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

Worried About APOE4? Here’s What to Know

9 Mar 2026 · 1 min

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1:20

In this brief video, board‑certified neurologist Dr. David Perlmutter explains that while the APOE4 allele—carried by roughly a quarter of Americans—does increase the risk of Alzheimer’s disease, that risk is not fixed. He emphasizes that lifestyle choices—particularly diet, sleep quality, and regular physical activity—can substantially offset the genetic predisposition. Using the metaphor “genetics loads the gun, environment pulls the trigger,” he reassures viewers that they can change their brain’s destiny by adopting healthier habits and encourages them to follow him for more guidance.

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You can change your genetic risk for Alzheimer's, and you can do it today. Hi, I'm Dr. David Perlmutter. I'm a board-certified neurologist, and there are people who carry what is called the APOE4 gene allele, and in fact, it's about 25% of the American population. The problem is that these individuals are told they have significantly increased risk for Alzheimer's disease, and just based upon genetics, that may be true, but what we now understand, which is so empowering, is that we can override our so-called genetic predisposition and really change our brain's destiny. Lifestyle factors are huge. It turns out that inappropriate lifestyle factors like diet, sleep, and not enough exercise, we call that sedentarity, really augment the genetic risk that's imparted by the so-called Alzheimer's allele that you might get if you've done a 23andMe or other genetic panel. What we say is that genetics loads the gun, environment pulls the trigger. So if you've received this report that you have an APOE4 allele and are worried about it, please understand that to a significant degree, each of us can offset that genetic risk panel by making appropriate lifestyle changes. If you need more of this information, please follow me. I'm Dr. David Perlmutter. Bye for now.