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APOE: How Your Gene Variant Shapes Your Profile
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What is it?
APOE is a genetic test that looks at your APOE gene.
The APOE gene provides instructions for making a protein called apolipoprotein E (apoE). This protein helps transport fats, including cholesterol, through the bloodstream and plays an important role in both brain health and cardiovascular health.
Different versions (alleles) of the APOE gene are associated with differences in:
- Risk for late-onset Alzheimer’s disease
- How the body handles cholesterol and other lipids
Why it matters
APOE is the most well-established genetic risk factor for late-onset Alzheimer’s disease, the most common form of Alzheimer’s. Symptoms typically begin after age 60–65.
Alzheimer’s risk varies by APOE version:
- e2: generally associated with lower risk
- e3: associated with average (neutral) risk
- e4: associated with higher risk and an earlier average age of onset
Importantly:
- APOE does not determine whether someone will or will not develop Alzheimer’s disease.
- Alzheimer’s risk is influenced by many factors, including cardiovascular and metabolic health, sleep, hearing, education, lifestyle, and environmental factors.
Because apoE is involved in fat transport:
- e4 is often associated with higher LDL cholesterol
- e2 is often associated with lower LDL cholesterol
- Rarely, individuals with e2/e2 may have an increased risk of a specific lipid disorder when combined with other factors; this would be reviewed with a clinician if relevant.
Important to know
- This test cannot diagnose Alzheimer’s disease and cannot predict with certainty whether you will develop it.
- Early-onset Alzheimer’s (before ~60–65) is uncommon and can be caused by rare genetic variants (e.g., APP, PSEN1, PSEN2), which are not assessed by APOE testing.
Most APOE research has been done in people of European ancestry, so risk estimates may be less precise for other populations.
Many major risk factors for brain health are modifiable, regardless of APOE status.
Reference ranges
Everyone has two copies of the APOE gene—one inherited from each biological parent. Together, these make up a person’s APOE result.
- e3/e3: The most common result; approximately 55–65% of people
- e3/e4: Typically 20–25% of people
- e2/e3: Usually around 10–15% of people
- e2/e2: Comparatively rare; about 1–3% of people
- e2/e4: Comparatively rare; about 1–3% of people
- e4/e4: Comparatively rare; about 1–3% of people
Bird, T. D. (2018). Alzheimer disease overview. In M. P. Adam, H. H. Ardinger, R. A. Pagon, et al. (Eds.), GeneReviews®. University of Washington, Seattle. https://www.ncbi.nlm.nih.gov/books/NBK1161/
Alzheimer Society of Canada. (2026). Alzheimer’s disease. https://alzheimer.ca/en/about-dementia/what-alzheimers-disease/genetic-testing-alzheimers-disease
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., Cooper, C., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Schneider, L. S., … Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet Commission. The Lancet. https://doi.org/10.1016/S0140-6736(24)XXXXXX
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Lumsden, A. L., Mulugeta, A., Zhou, A., & Hyppönen, E. (2020). Apolipoprotein E (APOE) genotype-associated disease risks: A phenome-wide, registry-based, case–control study utilising the UK Biobank. EBioMedicine, 59, 102954. https://doi.org/10.1016/j.ebiom.2020.102954
This information is educational and does not replace medical advice, diagnosis, or treatment. Your results should be interpreted with a qualified healthcare professional in the context of your health history.
