Journal
ALZHEIMER DISEASE & ASSOCIATED DISORDERS
Volume 20, Issue 1, Pages 63-72Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.wad.0000201854.62116.d7
Keywords
Alzheimer disease; brain reserve; clinical expression; early life; life course; risk factors
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Funding
- NIA NIH HHS [AG09769] Funding Source: Medline
- NATIONAL INSTITUTE ON AGING [R01AG009769] Funding Source: NIH RePORTER
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Research findings obtained over the past 20 years suggest that Alzheimer disease (AD) may have its origins in early life. In this review, we consider the evidence for early-life risk factors for this illness. We propose that risk factors that predict neuropathology are largely distinct from those related to the clinical expression of Alzheimer disease. Early-life risk factors for pathology include genes, chromosomal abnormalities, head injury, insulin resistance, and inflammation. With regard to risk factors for clinical expression of Alzheimer disease, six general groups of childhood exposures are reviewed: (1) perinatal conditions, (2) early-life brain development, (3) early-life body growth, (4) early-life socioeconomic conditions, (5) environmental enrichment, and (6) cognitive reserve. The literature reviewed suggests that risk of Alzheimer disease is probably not determined in any single time period but results from the complex interplay between genetic and environmental exposures throughout the life course. Enhancement or preservation of brain or cognitive reserve could delay the onset of Alzheimer disease and in some cases prevent the disease from occurring altogether.
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