I agree that this line of research presents a very interesting and positive potential intervention therapy for APOE4's. The article itself is a bit difficult to immediately relate to the real world as the authors seem to really like taking the "normalized base ten log" of many standard lipid profile numbers (and others) prior to presenting them in the text or in charts. For example, their very important "PBV" value is an amalgam of 4 or 5 serum plasmalogen numbers, normalized to an APOE3 baseline then transformed by taking the base 10 log. For me, giving up on trying to relate these types of numbers to the real world and instead just looking at relative values proved most helpful. For example:

1. Each 1 standard deviation (SD) increase in serum PBV is associated with a 30% reduction in the odds ratio for developing MCI and AD in the APOE4 community.

2. Each 1 SD increase in HDL-R (HDL to total cholesterol ratio) is associated with a 10% decrease in odds ratio for MCI/AD in the APOE4 community.

Using the APOE3/3 community as a baseline, the odds ratio for the APOE 3/4 4/4 (the authors combine these) community for MCI/AD is 1.996, or about a factor of two (the authors numbers). I interpret this as meaning that an increase in PBV level for the APOE4 community of somewhere between 1 and 2 standard deviations would put our odds ratio for MCI/AD on a par with that of the APOE3/3 community. This would be very nice indeed!

Even better is the fact that changes of serum PBV values of this magnitude are already seen in the various APOE genotype populations. This means that a 1 or 2 (or more) standard deviation increase in PBV might be relatively achievable as a therapy.

With regard to HDL-R values, the higher the better. However, obtaining the same "bang for the buck" in attempting a many multiple standard deviation increase in HDL-R to realize the same decrease in odds ratio for MCI/AD as seen with the 1 or 2 SD increase in PBV would seem to be pretty much impossible.

In searching the web for means to increase serum plasmalogens (and thus PBV) it seems that some natural foods or supplements such as shark liver and krill contain very small amounts. There are also a handful of chemical precursors that come up, especially alkyl-glycerol (I don't know what this is or if it can be ingested safely). Is anyone in this community taking supplements or precursors to increase their plasmalogen level?