Brain HealthTom Dayspring Unpacks How Brain Cholesterol and APOE Drive Alzheimer's Risk
In this deep-dive episode of The Peter Attia Drive, lipidologist Tom Dayspring explains how the brain manages its own cholesterol system almost entirely separate from circulating lipids. He covers how APOE genotype — especially the APOE4 variant — disrupts cholesterol transport in the brain and raises Alzheimer's disease risk. The conversation explores connections between cholesterol metabolism, amyloid buildup, and tau pathology, and reviews the evidence on statins, ezetimibe, omega-3 fatty acids, and the emerging CETP inhibitor obicetrapib for both cardiovascular and brain health. Key biomarkers like desmosterol and 24S-hydroxycholesterol are discussed as tools for monitoring brain cholesterol metabolism. This is a technically rich but clinically essential episode for anyone trying to understand how lipid-lowering strategies affect neurodegenerative disease risk.
