Frequently Asked Questions

  • In 2017 it was estimated that 47 million cognitively normal people in the United States may already have brain amyloidosis, the physical finding used to define preclinical Alzheimer’s disease. This suggests that dementia is something we should all be concerned about.

    Genetics is certainly powerful but it’s not the only risk for dementia since it is such a complex condition without just one cause. Hormones, trauma, inflammation, cardio-metabolic, mental health issues are just some of the factors that contribute. A focused, personalized assessment can uncover hidden risks and most importantly, help determine strategies to mitigate them.

  • Signs of dementia are evident in brains even 10-30 years before cognitive symptoms begin so it’s never too early to start. In women it’s especially helpful to start before or in early menopause. Ideally we start to think proactively in our 30s to 60s but it’s also never too late to optimize brain health and resilience.

  • I do not participate in any insurances but Healthspan Neurology is NOT a concierge practice. There are no premiums or monthly fees. Fees will be transparent and discussed during your complimentary 20-minute introductory call. My fee structure is en par with most professional fees (lawyers, accountants etc) and payment is expected at time of scheduling.

  • Dementia Prevention should be highly individualized to be most effective and we use data to direct our strategy. All patients will have baseline in-house cognitive testing using an FDA class 2 medical device (included in my charges). Bloodwork will almost always include advanced lipids, hormone, nutritional, metabolic and inflammatory testing (non-routine).

    We will also discuss whether genetic testing might be appropriate for you, what it could mean in terms of your risk and most importantly, what would you gain by knowing this information.

    Further testing may also include:

    • NeuroQuant MRI

    • Continuous Glucose Monitoring (CGM)

    • body composition DEXA

    • coronary CT calcium scan

    • vascular imaging studies

    • sleep study

    • exercise physiology testing

    • serum amlyoid/tau biomarkers

  • Most testing will be done at a local lab or imaging facility in Rochester, NY that participates with insurance so some of this may be directly covered by your insurance.

    There is some testing that I know insurance will almost definitely not cover. In these cases, although I can not guarantee charges from an outside facility, I can provide information about the fees that they have set.

    I will always consider cost/benefit when prioritizing testing and will try to help get prior authorization for testing when possible.

  • Yes. I welcome you to schedule an introductory phone call to discuss your needs and determine whether the Dementia Prevention Pathway or the Neurologic Consultation Pathway are appropriate for you.

  • I do! I’ve been a general neurologist for over 25 years and have expertise in diagnosing and managing a broad array of conditions such as epilepsy, migraine, multiple sclerosis, neuropathy and neuromuscular disorders, gait and movement disorders (such as Parkinsons Disease) as well as dementia (such as Alzheimers Disease). I invite you to call me to learn more about my general neurologic consultation services.

  • No, I do not.

  • Amazing! You have already built the foundations of optimizing your brain health. This takes a lot of time and energy but I want you to work smarter, not harder and knowing the data can help motivate how you focus your efforts. Advanced diagnostics can also identify risks you may not have been aware of and which often go unnoticed on routine testing or in spite of looking and feeling “in shape”.

    The Dementia Prevention Pathway will 1) identify your healthspan goals 2) determine your individual risk factors so you know how to prioritize your efforts 3) objectively measure your progress over time to keep you motivated 4) break it down for you into a simple stepwise strategy and personalized tactics 5) hold you accountable.

    We are in it for the long game!

  • I really value the in-person experience but understand that telemedicine is often more convenient or all that’s possible.

    Home visits are also an option for patients with mobility issues.

    I invite you to discuss your preferences during our introductory phone call.

  • Over 21 years I built many special relationships with my patients and their families and I miss them dearly. I invite prior patients to call to find out if the Neurologic Consultation pathway is an appropriate option for prior patients if they feel that a single visit would be helpful to review their status, medications and other treatment modalities.