Angela Calman on the Power of Genetic Data
Angela Calman spent years making genetic testing more accessible as a communications leader at 23andMe and the FDA. Then, her parents’ diagnoses and her own test results made the science personal. In this episode, she shares her experience learning she carries two copies of the APOE4 gene, why her parents’ Alzheimer’s journeys were so different, and the financial reality many families never see coming until it’s too late.
In This Episode:
Your Host: Emily Kaplan
Our Guest:
Angela Calman, founder of the Alliance to End Protein Misfolding Disease, former Vice President of Communications at 23andMe, and former director in the FDA’s Office of Communication and Education
This Episode Explores:
- What does it mean to carry two copies of the APOE4 gene?
- How did Angela Calman’s own health crisis unfold alongside her father’s diagnosis?
- Why did her parents’ Alzheimer’s journeys look so different?
- What does late-stage dementia care actually cost a family?
- How can genetic testing become a tool instead of a fear?
What Does Having Two Copies of APOE4 Actually Mean?
While working at 23andMe, Angela Calman made personal genetic testing accessible on a scale like never before. This included testing for APOE4, the gene most strongly linked to Alzheimer’s risk. She later learned she carries two copies herself, one inherited from each parent.
Calman says the first 24 hours were disorienting. But she quickly shifted from fear to action, asking herself what she could actually do with the information. She began researching, changing her diet, exercising more, and paying closer attention to her body. Since APOE4 raises risk without guaranteeing the disease, the result became less about a prediction and more of a head start.
Why Her Parents’ Alzheimer’s Journeys Looked So Different
Calman calls her parents a real-world case study in the benefits of getting ahead of Alzheimer’s. Her father, a former Marine Corps pilot, showed signs of decline for months before a crisis forced a diagnosis, and by then, the disease had already progressed further than anyone realized.
Her mother’s path looked different from the start: She was diagnosed early, while still living an active, health-conscious life.
Watch the full episode to hear how her parents’ two very different lifestyles shaped two very different outcomes.
What Late-Stage Dementia Care Actually Costs Families
The financial toll of her father’s care came as a surprise to Calman, even after 25 years working in healthcare. Once a hospital stay ends, residential memory care can run $12,000 to $15,000 a month — in some places, $20,000.
Qualifying for Medicaid is difficult, Calman says, and she argues the cost isn’t just personal; it’s structural. Late diagnosis across enough families can strain the broader healthcare system, not just individual bank accounts.
Watch the full episode to hear Calman’s full case for why early detection is as much a financial issue as a medical one.
FAQs About APOE4, Amyloidosis, and Alzheimer’s Care Costs
What is the APOE4 gene?
APOE4 is a gene variant linked to a higher risk of Alzheimer’s disease. About 25 percent of people carry one copy, and 2 to 3 percent carry two, according to the National Institute on Aging (National Institute on Aging).
What does it mean to carry two copies of the APOE4 gene?
Carrying two copies of APOE4 significantly increases Alzheimer’s risk compared to carrying one copy or none, though it doesn’t guarantee someone will develop the disease. Angela Calman, who carries two copies herself, says the distinction between elevated risk and certainty is critical to understanding what a result like hers actually means.
What is amyloidosis?
Amyloidosis is a disease in which abnormal proteins called amyloids build up in organs and tissue, interfering with normal function. It falls under the broader category of protein-misfolding diseases. Angela Calman’s organization, the Alliance to End Protein Misfolding Disease, was founded to address these diseases.
How much does memory care cost per month?
Residential memory care commonly costs between $12,000 and $15,000 a month, and can run as high as $20,000 in some areas, based on Angela Calman’s experience with her father’s care. Families who need concurrent rehab and residential care can face both costs at the same time.
How does early diagnosis change the outlook for Alzheimer’s compared to late diagnosis?
Catching cognitive decline earlier gives patients and families more time to intervene with lifestyle changes, medical care, and planning before the disease progresses further. Late diagnosis, often triggered by a crisis, can mean the disease has already advanced significantly by the time it’s identified.