How Do You Evaluate an At‑Risk Patient?

In this episode of The Neuro Experience, I sit down with Dr. Kellyann Niotis—one of the first fellowship-trained preventive neurologists—to reveal how you can protect your brain long before symptoms of Alzheimer’s or dementia appear. With Alzheimer’s cases expected to triple by 2050, Dr. Niotis explains the difference between dementia types, the real role of genes like ApoE4, and why lifestyle choices may be more powerful than genetics.

If you want actionable tools to lower your risk, strengthen your memory, and understand the future of preventive neurology, this conversation delivers science-backed strategies you can start applying today.

About Dr. Kellyann Niotis:

Dr. Kellyann Niotis is the first fellowship-trained preventive neurologist focused on reducing risk for Alzheimer’s, Parkinson’s, and Lewy Body Dementia. She launched the nation’s first Alzheimer’s Prevention Clinic at Weill Cornell and now leads early-detection and brain health research at the Institute for Neurodegenerative Diseases Florida. Her work appears in leading medical journals and has been featured by CNN.

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I’m Louisa Nicola — clinical neuroscientist — Alzheimer’s prevention specialist — founder of Neuro Athletics. My mission is to translate cutting-edge neuroscience into actionable strategies for cognitive longevity, peak performance, and brain disease prevention.

If you're committed to optimizing your brain — reducing Alzheimer’s risk — and staying mentally sharp for life, you’re in the right place.

Stay sharp. Stay informed. Join thousands who subscribe to the Neuro Athletics Newsletter → https://bit.ly/3ewI5P0

Instagram: https://www.instagram.com/louisanicola_/

Twitter : https://twitter.com/louisanicola_

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Topics discussed:

00:00 – Introduction

01:25 – Preventative neurology

02:23 – Dementia vs. Alzheimer’s & Other Types of Dementia

04:08 – What Is Alzheimer’s?

05:26 – Clinical Diagnosis: Imaging & Symptoms

07:07 – How Amyloid Disrupts Neural Communication

09:48 – Genetics vs. Lifestyle: Public Misunderstanding

12:02 – Role of Family History & Genetic Risk

14:04 – The ApoE4 Gene Explained15:07 – ApoE Variants

17:08 – ApoE4 and Lipid Transport in the Brain

18:35 – Immune Response & Infection Susceptibility

20:05 – Hormones: Key Role in Brain Health

21:08 – Genotypes & Risk Multipliers

23:01 – ApoE4 Not Always Deterministic: Population Studies

24:15 – Other Genetic Factors Beyond ApoE

25:13 – Biomarkers: Current Use & Limitations

27:13 – Risks of Self-Testing Biomarkers

28:45 – Why Two-Thirds of Patients Are Women

29:46 – Estrogen, Menopause & Neuroprotection

32:07 – Testosterone & Dementia Risk

35:01 – LDL, ApoB & Brain Health Debate

37:01 – Statins & Dementia: Myths vs. Evidence

39:08 – Fear & Misconceptions Around Cholesterol

41:09 – Lipoprotein(a) & Vascular Dementia Risk

44:39 – Brain Vasculature & Hypertension

49:15 – New Alzheimer’s Drugs & Risks

55:32 – Why Rates Keep Rising (Lifestyle & Stress)

58:11 – Early Signs

01:00:23 – Tau Protein, Tangles & Neuronal Damage

01:05:49 – Keto vs. Mediterranean

01:07:14 – Personalization & Preference for Mediterranean Diet

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