This finding may be due to the presence of several epigenetic factors (i.e., environmental factors, lifestyle and gut microbiota) that may have influenced both NAFLD (Frank et al., 2021) and cognitive impairment in aging subjects (Morris et al., 2019) and then could have a hidden confounding effect or interplay between apoe4 and dementia. The gene discussed is APOE; the disease is metabolic dysfunction-associated steatotic liver disease.