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Understanding genetic risk

Deborah Kan

Created on November 11, 2025

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Genetics, family history, and Alzheimer’s

Understanding genetic risk

Dementia and family history

Testing, prevention and what’s next

Genetics & Alzheimer’s: What the science says

  • 5% of Alzheimer’s cases are attributed specifically to genetics.
  • 95% of cases involve factors like genetics, lifestyle and the environment.

What we know about Alzheimer’s risk and genetic variants

‘‘The Alzheimer's gene’’

Early-onset genes

Protective genes

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Limited diversity, limited data

To date, most genetic studies have focused on non-Hispanic, white, male populations, limiting scientists’ understanding of why Alzheimer’s starts and how it progresses in other racial, ethnic, and gender groups.

An expert's perspective

“We make a lot of assumptions on the basis of data and results found in non-Hispanic white people and also in men. I think, historically, that has maybe been an aspect of convenience and availability — but to the detriment of our understanding of disease and all people.”

Astrid M. Suchy-Dicey

Associate Professor at University of Washington Medicine

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Understanding ApoE4, the ‘‘Alzheimer’s Gene’’

Everyone inherits a version of the ApoE gene from each parent. In white populations, science shows E4 is the version linked to higher Alzheimer’s risk:

Carrying one copy of E4 can increase risk of developing Alzheimer’s 2-3x
Carrying two copies (one from each parent) can raise risk up to 12x

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What it means to carry ApoE4

In people of color, more research is needed. One study in Native Americans found no significant association between E4 and cognitive decline.

Being an ApoE4 carrier does not mean you will develop Alzheimer’s: Many people with E4 never develop Alzheimer’s, and some people without E4 still do.

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Real stories from people living with genetic risk

Kim & Robert Reid

Kim was diagnosed with Alzheimer's at age 52

Andres Martin

Carrier of a rare Jalisco gene that causes early-onset

Michele Castro

Carrier of PSEN1 and Alzheimer's advocate

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Systemic inequities in healthcare

Certain groups face greater Alzheimer’s risk yet encounter systemic barriers when it comes to healthcare:

Black Americans

Latinos

Discrimination at the doctor’s office adversely affects access to diagnosis and care. Research shows the vast majority of people of color experience discrimination or being dismissed by healthcare providers.

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An expert discusses genetic testing

An expert's perspective

"You have to think about whether the testing is right for you. The first is, do you have a family history? Is there some reason that you might be at higher risk? The second is, will the information you get from the tests be of value to you?"

Dr. Doris Zallen

Professor and genetic testing expert at Virginia Tech

Read more

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Lifestyle changes that lower Alzheimer's risk

Research shows science-backed, brain-healthy lifestyle changes can make a difference, even if you carry high-risk genes.

  • Studies like U.S. POINTER show that diet, exercise, sleep, and social engagement can lower Alzheimer's risk.
  • The FINGER-MET and other global studies look at how combining lifestyle and medication may prevent or delay Alzheimer’s.

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What’s next in genetics research?

Considering Alzheimer’s disease’s genetic links, scientists are exploring targeted therapies to address familial Alzheimer’s through our DNA. For people who carry the ApoE4 variant, doctors and scientists recommend science-backed healthy lifestyle modifications, as well as monitoring for early signs of cognitive decline.

Gene therapy

Stem cell therapy

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Steps forward: Community and health equity

Alzheimer’s researchers want to see clinical trial opportunities be made more accessible to communities of color.

An expert's perspective

“Maybe the doctors who are providing care are not aware of [a clinical trial] opportunity — or the doctors that are participating in that research are not offering it to everyone. Diversity is important to make sure that the diagnostic tools that we use, the treatments we develop, are efficacious for all.”

Dr. Monica Parker

Emory University’s Goizueta Alzheimer’s Disease Research Center

Read more

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Want to learn more?

Visit

beingpatient.com

for the latest news and information on brain health and Alzheimer's disease

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While some genes increase Alzheimer’s risk, other genes appear to be protective, lowering risk. Scientists are studying the protective powers of a gene called , which appears to counteract the effects of ApoE4.

FN1

Scientists are also exploring the use of stem cells in Alzheimer’s research. Although is already available in some places, experts say it is highly unregulated, lacks evidence, and could even be dangerous.

stem cell

therapy

“When people mention Alzheimer’s, a picture pops into your mind, typically of an older white person. But when you look at statistics, you learn that more Black and Hispanics are affected by the disease than white people. I would tell others to get a good understanding of the disease and your medical history, if you can. Don’t be afraid to advocate for yourself and speak up.” - Robert Reid, Kim’s husband and caregiver

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2x

as likely to develop Alzheimer's than white Americans.

However, this group is massively underrepresented in clinical trials (only ~8% of participants).

Researchers are studying whether editing or delivering protective could prevent Alzheimer’s.

genes

1.5x

more likely to develop the disease, yet:

As few as 4% of participants in recent Alzheimer’s disease-modifying drug trials were Latino.

“I have been asked if I plan to have more kids knowing that they each have a 50% chance to carry the mutation. I have an amazing wife and daughter, amazing friends, and I got to fulfill my dream to become a naval aviator. I’m one of the few people that has done that in the world. If my mom and dad knew about this disease and didn’t have me, I wouldn’t have been able [to experience any of this]. [But] if my kids have to deal with this disease like I am, science has failed completely.”

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“​​Within our community, a lot of people don’t want to get tested. The Hispanic community is very loving, caring, but they can also be very private. We don’t want people to know our business. It’s a difference, and I’m not going to bundle everybody into that circle. But, the older generation, that’s kind of the mindset… I don’t know how to change that. All I can do is continue to talk about it.”

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In white populations, studies show that a genetic variant called ApoE4 raises risk of late-onset Alzheimer’s (the most common form of the disease).

Early-onset Alzheimer’s can be directly inherited through rarer variants like PSEN1, PSEN2, and APP.