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Chapter 17 - Alzheimer’s Disease as a Disease of Evolutionary Mismatch, with a Focus on Reproductive Life History

Published online by Cambridge University Press:  08 September 2022

Riadh Abed
Mental Health Tribunals, Ministry of Justice, UK
Paul St John-Smith
Hertfordshire Partnership University NHS Foundation Trust, UK
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Risk factors for Alzheimer’s disease, such as cardiovascular, metabolic and inflammatory problems, were probably less prevalent throughout much of human history compared to today in post-industrial societies. Therefore, I explore the possibility that individuals today have greater Alzheimer’s disease risk compared to our age-matched, pre-modern counterparts. Additionally, a critical way in which human physiology has changed across history relates to dramatic changes in female reproductive life history norms. Reproductive life history may exert cumulative effects across an individual’s lifespan, bestowing considerable influence on geriatric disease risk. A growing body of research links women’s reproductive life histories with Alzheimer’s disease risk. Here, I briefly discuss ways in which aspects of female reproductive life history (e.g. reproductive span, pregnancy and breastfeeding) might alter physiological pathways implicated in Alzheimer’s disease aetiology, as well as how each of these aspects of female reproductive life history have shifted across our species’ evolutionary past. I also explore the connections between the apolipoprotein E gene, its context-dependent role in Alzheimer’s disease risk and its emerging role in women’s reproductive function. In summary, some aspects of pre-modern female reproductive life history patterns could indicate lower age-matched risk in the past, but further research is needed to establish the relevant biological pathways and epidemiological patterns.

Evolutionary Psychiatry
Current Perspectives on Evolution and Mental Health
, pp. 260 - 275
Publisher: Cambridge University Press
Print publication year: 2022

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