The Gene behind Alzheimer's: What the ApoE Genetic Test reveals, and Why Filipinos should know about it

Nearly a million Filipinos are living with dementia right now. By 2030, that number is expected to reach 1.5 million. By 2050, 2.5 million.

And here is the part that most people do not know: in the majority of those cases, the changes in the brain that lead to Alzheimer's disease, the most common form of dementia in the Philippines, began decades before any memory problems appeared.

That means there is a window. A long window, measured in years, sometimes in decades, where something can still be done.

The ApoE genetic test exists to open that window for you.

Neuro Strand (ApoE)

Starts at ₱36,000
The Neuro Strand (ApoE) test analyzes the Apolipoprotein E (ApoE) gene, which is associated with the risk of developing late-onset Alzheimer's disease. This genetic test helps identify inherited variants that may influence an individual's susceptibility to cognitive decline and supports personalized preventive health planning.

Book this test now!

The test in plain terms: a quick summary

What it is: A blood test that identifies which version of the APOE gene you carry.

What it tells you: Your genetic risk level for late-onset Alzheimer's disease and cardiovascular disease.

What it is not: A diagnosis. A sentence. A guarantee of anything.

Who it is for: Anyone who wants to understand their risk, especially those with a family history of dementia or cardiovascular disease, or those in their 30s to 60s taking a proactive approach to health.

How to get it: Book directly through hati.health or the Hati Health app. The blood draw is done at one of our partner collection sites, and the sample is processed by LifeStrands Genomics Singapore through Singapore Diagnostics (SGD).

What happens next: Your result guides your doctor and you toward the right monitoring plan, lifestyle interventions, and — if needed — specialist referrals.

What is the ApoE Gene and why does it matter?

Every person inherits two copies of the APOE gene — one from each parent. This gene produces a protein called apolipoprotein E, which the body uses to carry cholesterol through the bloodstream and to help clear waste from the brain.

The gene comes in three versions, called alleles: E2, E3, and E4.

• APOE E3 is the most common version, found in about 78% of the population. It is considered neutral — neither protective nor harmful.
• APOE E2 is the rarest, found in about 8% of people. It may actually be protective against Alzheimer's disease.
• APOE E4 is the version that changes everything.

Having at least one copy of the APOE E4 gene increases your risk of developing Alzheimer's disease. And because you inherit two copies of the gene — one from each parent — the combination you carry determines your level of risk.

Here is what the numbers look like:

To put this in context: approximately 15% of the population carries one copy of APOE4, while 2 to 3% carries two copies. That is not a rare genetic mutation — it is a common variation that a significant portion of people carry without knowing it.

But what does APOE4 actually do to the brain?

This is where the science gets important to understand, even if you are not a doctor.

The APOE4 protein does not perform its job as well as E2 or E3. Specifically, it is less effective at clearing amyloid-beta — a type of protein fragment that accumulates in the brain as we age. When amyloid-beta is not cleared efficiently, it builds up into plaques. These plaques are one of the hallmarks of Alzheimer's disease.

The APOE4 version also promotes the formation of tau tangles — another type of abnormal protein accumulation that damages the connections between brain cells and contributes to neurodegeneration.

A landmark study published in 2024, analyzing data from more than 13,000 people, found that nearly all individuals who carried two copies of APOE4 showed biological signs of Alzheimer's in the brain, and they typically developed dementia and died sooner than people with Alzheimer's who did not carry APOE4.

This is why APOE4 is described not just as a "risk factor" but increasingly as the single most important common genetic influence on whether someone develops late-onset Alzheimer's disease.

What the ApoE genetic test actually is and how to get it in the Philippines

The ApoE genetic test is a simple blood test that reveals which combination of APOE alleles you carry. In the Philippines, you can book it directly through Hati Health—no referral letter needed, no hospital admission, no complicated process.

Through Hati Health's partner network, the test is processed by LifeStrands Genomics, a CAP-accredited and ISO 15189-certified genomic laboratory in Singapore, in partnership with Singapore Diagnostics (SGD). These are the same international accreditation standards used by leading hospitals and research institutions worldwide—so you can be confident the result you receive is clinically reliable.

Here is what the process looks like:

Step 1 — Book through Hati Health. Visit hati.health or the Hati Health app to book your ApoE test. You will be directed to one of our partner collection sites for your blood draw.

Step 2 — Give a small blood sample. The collection requires only 3 to 4 ml of blood in a standard EDTA tube — the same lavender-capped tube used in a routine blood chem. No fasting required.

Step 3 — Wait for your results. Turnaround time is 14 to 21 working days. Your report will be made available through Hati Health.

Step 4 — Understand your report. Your results will show:

• Your APOE genotype (e.g., E3/E3, E3/E4, or E4/E4)
• An interpretation of what that genotype means for your risk of late-onset Alzheimer's disease
• Guidance notes for your doctor on recommended next steps

Step 5 — Know what to do next. Hati Health can connect you with the right specialist — whether that is a neurologist, a cardiologist, or a genetic counselor — so your result does not sit in a folder. It becomes the start of a plan.

The critical thing the test does NOT mean

Before going further, this needs to be said clearly: a positive result for APOE4 is not a diagnosis. It is a risk assessment.

Even APOE4/APOE4 homozygotes with 8 to 12 times higher risk have only a 35 to 60% probability of dementia by age 85 — meaning 40 to 65% avoid the disease entirely.

Genes are not destiny. They are information. And information, received early enough, is something you can act on.

Why this matters specifically for Filipinos

There are approximately almost a million Filipino senior citizens living with dementia right now, a figure which is estimated to increase to 1.5 million by 2030, nearly 2 million by 2040, and 2.5 million by 2050.

The most common type of dementia in the Philippines is Alzheimer's Disease.

And yet dementia in the Philippines is almost entirely caught late — at the point where someone's family has already noticed significant memory loss, behavioral changes, or functional decline. By then, the brain changes that drove those symptoms have been accumulating for 15 to 20 years.

There are two reasons this matters for how you approach the ApoE test:

First: Alzheimer's does not start when memory fades. It starts in the brain, quietly, years or decades earlier. The plaques and tangles that Dr. Edmund Pua, Genetic Scientist and Laboratory Director at LifeStrands Genomics, studies begin forming long before a person forgets a single name. The test gives you information about your biological risk before those changes accelerate.

Second: The risk is higher for women. Females consistently show higher age-standardized prevalence and mortality from Alzheimer's disease and other dementias compared to males. Given that Filipino women are also typically the primary caregivers for aging parents — often managing someone else's dementia while potentially carrying their own unexamined genetic risk — the case for knowing your status early is particularly strong.

Who should consider getting the ApoE test?

The ApoE genetic test is not only for people who are already showing symptoms, or people whose parents have been diagnosed with Alzheimer's. It is for anyone who wants to understand their genetic risk profile and make informed decisions about their health.

It is particularly worth considering if you:

• Have a parent, grandparent, or sibling who was diagnosed with dementia or Alzheimer's disease
• Are in your 30s, 40s, or 50s and want to take a proactive approach to brain health
• Have been told you have high cholesterol or cardiovascular risk (APOE4 affects cholesterol processing in addition to brain health)
• Are approaching your 60s and want a clearer picture of what risks you may be managing
• Are a healthcare decision-maker for your family and want to understand what your children may have inherited

One important note: because the ApoE gene also affects how the body processes cholesterol and fats, the test provides information relevant to both brain health and cardiovascular risk — two of the leading health concerns in the Philippines.

What can you actually do with this information?

This is the most important question, and the one that distinguishes useful genetic testing from anxiety-inducing speculation.

If your result shows E3/E3 — the neutral, most common result — your Alzheimer's risk from this gene is average. This does not mean you are immune to Alzheimer's, but it does mean APOE4 is not a factor driving your risk. The result gives you a clean baseline.

If your result shows E3/E4 or E4/E4 — meaning you carry one or two copies of APOE4 — you have actionable information. Here is what the research says you can do:

Exercise. This is the single most consistently supported intervention for reducing cognitive decline risk in APOE4 carriers. Regular aerobic exercise — walking, swimming, cycling — promotes brain blood flow and neuroplasticity.

Eat a Mediterranean-style diet. Nutritional interventions emphasizing Mediterranean-style diets have been associated with improved cognitive outcomes, while regular physical exercise promotes neuroplasticity and vascular health. For Filipinos, this translates to more fish, vegetables, olive oil or coconut oil, legumes, and nuts — and less processed food and refined carbohydrates.

Protect your sleep. Getting six hours or less of sleep per night at ages 50 and 60 was associated with 24 to 37% higher risk of dementia compared to those who got seven hours. Sleep is when the brain clears waste — including amyloid-beta. This is not optional.

Manage your cardiovascular risk. High blood pressure, high cholesterol, and diabetes all accelerate brain aging — and APOE4 carriers are especially sensitive to these effects. If your blood pressure is elevated, address it. If your lipids are off, treat it.

Stay socially and mentally engaged. Multimodal interventions including nutrition, physical activity, cognitive engagement, and management of comorbidities have been shown to improve cognitive functioning in non-impaired individuals at risk for Alzheimer's disease.

In the landmark FINGER trial conducted in Finland, APOE4 carriers who made structured lifestyle changes improved overall cognitive function and memory after two years compared to carriers in a control group who only received general health advice.

This is what early information makes possible: not fear, but a plan.

After your results: what happens next

The ApoE genetic test result is not the end of the process — it is the beginning of a more informed health journey. This is where Hati Health comes in.

Because the test can reveal elevated risk for both Alzheimer's disease and cardiovascular disease, your doctor may recommend:

• A full lipid panel and metabolic workup, especially if your APOE4 status suggests elevated cardiovascular risk
• A referral to a neurologist or geneticist for counseling if you carry E4/E4
• Baseline cognitive assessments that can be repeated over time to track any changes
• A structured lifestyle modification plan

Through the Hati Health platform, you can book follow-up consultations with specialists — cardiologists, neurologists, and other relevant doctors — directly from your phone. You do not need to navigate the Philippine healthcare system on your own. We connect the dots for you, from the test result to the right next step.

A final word

Alzheimer's disease does not have a cure. But it does have a timeline, and that timeline starts long before any symptoms appear.

The ApoE genetic test does not predict the future with certainty. What it does is tell you something true and specific about your biology, while there is still time to act on it.

Nearly a million Filipinos are already living with dementia. The question the ApoE test helps answer is: what can your family do now, so that number does not have to include you?

The ApoE Genetic Test is available to book now through Hati Health. Visit hati.health or download the Hati Health app to get started. Your blood draw takes place at one of our partner collection sites across the Philippines, and your results come back within 14 to 21 working days.