How to Lower Your Alzheimer’s Risk if You Have the APOE4 Gene Variant

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How to Lower the Likelihood of Alzheimer’s if You Have a Genetic Risk

People with the APOE4 gene variant have more to lose from unhealthy habits — and potentially more to gain from healthy ones.

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· 6:12 min

Oct. 21, 2026

APOE4 is the most common genetic variant associated with Alzheimer’s disease.

People with one copy of APOE4 have roughly three times the risk of developing dementia. Those with two copies carry, on average, 12 times the risk, though that can vary widely depending on ethnicity, sex and other genes. The variant is linked to an earlier onset of Alzheimer’s symptoms, as well.

For APOE4 carriers, who represent an estimated 20 to 25 percent of the population, that information can be terrifying. But experts emphasize that having the variant, especially only one copy, does not guarantee someone will develop dementia.

People “find out they have an E4 and they think they’re doomed,” said Dr. Hussein Yassine, a professor of neurology at the University of Southern California’s Keck School of Medicine. “And that’s not true.”

In fact, research suggests that lifestyle factors — whether you smoke, how often you exercise, what you eat — may be especially important for APOE4 carriers when it comes to altering their risk of dementia.

There are three versions of the APOE gene, each associated with a different risk of Alzheimer’s: APOE2 lowers the risk, APOE4 raises it and APOE3 (the most common) is considered neutral. People inherit two copies of the gene, one from their mother and one from their father.

The protein that the APOE gene produces, apolipoprotein E, is involved in shuttling cholesterol and other fats around in the brain and the rest of the body. For reasons scientists don’t fully understand, the E4 version of the protein disrupts other important brain processes — including the brain’s immune response and the removal of the protein amyloid-beta — which in turn are linked to Alzheimer’s.

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