APOE genetic test: what it tells you, what it costs, and how to get it
The APOE test tells you which variants of the APOE gene you carry and what they mean for your Alzheimer's risk.
Added to a Blueprint assessment, which starts at $89 with insurance ($399 cash).
- APOE genotype from the same blood draw
- 50+ biomarker panel
- 15-minute cognitive assessment
- Up to 90-min 1:1 with a Brain Health Coach
- Personalized action plan, ranked by impact
- Lifetime access to the BetterBrain app and ongoing support
A blood test that reads your two copies of the APOE gene (variants e2, e3 and e4).
$149, added to a Blueprint assessment. Blueprint starts at $89 with insurance ($399 cash). The add-on is always paid out of pocket.
Add it at checkout. It runs from the same Quest blood draw as your 50+ biomarker panel, and a Brain Health Coach walks you through the result.
Available in every state except NY, NJ and RI.
What is the APOE gene?
APOE is the gene that makes apolipoprotein E, a protein that carries cholesterol and other fats through the blood and into cells. Your brain depends on that transport to build and repair cell membranes and to clear waste, including amyloid-beta, the protein fragment that builds up in Alzheimer's disease.
There are three common variants: e2, e3 and e4. You inherit one copy from each parent, which gives six possible combinations. About 20 to 25% of people carry one copy of e4, and about 2 to 3% carry two. Many people who develop Alzheimer's do not carry APOE4, and many people who carry it never develop dementia.
See the APOE genotype biomarker reference for how BetterBrain reports this marker.
What does an APOE result mean?
Your result is a genotype, written as two variants (for example, e3/e4). Each combination is associated with a different level of Alzheimer's risk relative to the most common genotype, e3/e3.
| Genotype | Associated risk | What it means |
|---|---|---|
| e2/e2, e2/e3 | Lower than average | e2 is associated with some protection against late-onset Alzheimer's. |
| e3/e3 | Average (baseline) | The most common genotype. Risk is driven mostly by age, health and lifestyle. |
| e2/e4, e3/e4 | Roughly 2 to 3 times baseline | One copy of e4. Prevention efforts tend to matter more here, and some respond differently to interventions. |
| e4/e4 | Roughly 8 to 12 times baseline | Two copies of e4. Highest genetic risk and, on average, earlier onset. Still not a diagnosis. |
An APOE result does not tell you whether Alzheimer's changes are present in your brain today; for that, see the pTau-217 blood test. And it cannot predict an individual outcome. Risk is a probability across a population, and a large share of that probability sits in factors you can measure and change.
Should you get tested for APOE4?
It is a personal decision, and the useful question is what you would do with the result. Testing tends to be worth it for people who respond to information with action and who have support for interpreting it. It is a harder call if the result would create worry without a clear next step.
On the worry itself, the data are reassuring. In the REVEAL study, learning APOE4 status did not cause clinically significant anxiety or depression at six-month follow-up, though individual reactions vary.
Reasons people choose to test:
- A parent or sibling had dementia and they want to know how much of that is inherited. (Read more: Is Alzheimer's hereditary? and Your genetics aren't your destiny.)
- APOE4 carriers may benefit more from certain interventions, such as higher omega-3 DHA intake, so the result changes the plan.
- It informs decisions about further testing, such as pTau-217, and eligibility for clinical trials.
Reasons people choose not to:
- There is no cure for Alzheimer's, and no result guarantees prevention.
- Privacy. Genetic information has specific legal protections and specific gaps (see below).
For a fuller treatment of the trade-offs, read Should you get tested for APOE4?
Can you lower your risk if you carry APOE4?
Yes, within the limits of what the evidence shows. APOE status is one input to risk, and the modifiable inputs appear to matter as much or more for carriers than for non-carriers.
The clearest recent example is a 2025 study in Nature that followed more than 5,700 people for 34 years. Among people with two copies of APOE4, closely following a Mediterranean-style diet was associated with at least a 35% lower risk of dementia, with higher adherence linked to further reductions. Dr. Richard Isaacson, quoted on that work: "Genes do not have to be your destiny."
What BetterBrain's Brain Health Coaches focus on with APOE4 carriers:
- Lipids. APOE4 impairs cholesterol transport, so ApoB and LDL are tracked and managed more closely. (ApoB, ApoB and brain health)
- Omega-3 DHA. Carriers appear to take up DHA less efficiently, so intake from fatty fish or a concentrated supplement gets more attention. (Omega-3 index)
- Aerobic exercise, which is associated with preserved brain volume and cognition in carriers.
- Sleep, which supports amyloid clearance. (Sleep and dementia)
- Inflammation and blood sugar, tracked through hs-CRP and HbA1c. (Alzheimer's and blood sugar)
- Avoiding head injury and limiting alcohol, both of which are associated with worse outcomes for carriers.
Coach Erika Schwan, whose mother lived with Alzheimer's, walks through the diet and omega-3 side in Understanding APOE status. The broader prevention evidence is in How to prevent dementia.
Dementia risk doesn't stop at genetics.
Every BetterBrain APOE result comes with your 50+ biomarker panel and an up to 90-minute 1:1 with a Brain Health Coach, so you leave with a specialist-led prevention plan, ranked by impact and tailored to you.
How much does the APOE test cost?
The APOE test is a $149 add-on to a BetterBrain Blueprint assessment. Blueprint starts at $89 with insurance, or $399 cash pay. The APOE add-on is always paid out of pocket, and Blueprint itself is HSA and FSA eligible.
BetterBrain does not sell APOE as a standalone test. The result is only useful alongside the rest of your picture (lipids, inflammation, metabolic markers, cognition) and someone to interpret it, so it is only offered with the assessment that provides both.
Not sure what you would pay? Check your coverage in about 3 minutes, or see full pricing.
How do I get an APOE test?
- Start a Blueprint assessment and add APOE at checkout. You can add pTau-217 ($299) at the same step.
- Get your blood drawn at a Quest location. APOE is run from the same draw as your 50+ biomarker panel, with no separate visit.
- Complete a 15-minute cognitive assessment in the BetterBrain app.
- Review everything with a Brain Health Coach in an up to 90-minute 1:1. Your APOE result is read in the context of your other markers, and you leave with a personalized action plan ranked by impact.
- Keep going. Lifetime access to the BetterBrain app, retesting to see what moved, and your coach for the questions that come up later.
Is my genetic information private?
Your results are protected with HIPAA-grade security, and you can delete your data at any time.
Federal law also protects you. The Genetic Information Nondiscrimination Act (GINA) prohibits health insurers and employers from using your genetic information against you. GINA does not cover life, disability or long-term care insurance, so if you are shopping for one of those policies, it is worth knowing that before you test.
More on this in BetterBrain's FAQ and the privacy policy.
APOE vs pTau-217: which test do I need?
They answer different questions. APOE is inherited and does not change; it tells you about lifetime risk. pTau-217 is a blood protein that reflects Alzheimer's-related changes happening in the brain now, and it can shift over time. Many clients with a family history start with APOE for the long view and add pTau-217 to see where they stand today.
| APOE genetic test | pTau-217 blood test | |
|---|---|---|
| Measures | Which APOE variants you inherited | A protein associated with Alzheimer's pathology |
| Tells you | Inherited risk over a lifetime | Whether related changes may be present now |
| Changes over time? | No | Yes |
| Price | $149 add-on | $299 add-on |
| Diagnoses Alzheimer's? | No | No |
How much does a pTau-217 test cost? · Amyloid-beta and tau explained
Does having APOE4 mean I will get Alzheimer's?
No. APOE4 is associated with higher risk, but it is a susceptibility gene, not a cause. Many carriers never develop dementia, and many people with Alzheimer's do not carry APOE4. The rare genes that reliably cause early-onset Alzheimer's (APP, PSEN1, PSEN2) are different from APOE.
Is the APOE test covered by insurance?
No. The $149 APOE add-on is always paid out of pocket. The Blueprint assessment it is added to starts at $89 with insurance or $399 cash, and Blueprint is HSA and FSA eligible.
Can I get just the APOE test without the rest of the assessment?
Not at BetterBrain. A genetic result on its own is hard to act on, so APOE is offered only alongside the 50+ biomarker panel and a coaching session that puts the result in context.
Where is the APOE test available?
Everywhere in the US except New York, New Jersey and Rhode Island.
Related reading
Have a question about your own risk?
Talk it through with a Brain Health Coach. The coverage check takes about 3 minutes.