Q&A: APOE4 gene test for Alzheimer's; "white coat" hypertension; anxiety tips & the Avian Flu
It’s Friiiiiiiiiiday 👑
ICYMI 👉
The first question (about APOE4 gene testing for Alzheimer's) is free for all subscribers. Questions 2-4 (on "white coat" hypertension; anxiety tips & the Avian Flu) are for paid subscribers only.
If you would like a paid subscription but it’s not in your budget (or if you are a family member, friend, or patient who should be getting it free!), please message me directly. ❤️
Click here to submit your questions (about anything) for future Q&A posts!
Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.
QUESTION #1: APOE4 GENE TESTING FOR ALZHEIMER’S
When, if ever, do you recommend a patient find out their APOE status? I am prone to health anxiety, but I also hear there are lifestyle interventions you should take if you carry an APOE4 gene. Thanks!
-Amanda
Dear Amanda,
Great question. As you know, the APOE4 gene test is primarily associated with Alzheimer's disease risk assessment. The variant of the APOE gene called “APOE4” (also known as an “allele”) is considered a risk factor for late-onset Alzheimer's disease.
What does it mean if you have the gene variant? It’s important to note that the presence of the APOE4 allele (as found in a blood test) does not guarantee the development of Alzheimer's. Conversely, not everyone with Alzheimer's has the APOE4 allele. In other words, screening for Alzheimer’s involves more than a single blood test.
Why wouldn’t you want to know your APO4 status? There are ethical considerations and potential psychological harms associated with APOE4 testing. The knowledge of the presence of the APOE4 variant can be emotionally difficult. Because APOE4 status doesn’t necessarily change the management of a symptom-free patient at risk for dementia, this test is typically best suited for clinical trials focused on Alzheimer’s treatments.
What can you do to prevent Alzheimer’s, regardless of APOE4 status? A lot. We know that lifestyle modifications such as engaging in regular physical exercise, maintaining a healthy diet rich in antioxidants and omega-3 fatty acids, and staying mentally and socially active can reduce your risk for dementia. We also know that screening for cardiovascular risk factors, such as high cholesterol, hypertension, and diabetes can protect your cognitive health, regardless of APOE4 status.
The upshot? It's crucial to understand the limitations of APOE4 testing. Like many other diseases, the development of Alzheimer’s reflects a complex interplay of genetic, environmental, and lifestyle factors—some of which we cannot control, and some of which we can. I hope that helps!
If you like what you are reading, hit the ❤️ button on this post so more people can discover my writing on Substack! 🙏
QUESTION #2: “WHITE COAT” HYPERTENSION
My blood pressure goes up every time I see my doctor, but when I check it after taking some deep breaths at home, it’s fine. My doctor wants to put me on blood pressure pills, and it’s stressing me out. Do you have any advice for how I can calm myself in her office- or should I take medication?
- Laura
Hi Laura,
Great question.
Keep reading with a 7-day free trial
Subscribe to Are You Okay? to keep reading this post and get 7 days of free access to the full post archives.