Unraveling Alzheimer’s – Genetics, Early Detection & The ReCODE Approach

Eric Marquette

So, one thing I’ve been hearing a lot about lately is this APOE4 gene and how it seems to be linked to Alzheimer’s risk. What exactly are we dealing with here? Is it as straightforward as, "If you have it, you're destined to develop Alzheimer’s?"

Gerontologist Tanya Dave

Not at all. APOE4, or Apolipoprotein E4, is definitely one of the stronger genetic risk factors for Alzheimer’s, but it’s not, you know, a death sentence. It’s more like, um, an increased probability. People with one copy of APOE4 from one parent have a higher risk, and those who inherit two copies—one from each parent—well, they’re at an even higher risk. But there’s—there’s still so much more to the story. From a genetic perspective we need to take into consideration the rest of the genetic profile, like the combination of . The compounded effects on .

Eric Marquette

Okay, so it’s not like the gene itself makes Alzheimer’s inevitable. What else comes into play?

Gerontologist Tanya Dave

Right. Environmental factors, lifestyle choices—it’s really a multifactorial situation. Things like diet, exercise, sleep quality, and even stress management play a huge role. You could have the APOE4 gene but implement certain changes that might significantly reduce your overall risk. And—this is so important—there are even studies showing that people with APOE4 who stick to, say, a Mediterranean diet or engage in regular cognitive stimulation, they can actually delay or sometimes even avoid symptoms altogether.

Eric Marquette

Wait, really?

Gerontologist Tanya Dave

Absolutely. I mean, genes load the gun, but environment and lifestyle pull—or don’t pull—the trigger. We’re not at the mercy of our genes as much as we once thought. The key is understanding your risk and then, proactively managing it.

Eric Marquette

That’s fascinating. So, for someone listening who maybe, uh, has a parent or a grandparent with Alzheimer’s, knowing their APOE4 status could be really valuable then, right?

Gerontologist Tanya Dave

Not just the APOE4 but also the rest of your genetic profile. Some people prefer to know, because it helps them plan and modify their habits early on. Others might feel—it’s almost too overwhelming to process. I—I like to recommend genetic testing when it’s paired with, um, a broader conversation about actionable strategies. Knowing your gene status is only helpful if you do something with that knowledge.

Eric Marquette

Hmm. Right, it’s not about scaring yourself into a corner. It’s about empowerment, really. It sounds like understanding your genes gives you more control, not less.

Gerontologist Tanya Dave

Exactly. It’s empowering when it’s framed as a chance to counteract risk factors instead of being resigned to them.

Eric Marquette

And I imagine this ties into why functional medicine, and even approaches like the ReCODE methodology, focus so much on a personalized plan. But, okay, APOE4 aside, are there other genetic markers we should keep on our radar?

Eric Marquette

So, beyond genetics, it’s clear there are many ways we can take control of our health to influence outcomes. This naturally brings up another question: early detection. What are some of the most important biomarkers or tools we now have for spotting Alzheimer’s risk before symptoms even show up?

Gerontologist Tanya Dave

Great question. Early detection is really where we’re making some exciting progress. Biomarkers like amyloid-beta and tau proteins play a pivotal role. These are proteins that, when they start accumulating abnormally in the brain, could signal the very early stages of Alzheimer’s—even decades before symptoms appear.

Eric Marquette

Decades? That’s wild—it almost feels like peeking into the future of someone’s cognitive health.

Gerontologist Tanya Dave

Exactly. And that’s what makes it so valuable—it gives us a window of opportunity to intervene early. But let me clarify. Measuring these biomarkers usually involves tools like cerebral spinal fluid analysis or advanced imaging, like PET scans.

Eric Marquette

Ah, so these aren’t exactly, uh, over-the-counter tests anyone can just go grab.

Gerontologist Tanya Dave

Not quite, no. And they can be resource-intensive or invasive. But cognitive assessments are another vital piece of early detection. These are non-invasive tests designed to evaluate memory, executive function, even processing speed, which can reflect the brain's health over time.

Eric Marquette

Okay, wait—so are these the same kinds of tests you’d get during, like, an annual physical?

Gerontologist Tanya Dave

They can be, but they’re often more detailed. It’s not just memory recall tests, though those are part of it. Advanced digital tools are now being developed—which use algorithms to detect very subtle changes in cognitive performance. Combine that with traditional assessments, and you get a comprehensive picture.

Eric Marquette

What about blood tests? I’ve been seeing buzz about blood-based biomarkers recently. Are those viable yet?

Gerontologist Tanya Dave

Oh, they are, and they’re very promising. Companies are developing blood tests that look for amyloid-beta levels, phosphorylated tau, and even signs of neuroinflammation. While they’re not fully mainstream yet, they could completely change how we approach early detection. Imagine getting a snapshot of your brain health with just a simple blood draw. It could democratize access to early diagnostics.

Eric Marquette

That’s huge. But, I assume there are still some hurdles, like accuracy and availability?

Gerontologist Tanya Dave

Definitely. There’s still the challenge of standardizing these tests and making sure they’re reliable across large populations. But the potential here is... it’s incredible. Catching signs of decline before it even starts, giving you more time to act—that’s revolutionary for healthcare.

Eric Marquette

And it seems like this is where functional medicine really shines—taking early warnings from biomarkers and assessments and then creating personalized prevention plans.

Gerontologist Tanya Dave

Exactly. It’s about weaving together all these pieces—biomarkers, cognitive tests, and even genetic insights—into a strategy that’s tailored to the individual. That’s how you get meaningful prevention.

Eric Marquette

Personalized strategies are game-changers. Speaking of innovative approaches, I’ve been hearing a lot about inflammation being a major driver of cognitive decline. Can you explain exactly, um, how that works?

Gerontologist Tanya Dave

Absolutely. Inflammation is kind of like, uh, the body’s alarm system—it’s there to protect us when there’s an injury or infection. But when it becomes chronic, particularly in the brain, it can actually damage neurons and disrupt communication between them. This is a major contributor to diseases like Alzheimer’s.

Eric Marquette

Okay, so it’s not just inflammation in the brain we’re talking about—it’s systemic inflammation too?

Gerontologist Tanya Dave

Exactly. Systemic inflammation can cross the blood-brain barrier, especially when it’s compromised. Things like poor diet, chronic stress, and conditions like obesity or diabetes can all fuel this. And when the brain’s immune cells, called microglia, stay in this overactive state for too long, they start attacking healthy brain cells instead of clearing out the bad stuff.

Eric Marquette

Wow, they’re like overzealous security guards who’ve turned on their own team.

Gerontologist Tanya Dave

Exactly—that’s a great analogy. And this is where insulin resistance can also wreak havoc. When the brain cells can’t properly absorb glucose because of insulin resistance, it’s like they’re being starved of their primary energy source. This adds to the dysfunction and fuels the neuroinflammation cycle even more.

Eric Marquette

Hmm. It’s fascinating—and kind of scary—how connected everything is. So what about toxins? Where do they factor into all this?

Gerontologist Tanya Dave

Toxins are... a really big piece of the puzzle. Environmental toxins—like heavy metals, pesticides, even some molds—can accumulate in the body and have a neurotoxic effect. They can directly damage neurons or even trigger more inflammation. One example is mercury, which can interfere with vital brain functions.

Eric Marquette

And how do these toxins get into our systems? Are we talking about, like, things in our water or something more niche?

Gerontologist Tanya Dave

Both. It can come from water, food, air, and even personal care products. For instance, BPA in plastics or certain ingredients in cosmetics—they’re everywhere. And over time, those exposures can add up, especially if your body’s detox pathways aren’t functioning optimally.

Eric Marquette

Wait, detox pathways—you mean like the liver and kidneys?

Gerontologist Tanya Dave

Exactly. If your liver isn’t breaking down toxins efficiently, they can circulate and deposit in places like the brain. So things like a poor diet, alcohol overuse, or certain genetic factors could hinder detoxification and make someone more vulnerable.

Eric Marquette

It’s wild how interconnected all these processes are. And it seems like these factors don’t exist in isolation—they’re more like a web, each one building on the other?

Gerontologist Tanya Dave

Exactly. And that’s why it’s so critical to address them together—treating just one piece of the puzzle doesn’t solve the whole problem.

Eric Marquette

It’s fascinating how all these pieces—like inflammation, toxins, and even detox pathways—fit into this interconnected web. So how does an approach like the ReCODE methodology help unravel and address all these factors together?

Gerontologist Tanya Dave

Of course. ReCODE, which stands for Reversal of Cognitive Decline, was developed by Dr. Dale Bredesen, and it treats Alzheimer’s not as just one disease but as a multifactorial condition. The methodology recognizes that many different pathways—like inflammation, nutrient deficiencies, insulin resistance, toxins—all contribute to cognitive decline. So instead of a one-size-fits-all approach, it’s tailored to the individual’s underlying causes.

Eric Marquette

Okay, so instead of thinking of Alzheimer’s as, like, one straightforward condition, it’s more like—like a combination lock with multiple dials?

Gerontologist Tanya Dave

Exactly. And each person’s “combination” is different. For one individual, it might be chronic inflammation and poor sleep quality. For another, it could be insulin resistance and environmental toxins. The ReCODE approach identifies these contributors through detailed testing and then creates a personalized protocol to address them.

Eric Marquette

Wow. So instead of just treating symptoms, you’re actually tackling the root causes?

Gerontologist Tanya Dave

Exactly. The idea is to shift the focus from managing decline to restoring balance—or even reversing it in some cases. Lifestyle factors play a huge role here, which is why ReCODE emphasizes things like optimizing diet, stress management, increasing sleep quality, even cognitive stimulation.

Eric Marquette

Right, and that aligns with what we’ve been talking about—how everything’s so interconnected. But, you mentioned this involves detailed testing. What kind of tests are we talking about?

Gerontologist Tanya Dave

Well, ReCODE dives into multiple areas: specific blood markers, genetic testing like APOE4, hormone levels, nutrient deficiencies, and even the presence of toxins like mercury or certain molds. It’s a very comprehensive approach—it’s almost like putting together a puzzle, with labs and imaging creating the pieces.

Eric Marquette

And once you have that puzzle, what happens next? How do you go from identifying issues to actually, you know, addressing them?

Gerontologist Tanya Dave

That’s where the personalized protocols come in. For instance, if someone’s lab work shows chronic inflammation, the plan might include a specific anti-inflammatory diet and targeted supplements like omega-3s. Or if toxins are a problem, the protocol might focus on detox pathways with liver-supporting nutrients. It’s incredibly detailed—and also highly adaptable.

Eric Marquette

It’s fascinating. And it must require a lot of patient buy-in, right? To make all these changes and stick with such a complex plan?

Gerontologist Tanya Dave

Oh, definitely. But the good thing is, these changes tend to have ripple effects—they improve overall health, not just brain health. People often feel better across the board, which keeps them motivated to stay consistent.

Eric Marquette

So, it’s almost like instead of approaching this as, “Oh no, I have all these risk factors,” you frame it as this empowering opportunity to take control of your health?

Gerontologist Tanya Dave

Exactly. It’s about taking the fear of something like Alzheimer’s and transforming it into actionable steps—a roadmap to better health, you could say.

Eric Marquette

So now that we’ve explored the ReCODE approach and how it addresses root causes, let’s talk about prevention. We’ve mentioned things like diet and sleep briefly, but what does a truly personalized prevention plan look like when it comes to optimizing brain health?

Gerontologist Tanya Dave

Great question. Diet is one of the most impactful areas, and the good news is, it’s something most people have some level of control over. Research shows that diets rich in whole, unprocessed foods—like the Mediterranean diet—are excellent for brain health. It’s high in healthy fats, like omega-3s from fish, and full of antioxidants from fruits and vegetables. These help reduce inflammation and oxidative stress in the brain.

Eric Marquette

And—and when people say “brain food,” is that... is that what they’re really talking about? Omega-3s and antioxidants?

Gerontologist Tanya Dave

Exactly. Those are big ones, but there are also specific nutrients to support brain function. Things like choline—found in eggs—helps with neurotransmitter support. And magnesium, which you can get from nuts and leafy greens, plays a role in neuroplasticity.

Eric Marquette

Interesting. So, it’s not just avoiding the bad stuff—it’s about deliberately adding the good stuff too?

Gerontologist Tanya Dave

Exactly. And part of personalizing this is figuring out what works for the individual. Some people might thrive on a ketogenic diet, where your brain uses ketones for energy instead of glucose. For others, just cutting down on sugar might be the big game changer. It’s not one-size-fits-all.

Eric Marquette

And, uh, fasting? I hear intermittent fasting tossed around a lot these days. Does it actually make a difference?

Gerontologist Tanya Dave

Oh, it can—absolutely. Intermittent fasting helps with something called autophagy. It’s like the brain’s housekeeping process, where damaged cells get cleared out. By giving your body a break from constant digestion—say with a 16:8 fasting schedule—you’re supporting brain repair and reducing inflammation.

Eric Marquette

Okay, but isn’t fasting kinda extreme for, well, a lot of people? Is it realistic to expect that from, like, the average person?

Gerontologist Tanya Dave

It can actually be pretty flexible. You don’t have to dive into a rigid 16- or 18-hour fast from the start. Even extending the gap between dinner and breakfast to 12 hours is a good place to start. It’s about gradual changes, not perfection.

Eric Marquette

That makes sense. So we have diet and fasting—let’s talk about sleep for a second. Everyone knows you’re supposed to get eight hours, but is there more to it than just clocking hours in bed?

Gerontologist Tanya Dave

Oh, definitely. Sleep isn’t just about duration—it’s about quality. During deep sleep, your brain undergoes a cleansing process where toxins, like beta-amyloid, get flushed out. That’s why chronic sleep deprivation is such a big risk factor for Alzheimer’s. Optimizing sleep means focusing on both quantity and creating a consistent routine—dark, quiet bedroom environments, limiting blue light exposure before bedtime, that sort of thing.

Eric Marquette

Got it. So it’s not just about sleeping more, it’s about sleeping smarter, right?

Gerontologist Tanya Dave

Exactly. Oh, and even supplements can come into play here—like melatonin to regulate sleep cycles or magnesium to promote relaxation. But again, it’s all about personalization. Not every supplement is suitable for everyone.

Eric Marquette

And beyond those basics, like, are there specific brain-supporting nutrients people should, uh, really prioritize?

Gerontologist Tanya Dave

Certainly. Vitamins like B12 and folate are crucial for cognitive health. Then you’ve got antioxidants like vitamin E, which protect brain cells from damage, and even certain amino acids that support neurotransmitter function. It’s a lot, which is why individualized testing can help people zero in on what they personally need.

Eric Marquette

Hmm, I can see how personalized approaches make all the difference. Otherwise, it feels easy to get overwhelmed with all these recommendations.

Eric Marquette

Alright, so we’ve talked about prevention strategies and how personalized approaches can make such a big difference for brain health. But I’m curious—what about the next level? Things like ketones, nootropics—or “smart drugs,” as they’re called—and even peptides. Are these the future of brain health interventions?

Gerontologist Tanya Dave

These are definitely some of the most intriguing areas of brain health research right now. Ketones, for instance, are fascinating because they provide the brain with an alternative energy source when glucose isn’t cutting it. This is especially useful for people with insulin resistance or other conditions that impair their brain's ability to use glucose efficiently.

Eric Marquette

So, it’s like... a backup power supply for your brain?

Gerontologist Tanya Dave

Exactly. And that’s why ketogenic diets or even supplements like exogenous ketones are gaining popularity in some circles—they’re designed to tap into this backup system and keep the brain fueled. But it’s not for everyone and, of course, has to be, you know, tailored to individual needs.

Eric Marquette

Interesting. And nootropics—are these really as game-changing as people claim? Or is it more hype than science?

Gerontologist Tanya Dave

Nootropics definitely have a lot of potential, but it’s a mixed bag. Some, like caffeine or certain adaptogens like ashwagandha, are well-studied and can improve focus and reduce stress. Others, like synthetic compounds, might not have enough evidence yet to back up their claims. It’s—

Eric Marquette

It’s kinda the Wild West out there?

Gerontologist Tanya Dave

Exactly. That’s why working with a professional to evaluate nootropics and their safety is so important. When used responsibly, they could enhance cognition or protect against decline, but there’s still a lot we need to learn about long-term effects.

Eric Marquette

Okay, and peptides—these sound super futuristic. What role do they play in cognitive health?

Gerontologist Tanya Dave

Peptides are essentially short chains of amino acids that act as messengers in the body. Some peptides are showing promise for things like reducing inflammation or even regenerating damaged tissues in the brain. But like nootropics, they’re cutting-edge—so while the science is promising, it’s still early days.

Eric Marquette

And then there’s regenerative medicine—that seems to tie all of these pieces together?

Gerontologist Tanya Dave

Exactly. Regenerative medicine aims to restore function on a cellular level, whether we’re talking about stem cells, tissue regeneration, or even gene therapy. It’s an area that has huge potential for combating diseases like Alzheimer’s—not just managing symptoms but actually addressing the damage itself.

Eric Marquette

It feels like we’re stepping into territory that was science fiction not too long ago. But also, there’s this balance, right? Between embracing these advances and sticking to approaches that are already proven?

Gerontologist Tanya Dave

Absolutely. These emerging treatments are exciting, no question, but they’re supplements to—not replacements for—the fundamentals like diet, sleep, and personalized prevention. The future’s bright, but we have to get the basics right as we move forward.

Eric Marquette

Well, this has been incredibly insightful. I think one of the big takeaways today is how much hope there is—whether it’s understanding your genetic risk, adopting proactive strategies, or looking ahead to these breakthrough treatments. There’s just incredible value in taking control of your health.

Gerontologist Tanya Dave

Absolutely. Functional medicine, and really any personalized approach, gives us tools to not only live longer but to live better. That’s something worth being excited about.

Eric Marquette

Couldn’t agree more. And on that note, we’ll wrap up here. Thanks so much for sharing your expertise, Tanya Dave. And to our listeners, thanks for tuning in—we hope you found this as fascinating as we did. Until next time, take care and be well.