Vascular health is brain health
What's good for your arteries is good for your brain. ApoB, insulin, inflammation and blood pressure all matter here.
✦ Aging Well
Sharp,engaged,yourself.
Memory, word-finding, processing speed — protectable, often improvable, and worth taking seriously early.
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✦ The pattern
“Most cognitive decline starts decades before symptoms. The earlier we look, the more we can do.”
I treat cognitive health as a long arc. By the time meaningful symptoms appear, the underlying changes have usually been going on for 15 or 20 years — but they don't appear out of nowhere, and the levers are real.
Whether you're noticing word-finding lapses in your 50s, watching a parent decline, or simply want to age with a sharp mind, the work-up and the protocol matter.
✦ Worth knowing
Three things to hold onto.
Sleep clears the brain
Deep sleep is when the brain literally washes itself. Chronic poor sleep is one of the most consistent predictors of cognitive decline.
Most early changes are reversible
Subjective cognitive decline and mild cognitive impairment often have addressable causes — thyroid, B12, sleep apnea, medication side effects, inflammation, depression.
✦ The work
How I think about cognitive health.
01
What I rule out
Full thyroid, B12 and folate (with MMA where indicated), vitamin D, homocysteine, hsCRP, ApoB, fasting insulin, hormones, sleep apnea screen, medication review (anticholinergics are a common silent driver). Sometimes APOE genotyping if it'll change the plan.
02
Where the levers are
Sleep architecture and apnea treatment. Strength training and aerobic capacity. Diet pattern (Mediterranean-style, blood-sugar-stable). Social and cognitive engagement. Targeted nutrients (omega-3s, B-complex, others). Stress and depression treatment when they're driving it. Hormone support for some.
03
When to escalate
Persistent change documented over months, anything affecting daily function, family history with strong concern — that's when imaging, neurology and formal cognitive testing belong. I refer and stay in the loop.
✦ How I'd work with youConsidered.
Considered.
Tested.
Re-tested.
Annual cognitive review, full labs every 12 months, ongoing protocol adjustments. This is slow work that compounds — and it's most powerful when started before symptoms become obvious.
Therapies I'd likely use
✦ Common questions
You're probably wondering.
I forget names — should I worry?
Probably not, but worth a baseline. Occasional word-finding lapses are common at any age. We rule out the simple causes and set a marker for the future.
My parent has dementia — what can I do for them?
Plenty. Even in moderate dementia, nutrient gaps, medication review, sleep and engagement matter. I work alongside their medical team and family.
Are nootropics worth taking?
A few have decent evidence (notably omega-3s and B-complex in deficiency states). Most aren't worth the cost. We choose based on your labs and case.
✦ Next step
Ready to talk it through?
Book a free 15-minute discovery call. I'll listen, you'll ask questions, and we'll decide together if this is the right fit.
Aging Well · Cognitive Health