Alzheimer's & Dementia Prevention Needs to Start Decades Before Symptoms Begin
Most people don't know you can prevent dementia. The brain changes that lead to Alzheimer's disease begin 20 to 30 years before the first symptom — during midlife, when there is still time to act.
At Healthspan Neurology, we don't wait for problems. The Dementia Preventive Program is a neurologist-led program that uses advanced diagnostics and evidence-informed strategies to identify your specific risk factors and build a plan to reduce them — before memory loss begins.
Why Preventing Alzheimer's & Dementia Matters
The projected lifetime risk of developing dementia after age 55 is 42%. Alzheimer's disease accounts for the majority of those cases — and research shows that nearly half of all dementia cases may be preventable.
The biology of Alzheimer's disease begins decades before diagnosis. Amyloid plaques accumulate. Vascular damage compounds. Metabolic dysfunction goes unaddressed. None of this is visible on a standard office visit — but it is measurable, and much of it is modifiable.
The greatest opportunity to change that trajectory exists long before memory problems start.
Why Current Care Falls Short
Most patients who ask their doctor about Alzheimer's or dementia prevention are told to eat well, sleep more, and exercise. That advice isn't wrong — but it isn't a plan.
Standard care doesn't identify which risk factors are most relevant to you. It doesn't test for genetic vulnerability. It doesn't measure the metabolic, cardiovascular, inflammatory and hormonal factors that drive Alzheimer's risk. And it rarely connects those findings to a specific, actionable plan.
Healthspan Neurology was built to fill that gap.
“I am 2/3 of the way through Dr. Gajaweera’s dementia prevention program. I enthusiastically recommend her to anyone who is concerned about warding off dementia. Part of what makes the program so valuable is that dementia is not just a neurological issue — it is tied to everything that goes on in your body. These are not just generic recommendations to eat more vegetables and spend more time at the gym. They are based on an extensive battery of tests that have measured everything from the state of my arteries to my metabolism rate. I can’t imagine finding another doctor who is simultaneously so knowledgeable, so attentive, so thoughtful, and so communicative. I am extremely grateful to have found her.”
How the Dementia Preventive Program Works
Step 1 — Comprehensive Assessment
Your first visit is 90 to 120 minutes. We begin by exploring what you want from your future — cognitively and physically — and what's driving you to act now. Dr. Gajaweera then conducts a detailed review of your medical and family history and any prior testing, followed by a neurologic evaluation and cognitive testing. Advanced diagnostic testing is ordered, reviewed by Dr. Gajaweera, and completed at trusted outside laboratories and imaging centers. Testing is comprehensive and tailored — spanning genetics, brain imaging, cardiovascular and vascular health, metabolic function, body composition, and emerging blood biomarkers for Alzheimer's pathology. Your panel is built around your specific risk profile.
Step 2 — Risk Stratification & Results Review
Your results are back — and this is where the work gets specific. Whether it's your imaging, genetics, or labs, we review your findings in full, identifying both strengths to build on and vulnerabilities that need attention. Nothing is looked at in isolation. Dr. Gajaweera synthesizes your results into a clear picture of where your greatest risks lie and where intervention will have the most impact. From there, we discuss strategies that are evidence-based and tactics that fit your actual life — your schedule, your preferences, what you're ready to act on.
Step 3 — Your Personalized Prevention Roadmap
This is where everything comes together. Together we build a targeted, prioritized plan — not a generic checklist. Your roadmap is designed to be actionable on your own, with your primary care provider, or with continued support from Dr. Gajaweera through biannual or annual follow-up visits. It may include cardiovascular and metabolic health, sleep, nutrition, movement, stress, hormone health, and evidence-informed use of medications or supplements where appropriate. We also determine whether additional testing would help sharpen the focus further. For those returning for follow-up visits, this is where we reassess — reviewing what's changed, what's working, and where to direct attention next.
Who This Program Is For
The Dementia Preventive Program is designed for adults who want to prevent dementia and protect against memory loss — ideally starting in their 40s, 50s, or 60s, before symptoms develop. It may be especially important if you:
Have a family history of Alzheimer's disease or dementia
Carry or are concerned about the ApoE4 gene
Are navigating perimenopause or menopause and experiencing brain fog or cognitive changes
Have cardiovascular risk factors, sleep apnea, diabetes, or a history of head injury or stroke
Want to understand their risk and know specifically what to do about it
It is never too late to reduce risk — but the earlier prevention begins, the greater the impact.
Frequently Asked Questions
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Not always — but the evidence is clear that risk can be meaningfully reduced. A landmark 2024 Lancet Commission report identified 14 modifiable risk factors that together account for nearly half of dementia cases worldwide. Alzheimer's disease, as the most common form of dementia, is the primary target of prevention efforts — and the condition we understand best in terms of modifiable risk.
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The earlier the better. Because Alzheimer's-related brain changes begin 20 to 30 years before symptoms, the 40s and 50s represent the highest-impact window for intervention. That said, risk reduction efforts are meaningful at any age.
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Early detection identifies symptoms after brain changes are already well established. Prevention targets the underlying drivers — vascular health, metabolic function, sleep, inflammation, hormones — before symptoms appear. Both matter, but prevention offers the greatest opportunity to change the trajectory.
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ApoE4 is the strongest known genetic risk factor for late-onset Alzheimer's disease. Carrying one copy increases lifetime risk; carrying two copies increases it further. Knowing your status allows us to tailor your prevention strategy — intensifying certain interventions and monitoring more closely where it matters most.
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Plasma pTau217 is an emerging blood biomarker that reflects Alzheimer's-related changes in the brain. Elevated levels can indicate early amyloid pathology — sometimes years before symptoms develop. It is one of the most promising tools we now have for identifying Alzheimer's risk at a stage when intervention is most meaningful.
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The Dementia Preventive Program is a direct-pay service. Many patients use HSA or FSA funds, and out-of-network reimbursement may be available depending on your plan. Diagnostic testing ordered during the program — labs, imaging, cognitive testing — is typically covered by insurance. See our Pricing & Policies page for details.
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No. The program is designed for people who do not yet have symptoms. If you are already experiencing cognitive changes, a Neurologic Consultation may be the more appropriate starting point — we can discuss which is right for you during your introductory call.
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Yes. We offer both in-person visits in Rochester and telemedicine appointments for patients throughout New York State, including New York City.
Getting Started
Your first step is a complimentary introductory call. We'll discuss your goals, review your concerns, and determine whether the Dementia Preventive Program is the right fit for you.
The Dementia Preventive Program is available to patients throughout New York State, including New York City, via telemedicine.