Alzheimer's & Dementia Prevention Starting Decades Before Symptoms Begin
At Healthspan Neurology, we don't wait for problems. We turn fear about your family history and dementia risk into a plan — using advanced diagnostics to identify and target your personal risk factors long before symptoms begin. The Cognitive Longevity Program is neurologist-led, evidence-driven, and built for people who are done waiting.
Dr. Gajaweera built this program with a personal understanding of what it means to have a family history of dementia — and a neurologist's conviction that the story doesn't have to repeat.
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 and other dementias begin decades before diagnosis because the brain is downstream of every single thing our bodies do. Over time, 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 view metabolic, cardiovascular, inflammatory and hormonal factors from the perspective of dementia 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.”
Who This Program Is For
The Cognitive Longevity Program is designed for adults who want to gain agency over their risk of dementia, rather than living in fear or denial. Ideally it starts 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
Have a history of traumatic brain injury, concussion, chemotherapy, brain tumor or stroke
Want to understand your 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.
Located in Rochester, NY and available via telemedicine throughout New York State.
How the Cognitive Longevity Program Works
Formerly known as the Dementia Preventive Program — same evidence-based approach, evolved name.
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. Computerized cognitive batteries, such as Creyos are used to assess your baseline, possible cognitive deficits and track progress over time. 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. 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.
Step 4 — Reassessment
Your final visit, 5 to 6 months after your roadmap is set, is where we take stock. We repeat key testing — including your cognitive battery — to see what's changed, review what's working, and identify where to direct attention next. From there, we adjust your plan. Once you've completed your first year, Continuing Care is available annually or biannually to keep your plan current as your life and risk factors evolve.
Pricing for Cognitive Longevity Program
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One Year Program Fee
Typically over 9-12 months
4 visits
8+ hours clinical time (not including administrative time)
First visit: 2 hours
Visits 2, 3 & 4: 90 min each + phone/portal check-ins
Digital Cognitive Assessment - two sessions to track over time
In person or telemedicine
$2,700
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Continuing Care
For Program graduates only
Annual/Biannual follow-up
Delivered over 2 visits
1st visit: 30 minute pre-visit phone call to review progress & order testing
2nd visit: 90 minute visit to review results and recommendations
Digital Cognitive Assessment - one session
In person or telemedicine
$800
Frequently Asked Questions About Cognitive Longevity
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The evidence is clear that risk can be meaningfully reduced in a majority of cases, particularly if we start decades before symptoms begin. 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.
If there is an extensive family history of dementia or known genetic propensity it is reasonable to think about prevention even in our 20s and 30s.
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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. Visit our YouTube channel to learn more about genetics and the ApoE gene.
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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 Cognitive Longevity 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 15–20 minute introductory call — directly with Dr. Gajaweera, not a scheduler or staff member. We'll talk through your risk factors, family history, and goals, and together decide whether the Cognitive Longevity Program is the right fit for reducing your dementia risk. Available in person in Rochester, NY, and via telemedicine throughout New York State.