I Have a Genetic Risk for Alzheimer’s. I Made These 5 Lifestyle Changes to Preserve My Brain Health - TODAY.com

What the report says

TODAY.com reports that Elena Castellanos, a 57-year-old school enrollment director and mother of three in Miami, began focusing on Alzheimer’s prevention after her father’s diagnosis at 68 and his death in 2020. In 2024, she learned through testing that she carries two copies of APOE e4, a genetic variant associated with higher Alzheimer’s risk. Castellanos told TODAY the result was frightening, but she now emphasizes that inherited risk does not make the disease inevitable.

The article cites Dr. Kellyann Niotis, a preventive neurologist at the Institute for Neurodegenerative Diseases who treats Castellanos, explaining that APOE helps move cholesterol in the blood and that the e4 version is linked to Alzheimer’s risk. TODAY reports that about a quarter of people carry one APOE e4 copy, while roughly 2% to 3% carry two. Niotis said one copy can raise risk substantially and two copies can increase it further, though the variant does not guarantee dementia.

After meeting Niotis in March 2025, Castellanos began monitoring her brain health through lab work, cognitive testing and imaging, while also addressing modifiable dementia risk factors. TODAY notes that some testing can be expensive and not fully covered by insurance, while related care for conditions such as sleep apnea or high cholesterol may be covered.

Castellanos’ reported changes include following a Mediterranean-style diet, prioritizing omega-3 sources and cholesterol management, adding varied exercise such as resistance training, HIIT, rowing and jump rope, improving sleep routines while managing sleep apnea, and eliminating alcohol, which she described as difficult. The story matters as an example of how people with elevated genetic risk may pursue prevention-focused habits, while the science of preventive neurology continues to develop.