The APOE protein plays a crucial role in lipid transport, particularly in cholesterol transport particles. However, the APOEε4 variant significantly increases the risk of Alzheimer’s disease by accelerating age-related neurodegeneration. Recent studies show that APOEε4 impacts the behavior of microglia and border-associated macrophages, leading to increased inflammation and oxidative stress in the brain. This disruption of macrophage function contributes to neurovascular dysfunction and susceptibility to white matter injury, ultimately affecting cognitive health. Researchers have identified BAMs as both the source and effector of APOEε4, emphasizing their cell-autonomous role in neurovascular dysfunction associated with this genetic variant.