A Key Factor in Protecting African Americans from Alzheimer’s Disease

In a study published in the Journal of Alzheimer’s Disease, researchers in the John P. Hussman Institute for Human Genomics at the University of Miami Miller School of Medicine have shown that Alzheimer’s disease patients of African descent with higher educational achievement are more resilient against the disease than those with less education.

“Alzheimer’s has a significant genetic component. One example is the APOE4 variant, which increases people’s risk of developing the disease,” said Margaret Pericak-Vance, Ph.D., director of the Hussman Institute, the Dr. John T. Macdonald Foundation Professor of Human Genetics and senior author on the study. “But social, behavioral and environmental factors can also contribute to Alzheimer’s disease risk, such as diet, stress levels and education. This research is part of a larger effort to understand how genetic risk factors and social, environmental and behavioral factors come together to influence risk for Alzheimer’s.”

Education and Alzheimer’s Disease

Researchers have long known that education can be protective against Alzheimer’s. In some cases, people with obvious disease pathology show only minimal clinical symptoms. However, many of these studies have measured memory-related clinical outcomes in individuals of mainly European ancestry.

Using an African American cohort, this study took a broader look at how the disease impacts Alzheimer’s disease by looking at functional outcomes, such as a person’s ability to engage in hobbies and perform self-care.

The study examined 410 African American Alzheimer’s patients, measuring their educational achievement and their APOE4 gene variant status. The team also measured pTau181, a biomarker for Alzheimer’s-associated brain changes.

“We observed that people with higher education showed better clinical outcomes than people with lower education,” said Farid Rajabli, Ph.D., assistant professor of human genetics and first author on the paper. “African American individuals in the higher educational group had better functional outcomes despite having increased brain changes typically linked to Alzheimer’s disease.”

Alzheimer’s Disease “Protection”

The study provides greater insights into the relationship between Alzheimer’s genetic drivers and a more protective lifestyle.

“People with genetic risk factors, such as APOE4, are less likely to be protected through education. The genetic factor mitigates the protective effect,” said Dr. Rajabli. “In addition, those who had both the APOE4 variant and low educational achievement experienced the most significant clinical issues.”

The authors note that educational achievement may serve as a proxy for other factors. Those with higher education may earn more money, eat better and experience less stress. All are potentially modifiable risk factors.

Education may also increase neural connections and fortify the brain against Alzheimer’s. Additional research will strive to unwind these complex factors.

“Learning more about these modifiable risk factors could give us new tools to help people,” said Dr. Rajabli. “While education does not prevent the disease, it may delay some of the worst symptoms, potentially adding years of improved cognitive health. In addition, if we can understand the interplay between environment and genetics, we could potentially develop better treatments.”

Other Miller School study co-authors include;

• Azizi Seixas, Ph.D., interim chair of the Department of Informatics and Health Data Science and associate professor in the Department of Psychology and Behavioral Sciences
• Gary Beecham, Ph.D., associate professor of human genetics
• Anthony Griswold, Ph.D., associate professor of human genetics
• Jeffery Vance, M.D., Ph.D., professor of neurology and professor and founding chair in human genetics
• Michael Cuccaro, Ph.D., associate professor of human genetics and psychology and behavioral sciences

University of Miami study co-authors include Bilcag Akgun, Larry Adams, Jovita Inciute, Kara Hamilton, Patrice Whithead, Ioanna Konidari, Tianjie Gu, Jamie Arvizu and Charles Golightly.

Other study authors include:

• Takiyah D. Starks and Goldie S. Byrd from the Maya Angelou Center for Health Equity at the Wake Forest University School of Medicine
• Renee Laux and Jonathan L. Haines from the Department of Population and Quantitative Health Sciences at Case Western Reserve University.

Tags: Alzheimer's disease, Dr. Azizi Seixas, Dr. Farid Rajabli, Dr. Margaret Pericak-Vance, genetics, John P. Hussman Institute for Human Genomics