APOE4 question
Should I get tested for APOE4, and how do I do it?
You can learn your APOE genotype from a consumer DNA test, whole-genome sequencing or a medical-grade lab test, usually for a few hundred dollars or less. In a randomised trial, adult children of people with Alzheimer's who learned their result did not become more anxious or depressed, and carriers were more likely to change their health habits; in a smaller study, older adults who knew they carry APOE4 judged their own memory more harshly. Guidelines still advise counselling before and after testing, so decide what you would do with the result and check the insurance rules where you live first.
This is not medical advice. Phoenix educates. Your doctor decides what is right for you.
What the research and Kevin's videos say
What the research says
Grade BAPOE4-specific evidence: yes
In a randomised trial, learning an APOE result did not raise anxiety or depression over a year and carriers were more likely to change health habits; a review of 14 studies found more worry specific to the test, and a smaller study found carriers who knew their result rated their memory worse.
Key studies
Green 2009, N Engl J MedGrade B
REVEAL trial, 162 adult children of people with Alzheimer's: learning the APOE result did not raise anxiety or depression over a year; carriers had more test-related distress than non-carriers.
Read on PubMed (opens in a new tab)Chao 2008, Alzheimer Dis Assoc Disord
REVEAL: people told they carry APOE4 were more likely to change health habits a year later (odds about 2.7x).
Read on PubMed (opens in a new tab)Bemelmans 2016, Alzheimers Res TherGrade B
Systematic review of 14 studies: disclosing APOE4 did not raise anxiety or depression but increased test-specific distress, health-behaviour change and long-term care insurance uptake.
Read on PubMed (opens in a new tab)
4 more key studies
Lineweaver 2014, Am J Psychiatry
144 healthy older adults: those who knew they carry APOE4 rated their memory worse and scored lower on a verbal memory test than carriers who did not know.
Read on PubMed (opens in a new tab)Zick 2005, Health Aff
REVEAL: carriers who learned their result were 5.76 times more likely to change long-term care insurance; other insurance purchases did not differ.
Read on PubMed (opens in a new tab)Goldman 2011, Genet Med
ACMG and NSGC practice guideline: APOE testing has limited clinical utility, few clinicians are prepared to discuss genetic risk, and it sets out counselling steps.
Read on PubMed (opens in a new tab)Ritchie 2024, Neurol Clin Pract
With amyloid-lowering drugs, APOE testing now guides treatment safety for people with symptoms, with consent and counselling before testing.
Read on PubMed (opens in a new tab)
What Kevin and experts say
Now showing: Dr. Kevin Tran · 3:41
Open on YouTube (opens in a new tab)
A consumer gene test can reveal your APOE4 status.
“you can discover that by doing any type of gene testing whether it's a 23 and me or whole genome sequencing”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
APOE4 testing is now available for a few hundred dollars.
“While [APOE4] testing now available for few hundred at whole genome sequencing companies or for medical grade testing through like Quest Diagnostics”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
Two DNA spots decide your APOE type.
“it's really two variants that you would look at and then you're able to go and determine whether it's APOE 2, three or four”
Dr. Brandon Colby, Physician, founder and CEO of Sequencing.com
Test only if you'll act on the result.
“you only do those tests if you believe that if the result is negative, you will be able to act on it”
Dr. Kevin Tran, Founder of The Phoenix Community, Doctor of Pharmacy, APOE4/4 carrier
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