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About this wiki
This wiki was created to organize information about how to prevent and treat ApoE4-associated pathology. (See Notes for rationale.) As of November, the page is still very much under construction, but much more information will be added in the coming weeks -- especially if you, the reader, contribute! Visit the wiki development forum at apoe4.info if you have questions about how to contribute or ideas about how these pages should be organized. (Or click on the "Discussion" tab above for thoughts specific to this introductory page.)
Introduction
The ε4 variant of the APOE gene is famous for conferring a significantly higher risk for Alzheimer's disease, but numerous other diseases have been linked to it, including, to name a few, other forms of dementia, heart disease, and gallbladder stones. Much of the focus of this wiki space will nonetheless likely be on Alzheimer's disease and other forms of dementia, since dementia is what most ε4 carriers are concerned about, given the devastating consequences of dementia and the current lack of effective treatment for it.
While the focus of the wiki will be on illness and its prevention and treatment, it should be noted that possessing an APOE-ε4 allele is not an entirely bad thing for health. A few minor health advantages seem to be conferred by ApoE4, among them, greater absorption or production via sunlight of vitamin D, resistance to malnutrition in children with conditions causing frequent diarrhea [1], protection against severe liver disease caused by hepatitis C [2], and slightly greater intelligence in youth [3].
Encouraging ApoE4 research
Here are some ideas about what can be done to focus more research on the APOE-ε4 allele and the protein it produces, ApoE4.
- Encourage researchers to pool existing data to get statistical significance. There are many researchers sitting on unpublished data looking at lifestyle and even drug interventions and their relation to outcomes based on ε4 status. The numbers of ε4 homozygotes in any particular study are in nearly all cases (I'd guess) too small to reach statistical significance, but if the data were pooled it would surely permit some at least tentative, if not solid conclusions.
- Those ε4 homozygotes who are interested in participating in trials could contact researchers and say they are available to be studied (heterozygotes could of course also be studied). Some researchers would jump at the chance to research non-demented ε4 homozygotes, since the expense of finding ε4 homozygotes in younger populations is enormous.
Some research teams or organizations that could be contacted:
Status: 23andMe is not currently pursuing ApoE-related research.
ε4 carriers who feel comfortable sharing their data (anonymously) can upload their sequencing and health information to existing open genome projects:
Possible modulators of ApoE4-associated pathology
Note: No cure for Alzheimer’s disease or dementia, nor any well-grounded prevention regimen, is currently known. The following is a list of putative treatment and prevention measures, or factors that affect risk of dementia or other pathology caused by ApoE4, along with a rationale (be it research support or speculation based on a plausible mechanism of action), with links to research papers.
Coffee (and caffeine)
Much evidence exists that coffee consumption, and caffeine in general (tea will be considered separately), seems to offer some protection against many forms of dementia, including Alzheimer's, regardless of ApoE status.
Main article: Coffee (and caffeine)
Omega-3 (n-3) fatty acids
Several lines of reasoning have led to the hypothesis that consumption of some, or any omega-3 fatty acids (DHA and EPA, found primarily in fish, and ALA, found in plants) will reduce the risk of dementia (and can even improve cognition in youth). The evidence is mixed, and the effects on ApoE-ε4 carriers appear to be especially weak, or non-existent.
Main article: Omega-3 fatty acids
Alcohol consumption
Correlative studies have shown that regular consumption of a small amount of alcohol is linked to a number of health benefits, especially cardiovascular benefits, which, themselves, are correlated with reduced risk of dementia.
But the studies are not all consistent, and many researchers speculate that there are too many confounding factors to be able to adequately isolate the effect of alcohol consumption.
Main article: Alcohol consumption
Turmeric and curcumin
There is evidence that turmeric, and in particular one of its components, curcumin, might protect against Alzheimer's and other forms of dementia.
Main article: Turmeric and curcumin
Blood Sugar
There is substantial evidence that controlling blood sugar levels can have a great impact on the risk of development dementia.
Main article: Blood Sugar
Resources -- learning more about APOE
Resources -- where to buy supplements, olive oil, etc.
Notes
In response to https://www.23andme.com/you/community/thread/15952/. (You need an account at 23andMe to follow this link. Demo accounts, which are free, work fine.)
Thanks to SNPedia for hosting an earlier version of this wiki!