David PerlmutterPresident,, Perlmutter Health Center · Board-Certified Neurologist | Functional Medicine Pioneer | #1 New York Times Best-Selling Author | International Speaker | Host of The Empowering Neurologist Podcast

Rethinking Everything We Know About Alzheimer's

2 Aug 2026 · 0 min

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In this segment, Dr. David Perlmutter challenges the common clinical narrative that carrying the ApoE4 allele inevitably leads to Alzheimer’s disease. He asserts that portraying ApoE4 as a fixed, unmodifiable risk is both factually incorrect and ethically negligent. Citing contemporary literature, he emphasizes that lifestyle, metabolic health, and other interventions can substantially alter disease risk, even for ApoE4 carriers. He warns that physicians who convey a deterministic view are effectively providing malpractice‑level counseling, as they ignore the modifiable nature of the risk and the broader scientific consensus.

And anyone who will poo-poo the ApoE4 as, oh, this is just an increased risk and there's nothing I can do about it. I can't modify my genes. Completely false. And ignorant to the literature, ignorant to what's going on in the rest of the world. It's malpractice, basically, if a physician is counseling their patients that this is, you know, sort of deterministic, that you're going to get this disease because you have an ApoE4 allele. In fact, it's the opposite. It's not deterministic.