HOW CAN INTERVENTIONS BE TRANSLATED FROM THE LABORATORY INTO CLINICAL PRACTICE

Individuals with a parental history of dementia often worry about their own risk of developing dementia. The average lifetime risk of developing Alzheimer disease (AD) is 10–12% and this risk doubles with the presence of a first-degree relative with AD. This increased risk has apparently more than one reason. Firstly, adult children of patients with AD are more often carrier of the apolipoprotein E (APOE) ε4 allele, a risk factor for AD, than those without a parental history of AD. Secondly, familial clustering of high blood pressure and vascular disease is seen among middle-aged offspring with a parental history of AD in old age. This study confirmed earlier findings that midlife hypertension is associated with the development of AD later in life. Thirdly, other vascular risk factors such as diabetes type 2, obesity and hypercholesterolemia cluster in families. Fourthly, the psychosocial behaviour runs in a family and affects health behaviour and contributes to dementia. Recently was also demonstrated that the human microbiome is associated with neuroinflammation: the gut-brain axis. Secretory products of the GI microbiome and translocation of these signaling molecules via the lymphatic and systemic circulation throughout the CNS are just beginning to be identified. New insights of the etiology of neuroinflammation might help us to design new therapeutic strategies to prevent or delay dementia.