A Family History of Dementia Shouldn't Mean Living With Anxiety.
We can do better.
She always came with her dad — clearly the apple of his eye. Same eyes, same great laugh. Once a formidable defense attorney, he still had that larger-than-life presence, but the years were taking their toll, and lately his memory had started to slip. His old colleages had noticed and called the daughter. After that, she couldn't deny it any longer — her dad's cognition was fading, just as her mom's had.
Mom had died of dementia five years earlier. Dad had cared for her around the clock at home. They were "lucky" to have the resources and family to make that possible. She knew that. But she didn't feel lucky — she felt afraid.
She was waking in the middle of the night. Sometimes hot flashes, sometimes just a racing heart and a mind to match. Was her brain fog from poor sleep or perimenopause? She googled it, asked Claude "how to prevent dementia," and got buried in advice — more protein, lift heavy, hormones and a dozen supplements promising vitality. Where do you even start with that much noise? Everyone, from the science bros to the menopause gurus, seemed to have an agenda and something to sell.
So she saw a neurologist. Got an MRI. Was told everything looked "unremarkable" — brain fog is normal in midlife, it'll get better. Come back if symptoms worsen.
The Gap
Come back if symptoms worsen.
The gap — the time between concern and waiting for symptoms — is what the Cognitive Longevity Program was built for. We now know dementia-related brain changes begin decades before symptoms show up, often in your 40s to 60s. And here's the part that matters most: the majority of dementia cases are preventable if you start early and take the right steps.
So instead of waiting, the daughter came to me. Together we mapped her risk and matched it to the right strategies. For most people, that starts with genetics — age, sex, and genetics are the non-modifiable part of the story, the things we can't change. But mindset and lifestyle can rewrite the rest of it.
Genetic testing is controversial. Most neurologists consider it outside their lane — why test if there's no drug to prescribe? I push back on that — as I explain in my recent YouTube videos. Less than 5% of later-onset dementia is tied to deterministic genes — genes that guarantee the disease. Which means that 95% of dementia risk isn't a verdict, it's a starting point.
We learned she was an ApoE3/4 carrier and took action through the lens of her ApoE4 status. That was only the beginning. Within six months, she had a plan, a clear focus, and confidence. The 3 a.m. wake-ups stopped. The brain fog cleared.
Don't Wait for "The Gap"
If you've been living in "the gap," don't wait — dementia prevention needs to start now.
We'll talk through your risk factors — genetic, lifestyle, and everything in between — and what a personalized Cognitive Longevity plan could look like for you.
Live Long, Be Strong, Stay Sharp,
Dr. G
This story is a composite drawn from patients I've worked with, with identifying details changed to protect their privacy.