Meet Ashanthi Gajaweera, MD

Why I Created Healthspan Neurology

I practiced neurology in Rochester for over two decades at Neurology Associates of Rochester, where I eventually served as Managing Partner. The clinical work was meaningful. But the model was reactive by design. By the time most patients reached me, the window for meaningful prevention had already narrowed.

We now know that the brain changes leading to Alzheimer's disease begin 20 to 30 years before the first symptom. We know that nearly half of dementia cases involve modifiable risk factors. We know that the menopausal transition is a critical neurologic window that influences a woman's long-term brain health in ways that are measurable and addressable — if you're looking for them.

Traditional neurology, structured around reactive care is not built to act on any of that. I decided to build something that is.

How I Think About the Brain

Before I was a neurologist, I was an engineer.

I studied mechanical engineering at MIT, and that training never left me. I still think in systems. I still ask where the failure points are, what the inputs and outputs look like, and what happens upstream when something goes wrong downstream. When I evaluate a patient's brain health, I'm not looking at one variable in isolation — I'm looking at the whole system.

The brain is the most energy-demanding organ in the body. It makes up roughly 2% of body weight but consumes nearly 20% of the body's energy at rest. It is exquisitely sensitive to disruptions in sleep, metabolism, hormones, cardiovascular function, and inflammation. Understanding those connections — and addressing them systematically — is the foundation of everything I do at Healthspan Neurology.

This is not wellness. It is applied neuroscience, informed by evidence, and grounded in 25 years of clinical practice.

Women's Brain Health

One area where the gap between what we know and what patients receive is particularly striking is women's brain health.

Women are nearly twice as likely as men to develop Alzheimer's disease. The biology behind that disparity runs through menopause — through the neuroprotective role of estrogen, through the metabolic and vascular changes that accompany its decline, through years of symptoms that are frequently dismissed or undertreated.

As one of the few board-certified neurologists in the country who is also a Menopause Society Certified Practitioner, I bring a neurologic lens to menopause care that most patients have never had access to. The menopausal transition is not a gynecologic inconvenience. It is a neurologic event with long-term consequences — and it is one of the most important windows we have for Alzheimer's prevention in women.

My Commitment to This Work

Healthspan Neurology is a small, deliberately designed practice. I see fewer patients than I did in traditional practice, and I spend far more time with each one. That is not a limitation — it is the point.

Every patient who walks through my door — or logs on from across New York State — gets a neurologist who has read their records, thought carefully about their case, and has no interest in moving them through quickly. The goal is not to manage your symptoms. It is to understand your brain, identify your risks, and help you do something about them before they become your diagnosis.

That is what I built Healthspan Neurology to do. I'm glad you found us.