Brain Health and Dementia
We go after dementia risk decades early.
The changes that lead to dementia start quietly, often twenty or thirty years before any memory problem shows up, which is exactly when there is the most to do about them. Our prevention plan works on every lever we can pull: exercise and strength training designed specifically to protect the brain, keeping blood pressure under 120/80, optimizing your Omega 3 levels and homocysteine, and getting your lipids, sleep, and metabolic health where they need to be. What is good for the heart is good for the brain, and we push on both harder and earlier than a standard checkup does.
We start with your inherited risk: family history and ApoE genotype (a gene that shifts your Alzheimer's risk up or down). People who carry the ApoE4 version get a plan built around it. Dementia affects women roughly twice as often as men, and we account for that.
Exercise is the most powerful tool we have. The right mix of strength and cardio training raises BDNF (a protein that helps the brain build and keep healthy nerve cells), so we prescribe training deliberately instead of telling you to stay active.
We drive vascular and metabolic health hard, because what is good for the heart is good for the brain: blood pressure under 120/80, lipids and blood sugar in range, homocysteine (an amino acid that, when high, is linked to faster brain aging) brought down, and an omega-3 index (the level of beneficial fish oil fats in your red blood cells) at a target of 10 to 12 percent.
We screen for sleep apnea and check hearing, since both are treatable contributors to decline, and sleep matters because it is when the brain clears out waste.
When warranted, we use the MoCA (a brief in-office memory test) or refer you, and for higher risk patients, brain MRI with NeuroQuant volumetrics (a scan that measures specific brain regions to catch shrinkage early). We also track plasma p-tau217 (a newer blood marker tied to the plaque buildup behind Alzheimer's) as an emerging tool.
We cannot promise to prevent dementia. What we can do is meaningfully lower your risk. As Dr. Richard Isaacson puts it, "Alzheimer's disease is in large part a preventable illness."
This is one part of a complete, personal risk assessment.
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