APOE & Alzheimer's Genetic Risk — the APOE ε4 allele is the strongest common genetic risk factor for late-onset Alzheimer's disease, and your APOE genotype now influences treatment eligibility for the first FDA-approved disease-modifying therapies.
Whole genome sequencing determines your exact APOE genotype (ε2/ε3/ε4) and evaluates rare deterministic Alzheimer's genes — PSEN1, PSEN2, and APP — providing the complete genetic risk profile that shapes prevention, treatment, and clinical trial eligibility.
APOE & Alzheimer's Genetic Risk
The APOE gene (apolipoprotein E, chromosome 19q13.32) has three common alleles — ε2, ε3, and ε4 — producing six possible genotypes. APOE ε3/ε3 is the most common genotype (~60% of the population) and represents average Alzheimer's risk. APOE ε4 is the strongest known common genetic risk factor for late-onset Alzheimer's disease: one ε4 copy (ε3/ε4, ~25% of people) increases lifetime Alzheimer's risk approximately 3-4 fold; two ε4 copies (ε4/ε4, ~2-3% of people) increases risk approximately 8-12 fold and shifts typical onset 10-15 years earlier. Conversely, APOE ε2 is protective — ε2/ε3 carriers have approximately 40% reduced risk.
APOE ε4 affects Alzheimer's through multiple mechanisms: impaired amyloid-β clearance, increased neuroinflammation, compromised blood-brain barrier integrity, and reduced synaptic plasticity. Critically, APOE genotype now has direct therapeutic implications. Lecanemab (Leqembi) and donanemab, the first FDA-approved amyloid-clearing antibodies, are more effective in APOE4 carriers but also carry higher risk of ARIA (amyloid-related imaging abnormalities) — particularly in ε4/ε4 homozygotes, where ARIA risk is substantial enough to require careful benefit-risk discussion. APOE genotyping is now recommended before initiating anti-amyloid therapy.
Beyond APOE, rare deterministic Alzheimer's genes cause early-onset familial Alzheimer's disease (EOFAD): PSEN1 (presenilin 1, chromosome 14q24.2, most common — >300 pathogenic variants), PSEN2 (presenilin 2, chromosome 1q42.13), and APP (amyloid precursor protein, chromosome 21q21.3). These autosomal dominant variants cause Alzheimer's with near-complete penetrance, typically with onset between ages 30-60. EOFAD accounts for <1% of all Alzheimer's but is critical to identify because affected families have 50% risk per offspring and may benefit from presymptomatic prevention trials.
APOE genotyping is now recommended before starting lecanemab or donanemab — APOE4/4 homozygotes have substantially higher ARIA risk that must be weighed against the treatment benefit. This makes APOE one of the first pharmacogenomic markers in neurology.
APOE genotyping is increasingly clinically actionable — influencing anti-amyloid therapy decisions, clinical trial eligibility, and risk-stratified prevention strategies. WGS provides APOE plus all rare Alzheimer's genes in one test.
Anti-amyloid therapy decisions now require APOE genotype — lecanemab and donanemab risk-benefit differs by APOE status
The FDA labels for lecanemab and donanemab recommend APOE genotyping before treatment initiation. APOE4/4 homozygotes have approximately 35% risk of ARIA (vs. ~5-10% in non-carriers), including rare cases of serious cerebral edema. For ε4/ε4 homozygotes, the treatment decision requires careful informed consent discussion weighing cognitive benefit against ARIA risk. For ε4 heterozygotes, the benefit-risk is more favorable but still requires ARIA monitoring. WGS provides definitive APOE genotyping alongside comprehensive neurogenomic evaluation.
Rare familial Alzheimer's genes (PSEN1, PSEN2, APP) cause deterministic early-onset disease — identification enables prevention trial enrollment
PSEN1, PSEN2, and APP pathogenic variants cause autosomal dominant Alzheimer's with near-100% penetrance, typically with onset before age 60. The Dominantly Inherited Alzheimer Network (DIAN) and other prevention trials specifically enroll presymptomatic carriers of these deterministic variants — offering the possibility of preventing or delaying disease onset. Identification of a deterministic variant also has profound implications for family members, who have a 50% chance of carrying the same variant. WGS evaluates all three genes comprehensively.
Your full DNA (not just a part of it)
Traditional genetic testing looks at narrow sets of genes, missing most parts of your genome. We sequence your full genome — every gene and every region between genes.
Comprehensive insights and specialized reports
Easy to read and with answers you and your doctor can act on. Not a file to interpret — 200+ clinical reports, organized by category.
Your test becomes more valuable every year
Your DNA does not change, but genome science is accelerating. Every month, new variant-disease associations are discovered. We validate these findings and update your reports automatically. Your test becomes more valuable every year.
The results doctors bring to their hardest cases.
Forty years of uncertainty. One test.
A patient had spent decades in the UK healthcare system without a diagnosis. Dante data, accepted by NHS clinical teams at Queen Elizabeth University Hospital Glasgow, identified Noonan Syndrome and a RUNX1 leukemia-associated variant that had gone undetected. After 40 years, they finally had an answer.
A complete read delivers a complete picture.
A patient came to Dante to investigate periodic paralysis. Reading the complete genome identified a concurrent hereditary cardiac finding — Brugada syndrome — that their doctor confirmed with an ECG. The result also explained a family member's unresolved cardiac history. One test. Every answer in it.
Sequenced in 2019. The data worked in 2021.
Jennifer sequenced her genome with Dante two years before her breast cancer diagnosis. When treatment began, Dante's pharmacogenomics data showed her prescribed chemotherapy would cause serious adverse effects. Her doctor selected an alternative — and she started effective treatment from day one.
Every genetic question deserves a complete answer.
Whether you are searching for answers today or protecting your health for tomorrow, a complete read of your entire genome is the only place to start.
It runs in your family. Now you can know if it runs in your genes.
Your genome contains inherited variants associated with medical conditions like cardiac, cancer, and neurological. We read all of them — with the clinical depth to give the result meaning.
Learn more →When traditional lab tests say you're fine. And you know you're not.
Standard diagnostic tests check for a pre-selected set of answers. We sequence your full DNA — including parts that no test was designed to check. If the answer is in your genome, we will help you find it.
Learn more →Your diagnosis may be right. Your treatment plan may be incomplete.
Your genes determine which treatments are most likely to work — and which are not. We give your doctor the tools and insights to inform your treatment plan.
Learn more →You want to know before something forces the question.
Some people don't wait for a diagnosis or a family history to act. Whole genome sequencing gives you the complete genetic picture now — so you and your doctor can make informed decisions before anything becomes urgent.
Learn more →You already took a DNA test. Here's what it couldn't tell you.
Most consumer DNA tests read less than 0.1% of your genome. We read all of it.
Learn more →Clinical-grade results. Chosen by individuals, trusted by doctors for their most complex cases.
Dante Genome Test helped specialists at a UK national acute hospital in the identification of Noonan Syndrome and a rare leukemia-associated genetic variant that had gone undetected. That result changed the medical care of the patient.
Accredited by & published in
Common questions about whole genome sequencing.
What is the difference between whole genome sequencing and a targeted genetic test?
Targeted genetic tests — including standard hereditary cancer panels — read a pre-defined list of known variants in a specific set of genes. They are designed to find what they already know to look for. Whole genome sequencing reads your entire genome: all 6 billion base pairs, every gene, every region between genes. A Mayo Clinic study published in JAMA Oncology found that standard testing guidelines missed more than half of patients with inherited cancer mutations. Genome Test does not have a fixed list.
What will I receive when my results are ready?
Your Dante Genome delivers 200+ physician-ready reports organized by clinical category — hereditary cancer, cardiac conditions, rare diseases, pharmacogenomics, carrier status, and more. Reports are delivered to your secure Genome Manager and are formatted for direct clinical use. Your genome data is permanently retained and re-analyzed automatically as science advances.
What happens if a clinically significant variant is found?
If a pathogenic or likely-pathogenic variant is identified, it will be clearly flagged in your physician-ready report with clinical context, published evidence, and recommended next steps. We recommend sharing any clinically significant finding with your physician or a genetic counselor, who can guide decisions about surveillance, risk reduction, or cascade testing for family members.
How is this different from a consumer DNA test like 23andMe or AncestryDNA?
Consumer DNA tests use genotyping chips that read less than 0.1% of your genome — a tiny pre-selected set of common variants. They are optimized for ancestry and population-level traits, not clinical genetic findings. The Dante Genome Test sequences 100% of your genome at 30X coverage, the same standard used in clinical diagnostic settings. The two tests are not comparable in scope, methodology, or clinical utility.
How long does it take to get results, and how are they delivered?
Your collection kit ships within 48 hours of ordering. Once your sample arrives at our CLIA-certified laboratory, sequencing and analysis takes 6–8 weeks. Results are delivered securely to your Genome Manager, where you can access your reports, share them with your physician, and receive automatic updates as new findings are validated against your genome.
We work with patient advocacy groups worldwide.
Dante Labs works with patient advocacy groups of any size — for APOE & Alzheimer's Genetic Risk and other conditions, rare and common. We support groups in any country, including virtual patient advocacy groups.
We can provide customized reports, group discounts, and packages tailored for your members. Please reach out using the form and we'll be in touch within two business days.
- Custom genomic reports for your members
- Group discounts and tailored packages
- Any country — including virtual groups
- Rare and common conditions covered
Message received.
We'll be in touch within 2 business days. To follow up directly: hello@dantelabs.com
One test.
A lifetime of answers.
One kit, sent to your home. Your entire genome sequenced at the clinical standard used for diagnostic decisions. 200+ physician-ready reports delivered to your Genome Manager in 6–8 weeks — permanent and updated as science advances.
Ships within 48 hours · Results in 6–8 weeks
