Elena Castellanos’ Journey with Alzheimer’s Awareness

Before Elena Castellanos, 57, understood her risk for Alzheimer’s, she had already experienced the impact of the disease. Her father was diagnosed at just 68, and Castellanos, who works in enrollment management at a school in Miami and is a mother of three, has vivid memories of their close bond.

“My dad and I were very, very close,” she shares, recalling how they would meet weekly for breakfast at a local deli. As his Alzheimer’s progressed, the challenges of the disease became more apparent, and she realized, despite knowing it would lead to memory loss, there was so much she didn’t understand. “It felt less discussed than conditions like cancer,” she adds.

Living through her father’s decline was tough. “There’s no definitive timeline—things can change so quickly, or they might not,” she explains. “It was difficult for our whole family to navigate.”

As her father’s condition worsened, he transformed into a shadow of his former self, which was heartbreaking for Castellanos, who watched her mother take on the role of primary caregiver. Her father passed away in 2020, prompting Castellanos to reflect on her own potential risks. In 2024, after taking a genetic test, she discovered she carries a particular genetic risk factor for Alzheimer’s—two copies of the APOE e4 gene.

“I just looked at my husband and said, ‘Oh s–t,’” she remembers. The realization was frightening, especially knowing there is no cure available. Yet, her perspective has shifted. Today, she has embraced significant lifestyle changes aimed at boosting her brain health and wants to inspire others facing similar risk factors.

“Your genes aren’t your destiny,” she insists, emphasizing that our choices can lead to genuinely positive changes.

A Rare Genetic Risk for Alzheimer’s

The genetic risk Castellanos carries is related to the apolipoprotein E gene, which is responsible for transporting cholesterol in the bloodstream, according to Dr. Kellyann Niotis, a neurologist specializing in preventive care. There are three versions of this gene—APOE e2, APOE e3, and APOE e4. Everyone inherits one version from each parent, shaping their genetic makeup.

Castellanos has the APOE e4 variant, which has been associated with a higher risk of developing Alzheimer’s later in life, as noted by the National Institutes of Health. Niotis explains that this variant is less efficient in cholesterol transport, leading to blockages that can culminate in health risks such as strokes and heart disease. “When cholesterol accumulates in certain brain cells, it’s toxic,” she elaborates, contributing to Alzheimer’s development.

There’s also growing evidence indicating this gene’s role in brain inflammation and the brain’s ability to clear harmful proteins that are linked to dementia.

While having one copy of the APOE e4 gene is relatively common, possessing two copies, as Castellanos does, is rare. Only about 2-3% of people share this trait. Awareness of the APOE e4 link to Alzheimer’s surged when actor Chris Hemsworth revealed he has two copies.

Having a single copy can significantly increase one’s risk for Alzheimer’s, while having two copies might heighten that risk by 10 to 15 times. Still, it doesn’t guarantee that someone will develop a neurodegenerative disease.

Lifestyle Changes to Support Brain Health

After her genetic testing, Castellanos consulted with Niotis in March 2025 to learn about maintaining her brain health and potentially preventing Alzheimer’s. Niotis points out that preventive neurology is still emerging, and Castellanos is contributing to research aimed at advancing the field.

Typically, Castellanos undergoes regular lab tests, cognitive assessments, and annual brain imaging to monitor her health. Niotis emphasizes focusing on modifiable risk factors—like physical activity, smoking, and social isolation—which can be vital for preventing dementia.

However, these tests can be pricey, and insurance may not cover everything; bloodwork, for example, can cost between $900 and $2,000. Fortunately, other tests related to brain health, like those for high cholesterol, frequently receive insurance coverage. Niotis also suggests a free app called Retain Your Brain, which offers personalized lifestyle tips for maintaining cognitive health.

Castellanos has made several lifestyle adjustments, though some have posed more challenges than others. Here are her key changes:

Healthy Food Choices

Adopting a healthy diet has become central to Castellanos’ routine. “I’m really focused on the Mediterranean diet,” she states, emphasizing the importance of high-quality olive oil, berries, and various greens in her meals. In addition to brain health, she’s attentive to heart health, incorporating omega-3s from sources like wild salmon and flaxseeds. Her typical morning smoothie includes ground flaxseeds, whey protein, and cocoa flavonols. “I literally chug that—it’s delicious,” she says.

A Varied Exercise Routine

Regular exercise is another cornerstone of Castellanos’ approach. She engages in diverse workouts, including strength training, HIIT, jump rope, and rowing. “How you move speaks volumes about your brain’s health, and exercise is crucial for reducing risk,” Niotis affirms, identifying it as a top protective measure.

Making Good Sleep a Priority

Sleep has been tricky for Castellanos, largely due to sleep apnea. Addressing this condition has been pivotal, she notes. She’s found success using nasal strips and sleeping with her head elevated, along with maintaining a consistent bedtime routine that limits screen time before bed. “I’m also using an eye mask and trying to get morning sunlight to help with my circadian rhythm,” she shares.

Cutting Out Alcohol

Eliminating alcohol was one of Castellanos’ most difficult changes. However, aware that alcohol can be particularly detrimental for those with the APOE e4 gene, she was determined to quit.

Keeping Up with Doctor’s Appointments

Although she didn’t prioritize annual check-ups before, Castellanos is now committed to regular medical visits, including dental and vision appointments. She’s become diligent about oral hygiene, acknowledging its connection to a reduced risk of dementia.

‘Remarkable Progress’

Through her work with Niotis over the past year, Castellanos has seen notable improvements in her brain health, reflected in specific blood biomarkers.