This study has two primary aims: (1) to address our lack of understanding of the relationship between a commonly used clinical biomarker of metabolic syndrome, plasma TG/HDL-C ratio, and cognitive outcomes in the MCI or dementia stages of AD, and (2) given that increased BBB permeability and related biomarker changes have been reported in MCI and dementia stages of AD [29], to clarify the relationship between plasma or cerebrospinal fluid (CSF) ApoA1 levels and clinical outcomes as well as evaluate their levels in relation to BBB integrity biomarkers. The gene discussed is APOA1; the disease is Alzheimer disease.