These findings align with previous studies demonstrating that KL-VSHET is associated with lower Aβ burden specifically in cognitively normal individuals carrying the APOE ε4 risk allele.5, , , , –10 Notably, our results suggest that this protection may extend to individuals already diagnosed with clinically symptomatic AD, as we observed a significant positive association between KL-VSHET and Aβ42/40 ratio specifically in the aMCI due to AD group. Here, APOE is linked to Alzheimer disease.