Lowering Your Alzheimer’s Risk: Understanding the APOE4 Gene
Updated: Feb 2
Who is most at risk of developing Alzheimer’s disease?
If Alzheimer’s runs in my family, do I have a higher risk of developing it?
These are common questions many people ask themselves, especially as they enter and live through middle-aged adulthood.
Women are disproportionately affected by Alzheimer’s disease, with close to two thirds of the millions of Americans living with Alzheimer’s being women. Women are also often the primary caregivers for loved ones with Alzheimer’s disease, placing an increased physical and mental load on their relationships, careers and health.
If you’re here to learn how to lower your risk of developing Alzheimer’s disease, you’re in the right place – and the first step is understanding the APOE4 gene.
Awareness of the APOE4 gene spiked in November 2022 when actor Chris Hemsworth learned through genetic testing that he is a carrier of two of the APOE4 gene variants. After learning of his genetic risk, Hemsworth took immediate steps to prevent development of the disease.
Fortunately, there are a number of preventative steps we can all take to lower our Alzheimer’s risk, even if you carry the APOE4 gene. For women, who carry a higher risk, new research even suggests that hormone replacement therapy (HRT) may prevent Alzheimer’s as well as offsetting many of the symptoms that come with being perimenopausal.
Read on to learn more.
What is the APOE4 gene?
Simply put, genetic variants can increase or decrease the risk of developing a specific disease.
Genes contain alleles (pronounced a-LEE-ull) which are variants found within genes. The ε4 allele of the Apolipoprotein E gene is called the APOE4 gene.
At the moment, studies suggest that APOE4 is one of the strongest risk factors of developing Alzheimer’s.
About 25% of people carry one copy of the APOE4 gene – and about 2 to 3% carry two copies of APOE4 - like Chris Hemsworth.
Carrying APOE4 genes may also increase the risk of earlier onset of the disease than in non-carriers.
Unfortunately the exact reasons behind why APOE4 increases Alzheimer’s risk is not clearly understood. However, recent research has found a link between Alzheimer’s and the brain’s ability to process fats (read more on this below).
It’s important to know that a genetic risk factor means having a genetic variant that increases the risk of developing a disease, but it alone does not directly cause a disease.
For example, some people who develop Alzheimer’s have no APOE4 genes, and some carriers of APOE4 genes don’t develop Alzheimer’s at all.
Think of genes as light switches. Possessing the gene does not automatically mean it will be “switched on,” and there are lifestyle changes we can make to try to keep that APOE4 genetic variant “switched off.”
APOE4 is not the same as APOE
APOE is the gene responsible for transporting cholesterol molecules to the brain through the bloodstream, including healthy fats and neuroprotective DHA (found in fatty fish and fish oil supplements).
APOE normally regulates how “sticky” a protein called amyloid becomes in the brain.
In Alzheimer’s patients, this APOE process falters, causing the amyloid to become too sticky. This causes the amyloid to form in abnormal clumps, creating a plaque on the brain which decreases brain function.
APOE4, on the other hand, tends to bring unhealthy forms of cholesterol like LDL to the brain, and is less efficient at bringing along any healthy fats.
A note on APOE4 and gender
Statistics have demonstrated that APOE4 affects men and women differently.
A female carrier of only one APOE4 gene is at greater risk of developing Alzheimer’s disease than a male carrier of two APOE4 genes – and is more likely to deteriorate more quickly.
It is absolutely critical that women are empowered with the knowledge and tailored health tools designed for our unique biology to manage and prevent our risk level from getting too high (more on this below).
Is Alzheimer’s genetic?
As you now know, there are genetic risk factors that may increase the risk of developing Alzheimer’s.
As genetic disorders or genetic risk factors are often passed down through generations, it is possible that a family history of the disease can increase your personal risk for developing the disease.
Similar to Chris Hemsworth, it’s possible to take a blood test to determine which APOE alleles you have or don’t have - but remember - this alone will not predict whether you will or will not develop Alzheimer’s. It will, however, provide you with important information on your personal risk level and offer insight into whether you may want to prioritize taking preventative steps to offset your chances of developing the disease.
Are genes the only factor in developing Alzheimer’s?
In addition to genes and family history, there are other factors that may impact your risk for developing Alzheimer’s.
Lifestyle choices, including diet, substance use, and exercise, are also key indicators of your risk for developing Alzheimer’s.
Poor sleep, damaged gut microbiomes, stress, poor diet, inflammation in the body, and low vitamin D levels are also factors that may increase risk, even for non-carriers of the APOE4 gene.
For instance, diets high in saturated fats are believed to decrease memory function, whereas the frequent consumption of fruits, vegetables, fish oils, and omega-3 rich oils may decrease the risk of Alzheimer’s disease – especially in carriers of the APOE4 gene.
Take a look at these 5 healthy habits to pick up this year to stay on track!
Who is at risk of Alzheimer’s?
According to the WHO, more than 55 million people live with dementia around the world (the most common form being Alzheimer’s), and 10 million new cases are diagnosed every day.
Age is the largest determinant of Alzheimer’s development, as after the age of 65, the risk of developing Alzheimer’s doubles every five years, and about one third of all adults over the age of 85 may have Alzheimer’s disease.
When Alzheimer’s develops earlier than the age of 65, it is considered early-onset Alzheimer’s, which in very rare cases can begin as early as the age of 30.
Women are disproportionately affected by Alzheimer’s disease compared to men.
Of the 6.2 million people living with Alzheimer’s disease in America alone, nearly two thirds of them are women, making them almost twice as likely to develop the disease than men.
As women age, they experience menopause - which has been attributed to the brain changes associated with increased risk for developing Alzheimer’s disease.
What are symptoms of Alzheimer’s?
Alzheimer’s may present a little differently from person to person, and depending on the severity of the disease.
Here are the common signs of Alzheimer’s development to watch out for:
If you’re concerned that you or a loved one are exhibiting any of the early signs of Alzheimer’s or dementia, please don’t hesitate to contact your doctor to book an appointment for testing.
Alzheimer's prevention: It begins with awareness
Being aware of your risk factors for developing Alzheimer’s helps you to prepare for life changes and start taking steps to lower your risk.
For women, part of awareness must be learning about your body’s natural processes, including the hormonal and brain changes that come with menopause.
There are four stages of menopause.
During perimenopause, an APOE4 carrier’s ability to metabolize glucose and ketones becomes doubly impaired, which may create a “brain fog” that greatly increases the risk of developing Alzheimer’s disease.
To make matters more complicated, many perimenopausal symptoms are also the same as risk factors for Alzheimer’s: disrupted sleep, poor gut microbiomes, stress, brain fog and more.
How to lower your risk
Fortunately, there are a number of steps you can take to lower your risk of developing Alzheimer’s disease.
From getting enough sleep, to maintaining a healthy weight and managing your blood pressure - there are preventative measures you can begin putting in place today to protect your future health.
Below we’ll look at two other considerations perimenopausal women should consider: supplementation and hormone replacement therapy (HRT).
Supplementation for disease prevention
Supplements can fill in important nutrient gaps and prevent deficiencies that are linked to common diseases like Alzheimer’s.
Not all supplements are considered equal however, and different brands tailor their formula to different populations and for specific health benefits or outcomes.
For example, at Revivele, we’re currently in the process of developing a comprehensive supplement system for women that contains all of the vitamins, nutrients, herbs needed to improve a woman’s well-being, brain health, mood and sleep.
Hormone replacement therapy
According to very recent studies, scientists believe that women taking HRT during perimenopause experienced greatly improved memory, cognitive function, and brain volumes compared to women who do not.
HRT can be a way to not only address the debilitating symptoms of perimenopause, but also reduce the risks of dementia
If you’re nearing menopause, ask your doctor about HRT medications, and start a plan to begin the process during perimenopause.
Women no longer need to continue suffering in silence.
Founded by Dr. Kavita Desai, Revivele is a women's health company with a primary focus on brain and hormonal health. In the late spring 2023 Reviele will be launching a monthly supplement system for peri-menopausal women. The subscription-based system is dosed based on evidence for disease prevention and symptom relief for women, with 40 ingredients blended into an easy-to-follow format. Some of the supplements include functional mushrooms, probiotics, vitamin D, vitamin C, B complex, omega 3, turmeric, magnesium glycinate and ashwagandha. To be notified once our products launch, please join our newsletter or email email@example.com