Is APOE4 inherited?
APOE4 is inherited: you get one APOE copy from each parent. What a parent with one or two copies passes on, what it raises, and what it does not decide.
Key takeaways · TL;DR
APOE4 is inherited: you get one APOE copy from each parent. What a parent with one or two copies passes on, what it raises, and what it does not decide.
By Dr. Kevin Tran, Doctor of Pharmacy · Last updated: October 24, 2026
Yes. APOE4 is inherited: you receive one copy of the APOE gene from each parent, so your genotype is the pair you were given. A parent with one copy of APOE4 and one of another version passes APOE4 to each child about half the time. A parent with two copies passes one on to every child. Inheriting APOE4 raises the chance of Alzheimer's disease later in life. It does not decide it (Genin, 2011).
How the inheritance works
Everyone has two copies of APOE, one from each parent. The gene has three common versions: APOE2, APOE3 and APOE4. Your genotype, such as 3/3, 3/4 or 4/4, is the pair you received.
When a parent makes an egg or a sperm cell, only one of their two APOE copies goes in, chosen at random. So:
Parent's genotype | Chance each child gets APOE4 from that parent |
|---|---|
4/4 (two copies) | Every child receives one APOE4 |
3/4 or 2/4 (one copy) | About half of children, one in two |
3/3, 2/3 or 2/2 (none) | None |
A child's own genotype combines both parents. A child who receives APOE4 from one parent and APOE3 from the other is 3/4. A child who receives APOE4 from both is 4/4, which is why two carrier parents can have a child with two copies. Each child is a separate draw: having one child with APOE4 does not change the odds for the next.
Is APOE4 dominant or recessive?
Neither, in the strict sense. The researchers who calculated lifetime risk by genotype describe it as semi-dominant: one copy raises risk, and two copies raise it further (Genin, 2011). By age 85, they estimated about 23 to 30 in 100 people with 3/4 and 51 to 60 in 100 with 4/4 develop Alzheimer's, against 11 to 14 in 100 in the general population. See risk by age, and APOE4 one copy vs two copies for how the two genotypes compare.
Is APOE4 a mutation?
Not in the usual sense. APOE4 is a common version of the gene, not a rare change that appears in a few families. APOE3 is the most common version, found in more than half of people (MedlinePlus). Worldwide, roughly one in seven copies of the APOE gene is APOE4 according to population databases such as dbSNP, which means a large minority of people carry at least one. Phoenix describes about 2% of the general population as having two copies.
What it does and does not decide
APOE4 raises the chance of late-onset Alzheimer's and is one of the strongest common genetic risk factors (Liu, 2013). It does not cause the disease by itself. The MedlinePlus entry for the gene puts it plainly: people with the APOE4 allele inherit an increased risk of developing Alzheimer's disease, not the disease itself; not everyone with Alzheimer's has APOE4, and not everyone with APOE4 develops it.
Common questions from families
A parent has Alzheimer's. Do I have APOE4? Not necessarily. Many people with Alzheimer's do not carry APOE4, and many carriers have no family history. The only way to know is a test.
A parent is a carrier. Should my children be tested? This is a family decision. Phoenix's genetic testing and family guide covers the odds of having passed the gene on and the ethics of testing minors. A genetic counselor can help you decide.
Can I protect my children? The healthy habits that help carriers help everyone. Children cannot change their genotype, and what they do from midlife on matters most.
For the conversation itself, see how to tell your family.
Frequently asked questions
If I have one copy, do my children get it?
Each child has about a one in two chance of receiving your APOE4 copy, and the other parent's copies decide the rest of the child's genotype.
If both parents are 3/3, can a child have APOE4?
No. A child can only receive versions that a parent carries, and neither parent has APOE4 to pass on.
Does APOE4 skip generations?
No. A parent with one copy passes it to each child about half the time, and a parent with two copies passes it to every child. It can look like it skips when a carrier is never tested or never develops Alzheimer's.
Is the risk the same for sons and daughters?
Inheritance is the same. Lifetime risk estimates are higher for women than for men in the same genotype group (for 3/4, 30% against 23% by age 85 in the Genin data).
Is this medical advice?
No. Phoenix educates. A genetic counselor or doctor can advise your family.
Sources
Genin, Mol Psychiatry 2011: APOE and Alzheimer disease: a major gene with semi-dominant inheritance
Liu, Nat Rev Neurol 2013: Apolipoprotein E and Alzheimer disease: risk, mechanisms and therapy
NCBI dbSNP, rs429358 allele frequencies (C allele about 15% in gnomAD and TOPMed)
Phoenix genetic testing and family guide (population figure of about 2% with two copies)
Phoenix is a community of 750+ APOE4 carriers. If you carry APOE4, apply to join Phoenix (60-day money-back guarantee).
This is not medical advice. Phoenix educates. A genetic counselor or doctor can advise your family.
Dr. Kevin Tran
Doctor of PharmacyDr. Kevin Tran is a Doctor of Pharmacy and APOE4/4 carrier dedicated to helping others with the APOE4 gene variant take proactive steps for their health. He founded The Phoenix Community to provide evidence-based resources and support for APOE4 carriers.
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