{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:56:37Z","timestamp":1788504997863,"version":"build-2803163510"},"reference-count":66,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Dement."],"abstract":"<jats:p>\n                    Interest in\n                    <jats:italic>APOE<\/jats:italic>\n                    testing has increased due to an aging population, direct-to-consumer testing options, media coverage and FDA approval of anti-amyloid therapies. Previous Alzheimer\u2019s disease (AD) guidelines cautioned against\n                    <jats:italic>APOE<\/jats:italic>\n                    testing in asymptomatic individuals. However, updated guidance is warranted due to the changing landscape and research demonstrating low adverse psychological outcomes of\n                    <jats:italic>APOE<\/jats:italic>\n                    testing. With testing for\n                    <jats:italic>APOE<\/jats:italic>\n                    now recommended prior to anti-amyloid therapies, more symptomatic individuals will be identified as having the higher risk \u03b54 variant. The children and siblings of the symptomatic individuals who test positive will have at least a 50% risk of also having an \u03b54 and may subsequently seek testing. Since testing for\n                    <jats:italic>APOE<\/jats:italic>\n                    is generally not clinically available to asymptomatic individuals, they may pursue direct-to-consumer genetic testing and, therefore, be tested without a clinician\u2019s involvement or counseling. Given limitations and caveats of\n                    <jats:italic>APOE<\/jats:italic>\n                    testing, it is important that patients have access to education, counseling and testing in labs certified for clinical testing. Pre- and post-test education and counseling content for\n                    <jats:italic>APOE<\/jats:italic>\n                    testing, including risk figures, are provided in this Perspective. Both Alzheimer\u2019s disease and cardiovascular disease risks associated with\n                    <jats:italic>APOE<\/jats:italic>\n                    should be addressed for all individuals undergoing testing. Given that it has been over a decade since\n                    <jats:italic>APOE<\/jats:italic>\n                    guidance was issued, the time has come for the medical community to discuss the changing landscape, expand\n                    <jats:italic>APOE<\/jats:italic>\n                    genetic testing access to individuals at higher risk, and update guidelines.\n                  <\/jats:p>","DOI":"10.3389\/frdem.2026.1808512","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T04:43:55Z","timestamp":1779770635000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Now is the time: the need to update guidance to expand access to APOE genetic testing"],"prefix":"10.3389","volume":"5","author":[{"given":"Wendy R.","family":"Uhlmann","sequence":"first","affiliation":[{"name":"Division of Genetic Medicine, Department of Internal Medicine and Department of Human Genetics, University of Michigan","place":["Ann Arbor, MI, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University","place":["New York, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill S.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University","place":["New York, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1177\/0891988721993575","article-title":"Safety and tolerability of APOE genotyping and disclosure in cognitively normal volunteers from the Butler Alzheimer\u2019s prevention registry","volume":"35","author":"Alber","year":"2022","journal-title":"J. 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