help individuals understand how their thoughts and feelings can influence their behaviors. Therapists may guide clients in examining how they think and behave in order to replace potentially negative patterns with more constructive ones.
Online therapy for dementia and Alzheimer’s disease
For those who are experiencing dementia or caring for a person with dementia, it may be difficult to schedule in-person appointments or travel regularly to a therapist’s office for sessions. Others may not be comfortable discussing the challenges they’re facing in a face-to-face setting, preferring instead to attend therapy via phone, video call, or in-app messaging. In these situations, it may be beneficial to explore other therapeutic formats, such as online therapy.
Effectiveness of online therapy
Research suggests that therapy delivered online can be as effective as in-person sessions in many cases. For example, in a 2022 study, researchers compared data from 12 studies to determine whether in-person or online therapy was more effective in the treatment of various mental health disorders. Their findings suggest no significant difference between therapy delivered online and therapy delivered in person.
Takeaway
Frequently asked questions about the risk of developing dementia
Read below for frequently asked questions about this topic.
Can you detect risk factors for early-onset Alzheimer’s disease through genetic testing?
In some cases, genetic testing may detect gene variants that indicate an individual might be prone to Alzheimer’s at an earlier age. That said, genetic testing isn’t routinely used unless an individual displays symptoms at a younger age and has a strong family history. A combination of multiple factors causes most Alzheimer’s cases, so individuals who don’t have genetic markers may still be at risk, and people who do may never develop symptoms. This testing type is often used in clinical trials to better understand the connection between genetics and Alzheimer’s.
Does genetics affect the risk of developing dementia?
Genetic factors, like the apolipoprotein E gene (also referred to as the APOE gene), might affect one’s risk of developing dementia. Although this changed gene variant might potentially increase an individual’s risk for developing dementia, the vast majority of dementia is not inherited from one generation to the next.
At what age does dementia usually start?
This depends on the type of dementia one has. Most people begin showing symptoms at 60+ years old. Early-onset Alzheimer’s is much rarer, with symptoms emerging as early as in a person's 30s.
Is dementia hereditary, and can it be avoided?
Most dementia cases aren’t caused solely by faulty genes but by a combination of factors like age-related brain changes, environment and lifestyle factors, and genetic variables. One can lower their risk of dementia through healthy lifestyle habits such as regular physical activity, eating a nutritious diet, cutting out smoking habits, and engaging in “brain training” activities. Experts say combining four or five of these lifestyle habits may lower a person’s risk of Alzheimer’s by up to 60%.
What are the biggest risk factors for dementia?
The most significant risk factor for dementia is aging, followed by genetics. However, dementia is a complex disease, and many other risk factors can be mitigated or avoided, including:
- Unhealthy lifestyle and environmental factors like physical inactivity, smoking, and excessive alcohol consumption. In some cases, environmental factors like low levels of education early in life, social isolation, and exposure to pollution might also contribute.
- Severe head trauma or inflammation
- Health conditions like heart disease, high blood pressure, being obese or overweight, high blood sugar, high cholesterol, and hearing loss
- Sex and gender—changes in sex hormone levels throughout one’s lifetime might influence dementia risk in women
Am I at risk of developing Alzheimer’s disease if my grandmother has it?
Although experts are still learning about the role genes play in developing Alzheimer’s, research suggests that people who have a first-degree relative with Alzheimer’s are at twice the risk for developing the disease compared with individuals who have no close relatives with Alzheimer’s disease.
Do doctors recommend genetic testing for Alzheimer’s disease?
Typically, no, doctors do not recommend genetic testing for Alzheimer’s in people without symptoms and only a minor family history of developing late-onset Alzheimer’s (the most common type). They may, however, recommend certain kinds of testing for people with a high genetic risk and early-onset symptoms.
If you are concerned about a family history of Alzheimer’s, consult your doctor. They may review your medical records and those of other members of your family to determine if you’re at risk. If they determine you might be at risk, your doctor might refer you to a specialist who can administer tests, review your genetic results, determine if you have a strong genetic link, and explain the role that different genes play in Alzheimer’s and dementia. If necessary, they may help you plan a treatment course. While genetic testing is sometimes covered by health insurance, plans may vary, so verify with your provider before you seek treatment.
What is the most common cause of dementias?
The most common cause of dementia in older adults is Alzheimer’s disease. Strokes are the second most common. Strokes are associated with vascular dementia, a condition that might occur in people with long-term high blood pressure or significant hardening of the arteries. Other potential causes of dementia include, but aren’t limited to:
- Dementia with Lewy bodies
- Frontotemporal dementia
- Infections that can cause brain damage, such as late-stage syphilis, HIV/AIDS, and Lyme disease
- Chronic traumatic encephalopathy
- Nutritional deficiencies
How do you avoid dementia?
While there is no guaranteed way to prevent dementia, there are ways one can reduce their risk by managing what are known as “modifiable factors”—or those that an individual can influence by staying mentally and physically healthy. To maintain good physical health, you might engage in regular physical activity, eat a nutritious diet, and get adequate sleep each night. Manage your cholesterol, blood sugar, and blood pressure. Treat hearing and vision problems by wearing a hearing aid and/or glasses or contacts if necessary. Finally, avoid smoking and protect your head from traumatic brain injury (TBI) when you ride a bike or participate in other activities where head injury is a possibility.
For your mental and cognitive well-being, prevent social isolation and loneliness by staying connected with friends and family. Stay mentally active by learning new skills, doing puzzles, reading, or other cognitively stimulating activities. Volunteering or taking up a new hobby can stimulate your brain, too. Depression is also a risk factor for dementia—with some studies estimating that individuals previously diagnosed with depression may have twice the increased risk of developing dementia later in life.
Does dementia run in families?
Most dementia cases aren’t inherited through a family member; however, there are some rare genes linked to some types of familial dementia. For example, familial Alzheimer’s disease (FAD), familial Lewy body disease, familial forms of Creutzfeldt-Jakob disease, and Huntington’s disease are different forms of dementia that might be caused by genetic variants in some people.
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