Rochester's Only Neurologist-Led Alzheimer's & Dementia Prevention Practice
Dementia doesn't begin when symptoms appear. The brain changes that lead to Alzheimer's disease and other dementias start 20 to 30 years earlier — during midlife, when there is still time to intervene.
At Healthspan Neurology, we don't wait for problems. The Dementia Preventive Program is a six-month, neurologist-led program that uses advanced diagnostics and evidence-informed strategies to identify your specific risk factors and build a personalized plan to reduce them.
Why Alzheimer's & Dementia Prevention 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, 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.
How the Dementia Preventive Program Works
The program unfolds over six months across four extended visits — in person in Rochester or via telemedicine throughout New York State.
Step 1 — Comprehensive Assessment (Visits 1 & 2)
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. Advanced diagnostic testing is ordered and reviewed by Dr. Gajaweera and completed at trusted outside laboratories and imaging centers — and in some cases, initial results inform a second round of targeted testing before we move to risk stratification.
Depending on your risk profile, testing may include:
Cognitive Assessment Bedside neurologic cognitive evaluation conducted by Dr. Gajaweera
Brain Imaging MRI brain with Neuroquant volumetric analysis
Genetic ApoE genetic testing
Laboratory Testing Comprehensive blood work spanning metabolic health, inflammatory markers, hormones, thyroid function, and nutritional status
Metabolic Monitoring Continuous glucose monitoring to assess real-world metabolic function
Cardiovascular & Vascular Imaging Coronary artery calcium (CAC) scoring and carotid artery imaging
Advanced Lipid & Nutritional Analysis Advanced lipid panel and omega-3 index
Body Composition & Fitness Body composition analysis and VO2 max fitness testing
Biomarker Testing of plasma pTau217
Step 2 — Risk Stratification & Results Review (Visit 1-4)
Your results are reviewed in depth. We identify your specific vulnerabilities — cardiovascular, metabolic, hormonal, genetic, sleep-related — and rank them by impact, so we know exactly where to focus.
Step 3 — Your Personalized Prevention Roadmap (Visit 2-4)
We build a targeted, prioritized plan addressing the risk factors most relevant to you. This may include cardiovascular and metabolic health, sleep, nutrition, movement, stress, hormone health, and evidence-informed use of medications or supplements where appropriate. You leave with a clear roadmap — not a generic checklist.
Who This Program Is For
The Dementia Preventive Program is designed for adults who want to take a proactive approach to brain health — ideally in their 40s, 50s, or 60s, before symptoms develop. It is particularly relevant for those who:
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.
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.