5 Lifestyle Changes I Made After Studying I Have a Excessive Alzheimer’s Risk

Years earlier than Elena Castellanos, 57, discovered about her personal danger for Alzheimer’s, she had first-hand expertise with the illness.

Her father was identified with Alzheimer’s on the age of 68, Castellanos, director of enrollment administration at an unbiased faculty and a mother of three in Miami, Florida, tells TODAY.com.

“My dad and I were very, very close,” she says, “and as the Alzheimer’s continued to progress, I would meet him at least once a week at 6 a.m. at a local deli here for breakfast.”

Although she knew Alzheimer’s meant her father would overlook issues, she wasn’t certain what precisely to count on for the reason that situation, to her, appeared a lot much less talked about than most cancers, for instance.

She rapidly discovered what number of unknowns are concerned in an Alzheimer’s analysis. “There’s no timeline. You can progress very quickly or not,” she says, “and living through that with our family was very difficult.”

As his illness progressed, “he became a shell of the person that he was, and it was very, very sad,” Castellanos recollects, including that her mom was his major caregiver throughout that point.

Her father handed away in 2020, leaving Castellanos to surprise about her personal Alzheimer’s dangers. In 2024, she took a check and discovered that she has a selected and comparatively uncommon genetic danger issue for Alzheimer’s: two copies of a gene known as APOE e4.

“I just looked at my husband and said, ‘Oh s–t,’” she recollects. “It’s such a scary feeling to see that and to know that there’s not a cure.”

But at this time, issues look very totally different for her. She’s made main life-style adjustments to assist her long-term mind well being and needs to be a supply of hope for others who’ve danger components for the illness.

“Your genes are not your destiny,” she says. “We can make choices that can really improve our lives and make a big difference.”

A Rare Genetic Risk for Alzheimer’s

The kind of genetic danger that Castellanos has is said to the gene that encodes apolipoprotein E, a protein that’s answerable for transporting ldl cholesterol within the blood, Dr. Kellyann Niotis, a preventive neurologist and director of Parkinson’s and Lewy physique dementia analysis on the Institute for Neurodegenerative Diseases, tells TODAY.com.

There are three totally different variations of this gene: APOE e2, APOE e3 and APOE e4. “You get one from your mom and one from your dad, and that makes up somebody’s genotype,” says Niotis, who can also be treating Castellanos.

The model that Castellanos has is APOE e4, which has been linked to an elevated danger for Alzheimer’s illness later in life, the National Institutes of Health defined beforehand, and is the strongest identified genetic danger for the situation.

“The APOE e4 variant of this gene is inefficient at transporting cholesterol, so cholesterol gets stuck in places it shouldn’t be,” Niotis says.

That results in plaque buildup in arteries, rising the dangers for strokes and coronary heart assaults. “When cholesterol gets stuck in certain brain cells, it’s toxic,” Niotis explains. “The brain cells can start to die, and that’s part of what contributes to Alzheimer’s disease.”

There’s additionally rising analysis suggesting that this gene could also be concerned inflammatory processes within the mind, in addition to how properly the mind clears the hallmark poisonous proteins (amyloid and tau) that may contribute to dementia and Alzheimer’s, Niotis says.

Specifically, Castellanos has two copies of the APOE e4 gene. While it’s not significantly unusual to have one copy of the APOE e4 gene, it’s uncommon to have two copies, Niotis says. It’s estimated that about 25% of individuals have one copy, however solely 2-3% have two copies.

Recently, extra folks discovered concerning the hyperlink between APOE e4 and Alzheimer’s when actor Chris Hemsworth spoke about having two copies in 2022, Niotis says.

Having a single copy can double or triple your danger for Alzheimer’s. And having two copies — inheriting a duplicate of APOE e4 from each your mother and pop — raises the danger for Alzheimer’s by about 10- to 15-fold. But, even with this genetic danger, it’s not a assure that somebody will develop a neurodegenerative situation.

Lifestyle Changes to Support Brain Health

After studying about her genetic danger, Castellanos met with Niotis in March of 2025 to grasp what she might do to protect her mind well being — and, hopefully, stop Alzheimer’s.

The subject of preventive neurology continues to be in its early phases, Niotis says, and Castellanos is participating in a few of Niotis’ analysis to advance the sphere.

Patients like Castellanos usually obtain common lab work (together with assessments to look for tau and amyloid proteins within the blood), cognitive assessments and annual mind imaging to trace progress, Niotis says.

Additionally, Niotis says, the main target in her apply is on the modifiable danger components, significantly the 14 danger components that specialists have recognized for preventing dementia. That contains issues like bodily exercise, smoking, alcohol consumption, air air pollution and social isolation.

However, the assessments and appointments may be costly, and insurance coverage doesn’t cowl the whole lot, Castellanos says. In specific, the bloodwork may be very expensive, within the vary of $900 to $2,000 per check, Niotis says. But insurance coverage usually does cowl the opposite assessments and coverings Niotis gives for different circumstances associated to mind well being, resembling sleep apnea or excessive ldl cholesterol. (You may also see a major care supplier for these circumstances.)

Niotis additionally recommends sufferers take a look at Retain Your Brain, a free app funded by the National Institutes of Health, which gives customized wholesome life-style tricks to keep mind well being.

Castellanos has been in a position to make some main life-style adjustments, however some had been simpler than others, she says.

Here are the adjustments she leans on most:

Healthy Food Choices

A nutritious diet is among the foundations of Castellanos’ routine now. “I’m really focused on the Mediterranean diet,” she says. “I eat high-quality olive oil, lots of berries in my breakfast and lots of greens and vegetables.”

Because she’s additionally prioritizing coronary heart well being proper now, Castellanos tries to eat a variety of omega-3s from wild salmon and floor flaxseeds. She additionally now takes medicines to assist handle her levels of cholesterol.

Her go-to morning smoothie contains 2 tablespoons of floor flaxseeds together with dietary supplements like whey protein powder, creatine and cocoa flavonols. “I literally chug that,” she says. “It’s delicious and chocolatey.”

A Varied Exercise Routine

Regular bodily exercise is an effective way to assist your general well being. And studying new expertise is an efficient technique to hold your mind in prime form as you age, as TODAY.com defined beforehand.

That’s precisely what Castellanos does along with her new exercise routine, which incorporates all kinds of motion sorts.

She’s engaged on constructing muscle power by way of resistance coaching, in addition to HIIT, bounce rope routines, step lessons and rowing.

“How you move tells us a lot about how your brain is functioning, and exercise is a huge lever to pull when thinking about ways to reduce risk,” Niotis says. “It’s probably the No. 1 thing someone can do to protect their brain.”

Making Good Sleep a Priority

Getting good sleep persistently has been a problem for Castellanos, partly on account of her sleep apnea. Being in a position to get that underneath management was a significant step ahead, Niotis says.

She now makes use of nasal strips and sleeps along with her head barely elevated due to a particular mattress. Castellanos can also be cautious to keep up a constant bedtime routine, which incorporates limiting display screen time at the very least an hour earlier than mattress, in addition to waking up and going to sleep at about the identical time day by day.

“I use an eye mask as well and try to get morning sunlight to set my circadian rhythm,” she says.

Cutting Out Alcohol

Castellanos lower out alcohol utterly, which she describes as “the most challenging thing that I did.”

But she was motivated to take action as a result of she knew that, whereas alcohol isn’t wholesome for anybody, it’s “especially toxic” for these with the APOE e4 gene, she says.

Keeping Up With Doctor’s Appointments

While Castellanos didn’t all the time keep on prime of her annual medical appointments previously, now she is dedicated to doing so. That contains dentist appointments, eye appointments and listening to assessments. She’s now a devoted flosser, she says, a behavior that research has tied to diminished danger of dementia.

‘Remarkable Progress’

Working with Niotis over the previous yr, Castellanos has improved her mind well being primarily based on sure mind blood biomarkers.

“The most impressive is actually her glial fibrillary acidic protein level, which is a marker of inflammation in the brain,” Niotis says. “In just one year, this decreased by nearly 32%.”

Her amyloid protein numbers additionally improved by 20%, and an early marker of tau protein improved by 29%. “This is really remarkable progress over one year,” Niotis says.

The greatest manner to consider these numbers is one thing akin to ldl cholesterol numbers, Niotis says. While excessive levels of cholesterol improve the danger for a coronary heart assault, they don’t alone assure one. The similar is true for these biomarkers: They can predict danger for a illness like Alzheimer’s, however having irregular ranges doesn’t imply you’ll positively develop the situation.

And much like the way in which decreasing ldl cholesterol reduces your coronary heart assault danger, Niotis says, it’s “likely true” that lowering these biomarkers can even scale back your danger for neurodegenerative ailments.

In addition to her mind well being progress, Castellanos says her ldl cholesterol numbers have improved, and he or she not too long ago placed on a pound of muscle. Beyond that, she’s regained a way of hope and management over a future that after felt terrifying, which she needs to share with others who might discover themselves in the same state of affairs.

“Going public with this was scary at the beginning because it’s almost like a stigma,” she says. She used to fret that, if mates and associates discovered about her genetic danger, they’d monitor her each transfer for indicators that she is likely to be creating Alzheimer’s.

But now, reflecting on her work with Niotis and her religion, “I’ve found purpose in adversity,” she says. “And I would love to be a source of hope or support for someone that may not have that.”