“This tells us something really important,” de Havenon explains. “Even if you’ve been dealt a bad genetic hand with APOE ε4, you’re not destined for dementia. The vascular component is modifiable.”
For instance, the health factors that can contribute to the development of WMH can be prevented or slowed through blood pressure management, diabetes control, and other cardiovascular interventions, he says.
“It’s really a two-hit scenario,” says de Havenon. “If you have APOE ε4 and you don’t take care of your vascular health, then you’re in a high-risk group. But having the APOE ε4 genotype is not a foregone conclusion for developing dementia later in life.
“Our analysis suggests that while the gene increases risk, the ultimate outcome is highly dependent on other factors. My hope is that people who find out they have this genetic mutation will be very serious about their vascular risk factors.”