Board-certified across five areas of brain function: Neurology, Psychiatry, Pain Medicine, Brain Injury Medicine, and Behavioral Neurology & Neuropsychiatry. Park Avenue Neurology was established on Manhattan’s Upper East Side in 1999 as the New York Memory and Healthy Aging Services.
Alzheimer's Prevention & Dementia Risk Reduction in New York City
“My mother's illness got me into brain health thirty years ago. I've practiced it ever since—for my patients, and for myself.” Gayatri Devi, MD
Not everyone who thinks about their brain is unwell. Much of what shapes brain health begins long before symptoms appear. Several of the risks for Alzheimer's disease and other dementias can be identified and changed.
For those who are well but want to understand and reduce their own risk—because of family history, an APOE result, or a wish to understand what can be done now—Dr. Devi's evaluation begins with a careful personal and family history, with attention to cerebrovascular and metabolic health. Formal cognitive testing establishes a baseline. Laboratory and genetic testing and appropriate brain imaging complete the evaluation.
The purpose of the evaluation is to decide what matters.
Each person leaves with a written plan: where things stand, the risks that deserve attention, and what can reasonably be done about them. For some, that means further testing or treatment, with medication, targeted brain exercises, or another approach such as brain stimulation. For others, changes in sleep, vascular health, hearing, or other aspects of daily life. The plan is clear and ordered, with the most important steps first.
Decades of caring for people with memory loss have shaped Dr. Devi's approach to brain health: understand what matters, and change what can be changed.
Can dementia be prevented?
Not all dementia can be prevented, but a substantial share of risk can be changed. The 2024 Lancet Commission on dementia estimated that about 45% of dementia cases worldwide are associated with 14 modifiable risk factors: less education, hearing loss, high LDL cholesterol, depression, traumatic brain injury, physical inactivity, diabetes, smoking, high blood pressure, obesity, excessive alcohol use, social isolation, air pollution, and untreated vision loss. The evaluation identifies which of these apply to each person and which deserve attention first.
Who should consider a dementia risk evaluation?
People without memory symptoms who have a parent or sibling with Alzheimer's disease or another dementia; people who have learned they carry one or two copies of APOE ε4; people with vascular or metabolic risk factors such as high blood pressure, diabetes, or high cholesterol; and women who notice changes in memory or concentration around menopause.
What does an APOE ε4 result mean?
APOE ε4 is the most common genetic risk factor for late-onset Alzheimer's disease. It raises risk, more so with two copies than with one, but it does not by itself determine whether or when a person will develop the disease. A result is most useful when it is interpreted alongside family history, vascular health, and cognitive testing. APOE genotype also matters if anti-amyloid treatment is ever considered, because it affects the risk of side effects known as ARIA.
Should I get an Alzheimer's blood test if I have no symptoms?
Blood tests that measure Alzheimer's-related proteins, such as p-tau217, are now available. Current clinical guidance supports their use in people who have cognitive symptoms, to help clarify a diagnosis. They are not recommended as a screening test for people who are well, because a positive result does not predict whether, or when, memory loss will develop.