How to Know if You Have a Genetic Risk for Alzheimer’s

Dr. Richard Isaacson, an adjunct associate professor of neurology at Weill Cornell Medical College, disagreed. “The reason that I believe in testing for APOE4 is that some people really want to know more about themselves, and it really democratizes the ability to learn about those risks,” he said. “Not about if they’re going to get the disease, but what we can do about it.”

If you do decide to get tested, Margaret Pericak-Vance, director of the John P. Hussman Institute for Human Genomics at the University of Miami Miller School of Medicine, said she would “suggest having a meeting with a genetic counselor afterward, because the risk is not straightforward.”

“By having one copy or two copies, it gives you an important part of the picture, but it’s just one part of a very complex risk picture,” Dr. Isaacson said. “Genes are not your destiny. You can win the tug of war against your genes.”

All the experts interviewed for this article agreed that regardless of your genetic status, it is possible to reduce your overall risk of dementia, including Alzheimer’s. Studies show that tried and true healthy habits — exercise, eating well, limiting your alcohol intake, getting enough sleep, not smoking and being socially engaged — are key to fending off neurodegenerative disease.

Exercise, both endurance and strength training, helps the brain grow new connections between cells, particularly in the hippocampus, an area important for memory. Scientists think that building up more connections can be protective against memory loss. Dr. Small said that if you have the APOE4 variant, “physical exercise still can be helpful. There’s some studies showing that may even be more helpful for people with a genetic risk.”

There’s also evidence that a healthy diet, such as the Mediterranean diet, can be beneficial. In particular, it helps to eat fruits and vegetables, which are high in antioxidants, and fish, which contain omega-3 fats that can reduce inflammation. “These kinds of diets can have a tremendous effect on brain health,” Dr. Small said.

While the importance of vitamins and healthy fats in your diet is clear, the case for taking supplements for brain health is weak. Dr. Isaacson said that a person’s genes may play a role in whether supplements can be beneficial. For example, research suggests that people with two copies of APOE4 can’t absorb omega-3 fats from their diet as well as people without the genetic variant. Taking an omega-3 supplement may be advantageous for that specific group of people, but likely isn’t helpful for others, he said.

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