Typically this type of Alzheimer’s Disease begins with the loss of ability to store new information and new memories, and also a harder time learning new things. Interestingly, long term memory is not lost, especially in the earlier stages of the disease process.

This means that people can recall details of events that happened 30, 40, or even 50 years ago, but may not be able to remember their conversation from five minutes ago. They also initially retain their ability to speak, perform mathematical calculations, spell, and write.

When an MRI is performed, the area where brain volume loss (atrophy) is most apparent is in the hippocampus, while other brain areas are typically spared. The hippocampus, named for its seahorse-like appearance, was traditionally thought to be the storage place for long term memories.

However, scientists have discovered that the hippocampus, together with its extensive connections with other areas of the brain, plays a much more complex role that includes not only memory, but also navigation skills, imagination & creativity, decision-making, character judgments, establishing and maintaining social bonds, empathy, social skills, and language use.

Some subtypes of Alzheimer’s are more commonly associated with specific genetic susceptibilities. This is true for the inflammatory subtype, which is more commonly associated with the higher risk ApoE4 gene, whether homozygous (two copies) or heterozygous (single copy).

We each receive two copies of the ApoE gene (one from each parent), and the possibilities are ApoE2, 3, or 4. It is most common for people to inherit two copies of the ApoE3 gene, which carries with it just a 9% risk of developing Alzheimer’s disease.

In contrast, having a single copy of the ApoE4, which is seen in about 25% of Americans, increases one’s genetic risk to 30%. Having two copies of ApoE4, seen in a little over 2% of the U.S. population, increases the risk to greater than 50%. Individuals with ApoE4 genes appear to be most likely to develop the inflammatory subtype of Alzheimer’s.

People who inherit two copies of the ApoE4 gene typically begin experiencing symptoms at a younger age, with their onset typically in their late forties or fifties. With just one copy of this gene, the onset is about a decade late. With no ApoE4 gene, the onset is more often in their upper sixties or seventies.

Different subtypes can’t always easily be distinguished by lab testing, but there are some unique findings in the inflammatory subtype that are worth mentioning. As expected, markers of inflammation like the CRP (c-reactive protein), IL-6, and TNF are often elevated.

The ratio of albumin to globulin (A/G ratio) is frequently decreased. This is important because albumin is an important protein in the blood for removing toxins and other detrimental molecules (including amyloid) from the body, and a lower ratio means this removal isn’t happening as it should.

Insulin levels may be elevated, showing at least some degree of insulin resistance developing in the body. Homocysteine levels are also often elevated, suggesting that a process of activating and utilizing vitamin B12 and folate (called methylation) is not working efficiently.

Target levels for these nutrients and biomarkers aren’t always the levels shown as normal by different lab companies. Discuss them with a practitioner trained in optimizing and personalizing these lab findings.