Multiple factors are associated with the risk of developing AD.4 The lifetime risk factors for AD mayvary, with middle age representing a critical period for changes in some of thesefactors.5 While a number ofclinical or lifestyle-related factors such as a low educational level (less than 12years), diabetes, hypertension in middle age, obesity in middle age, depression,dyslipidemia, and smoking are modifiable, biological or genetic factors such as age,gender, and apolipoprotein (APOE) ε4 genotypes are not.6 Here, APOE is linked to Alzheimer disease.