Can Alzheimer’s Risk Be Measured? The New Science of Early Detection
Alzheimer’s Awareness Series – Part 3
By Dr. Gregory C. Fors
Board Certified Chiropractic Neurologist
Chief Science Officer, Biospec Nutritionals
Pain and Brain Healing Center
You do not grow an Alzheimer’s brain in a year.
You do not wake up at age 75 and suddenly develop Alzheimer’s disease.
In many cases, the process began twenty or thirty years earlier.
It may have started in your forties or fifties.
Perhaps as insulin resistance.
Perhaps as chronic inflammation.
Perhaps as declining circulation.
Perhaps as poor sleep.
Perhaps as nutritional deficiencies.
Or perhaps as symptoms many people dismiss:
Difficulty concentrating.
Depression.
Anxiety.
Losing your train of thought.
Difficulty finding words.
Forgetfulness.
Feeling mentally slower than you once were.
The tragedy is that many individuals wait until significant memory loss develops before becoming concerned.
Unfortunately, by the time memory loss becomes obvious, pathological changes may have been occurring in the brain for decades.
That is why I believe waiting for memory loss is often waiting too long.
The future of Alzheimer’s prevention is not waiting for disease.
It is identifying risk early.
It is measuring dysfunction early.
And it is intervening before significant damage occurs.
That is where biomarkers become so important.
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Why Early Intervention Matters
Alzheimer’s disease rarely begins as Alzheimer’s disease.
Instead, it often develops gradually as a combination of metabolic dysfunction, inflammation, vascular compromise, poor sleep, nutritional deficiencies, chronic stress, and lifestyle factors slowly accumulate over time.
The encouraging news is that many of these risk factors can be measured.
More importantly, many of them can be improved.
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Metabolic Biomarkers
If there is one area of medicine I believe has been dramatically overlooked in the prevention of cognitive decline, it is insulin resistance.
Over the years I have become increasingly convinced that insulin resistance may be one of the most important modifiable risk factors for Alzheimer’s disease and cognitive decline.
Long before memory loss develops, many individuals begin developing metabolic dysfunction.
The problem is that conventional screening frequently misses it.
A patient may be told their blood sugar is normal while significant insulin resistance is already developing beneath the surface.
Fasting Glucose
Fasting glucose remains an important screening tool.
However, fasting glucose is often one of the last markers to become abnormal.
Many individuals develop insulin resistance years before fasting glucose begins to rise.
For that reason, fasting glucose should never be viewed in isolation.
Fasting Insulin
This is one of my favorite biomarkers.
In many cases, elevated fasting insulin is the earliest warning sign of metabolic dysfunction.
As insulin resistance develops, the pancreas compensates by producing more insulin.
The result may be years of elevated insulin levels before blood sugar ever becomes abnormal.
Chronically elevated insulin promotes inflammation, oxidative stress, vascular dysfunction, weight gain, and metabolic damage.
My preferred target is generally 5 µIU/mL or less.
When fasting insulin begins climbing above that level, I start paying very close attention.
Glucose-To-Insulin Relationship
One of the most important concepts I teach patients is that glucose and insulin should always be interpreted together.
A fasting glucose of 95 may appear normal.
However, if fasting insulin is elevated, the body may already be struggling to maintain normal blood sugar.
The pancreas is simply working harder to compensate.
This is often where prevention should begin.
Hemoglobin A1c
Most people have been told Hemoglobin A1c simply reflects average blood sugar over the previous three months.
While that is true, I believe there is an even more important way to think about it.
Hemoglobin A1c is fundamentally a measure of glycation.
Glycation occurs when excess glucose attaches itself to proteins.
The higher the A1c, the greater the degree of glycation occurring throughout the body.
This process does not just occur in the bloodstream.
It can occur within blood vessels, connective tissue, nerves, and brain tissue.
Excessive glycation promotes oxidative stress, inflammation, and cellular damage.
Within the brain, glycation may contribute to injury involving neurons and supportive glial cells.
My goal is generally to keep Hemoglobin A1c below 5.7%.
Above that level, we are increasingly seeing evidence of accelerated glycation, inflammation, and metabolic dysfunction.
Taken together, fasting glucose, fasting insulin, and Hemoglobin A1c provide a far more complete picture of metabolic health than any one test alone.
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Nutritional Biomarkers
The brain requires proper nutrition to function optimally.
Several nutritional markers deserve attention.
Omega-3 Index
One of my favorite biomarkers.
Omega-3 status influences inflammation, circulation, neuronal membrane function, and cognitive performance.
My target is generally between 8% and 10%.
Unfortunately, many individuals fall below 5%.
In my clinical experience, it often requires approximately 2 grams daily of combined EPA and DHA to consistently achieve optimal levels, although individual requirements vary.
RBC Magnesium
Magnesium participates in more than 300 enzymatic reactions throughout the body and plays critical roles in insulin sensitivity, mitochondrial function, nerve signaling, cardiovascular health, and brain function.
Unfortunately, magnesium deficiency is extremely common.
One of the reasons I prefer RBC magnesium testing is that serum magnesium often appears normal despite significant intracellular deficiency.
Low magnesium status has been associated with insulin resistance, chronic inflammation, impaired energy production, sleep disturbances, and neurological dysfunction.
Because magnesium influences so many systems relevant to healthy cognitive aging, it remains one of my favorite nutritional biomarkers.
Vitamin D
Vitamin D plays important roles in immune regulation, inflammation, neurological health, and overall resilience.
Deficiency remains extremely common.
While many laboratories define 30 ng/mL as acceptable, I generally prefer to see levels between 60 and 80 ng/mL.
Vitamin B12
Low B12 may contribute to fatigue, neuropathy, memory impairment, and cognitive decline.
Folate
Folate supports methylation, DNA repair, and neurological function.
Homocysteine
Homocysteine is one of the most important biomarkers I evaluate.
Elevated homocysteine has been associated with vascular disease, impaired methylation, cognitive decline, and increased neurological risk.
Many laboratories consider values up to 15 normal.
I do not.
My preferred functional target range is approximately 5.2 to 7.4 µmol/L.
I generally become concerned whenever homocysteine enters the double digits.
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Inflammatory Biomarkers
Inflammation is increasingly recognized as a major contributor to neurodegenerative disease.
High-Sensitivity C-Reactive Protein (hs-CRP)
Provides a sensitive measure of systemic inflammation.
My preferred target is 1.0 mg/L or less.
Erythrocyte Sedimentation Rate (ESR)
A broader marker of inflammatory activity.
Fibrinogen
An important inflammatory and cardiovascular biomarker.
Elevated levels may suggest increased vascular and inflammatory burden.
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Cardiovascular Biomarkers
Healthy brain cells require healthy blood flow.
Anything that impairs circulation may affect cognitive function.
Apolipoprotein B (ApoB)
ApoB reflects the number of potentially atherogenic particles capable of damaging blood vessels.
My general target is below 90 mg/dL.
Lipoprotein(a)
Lp(a) is largely genetically determined and can significantly increase cardiovascular risk.
Triglycerides
Triglycerides often serve as an early metabolic warning signal.
Elevated triglycerides frequently accompany insulin resistance and metabolic dysfunction.
My preferred target is 150 mg/dL or less.
HDL Cholesterol
Low HDL may suggest impaired metabolic health and increased cardiovascular risk.
The health of the brain and the health of the vascular system are intimately connected.
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Advanced Alzheimer’s Biomarkers
One of the most exciting developments in neuroscience has been the emergence of blood-based biomarkers that may provide insight into Alzheimer’s-related pathology.
Plasma p-Tau217
One of the most promising biomarkers currently available.
Plasma p-Tau181
Another important tau-related biomarker associated with neurodegeneration.
Beta-Amyloid 42/40 Ratio
May provide insight into amyloid-related changes occurring in the brain.
Neurofilament Light Chain (NfL)
A marker of neuronal injury and neurodegeneration.
APOE Genotyping
Evaluates genetic susceptibility.
However, genes are not destiny.
Lifestyle still matters.
A great deal.
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What These Tests Can Tell Us
These biomarkers may help identify:
• Insulin resistance
• Chronic inflammation
• Nutritional deficiencies
• Vascular risk
• Neurodegenerative activity
• Genetic susceptibility
Most importantly, they may identify opportunities for intervention years before significant cognitive decline develops.
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What These Tests Cannot Tell Us
No biomarker can predict the future with certainty.
No test can guarantee that someone will or will not develop Alzheimer’s disease.
Biomarkers provide clues.
They provide probabilities.
They provide risk assessment.
They do not provide certainty.
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Why Testing Must Be Combined With Clinical Evaluation
Laboratory testing should never be viewed in isolation.
At the Pain and Brain Healing Center, testing is combined with:
• Cognitive assessment
• Lifestyle evaluation
• Nutritional assessment
• Sleep evaluation
• Metabolic assessment
• Cardiovascular risk assessment
The goal is not simply collecting numbers.
The goal is understanding the entire person.
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Final Thoughts
After decades in clinical practice, I have become far less interested in waiting for Alzheimer’s disease to develop than I am in identifying the metabolic, inflammatory, nutritional, vascular, and lifestyle factors that create the conditions for Alzheimer’s disease decades earlier.
The patients who tend to do the best are often those who act early.
They do not wait until memory loss becomes severe.
They respond when they begin noticing brain fog.
When concentration declines.
When anxiety increases.
When sleep deteriorates.
When they simply do not feel as mentally sharp as they once did.
That is the time to investigate.
That is the time to test.
That is the time to intervene.
That is where prevention begins.
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Take Control of Your Health
If you have concerns regarding memory, family history, insulin resistance, brain fog, anxiety, depression, cognitive performance, or simply want a more proactive assessment of your future cognitive health, I encourage you to contact the Pain and Brain Healing Center.
As a Board Certified Chiropractic Neurologist, I have spent decades evaluating the metabolic, nutritional, inflammatory, vascular, and lifestyle factors that influence brain health.
Very few clinics provide the depth of cognitive risk assessment now available through the Pain and Brain Healing Center.
Together we can develop a personalized strategy designed to identify risk factors early, improve brain resilience, and help support long-term cognitive health.
Take Control of Your Health.
There Is Hope.
Ready to stop guessing and get a real plan?
Call (763) 862-7100 or book your free consultation/intake here: https://painandbrainhealingcenter.com/free-consultation-intake/ ... and start addressing the root cause.