FORT LAUDERDALE, Fla. — Is your memory faltering, or are you experiencing early signs of Alzheimer’s? Does your family history mean you are more likely to develop the disease?

Learning your Alzheimer’s risk — and taking steps to curb it — is getting easier in South Florida with less invasive, more accessible, and more accurate testing options.

Previously, evaluating Alzheimer’s risk or detecting early brain abnormalities required invasive spinal taps, expensive PET scans, or limited genetic testing. Today, advances in blood tests, biomarker screening, and comprehensive risk-profiling tools let you understand your susceptibility early and take action.

“The good news is dementia has really gotten easy to diagnose at an early stage,” said Dr. Robert Koltan, chairman of Thema Brain Health in Boca Raton.

Biomarker blood testing is a newer option

Alzheimer’s-specific biomarker blood tests are quickly becoming a go-to screening option. While primarily designed for people with subtle memory concerns, they can also indicate what may lie ahead before symptoms appear.

Available through commercial labs like Labcorp and Quest, these tests detect signs of Alzheimer’s disease by measuring specific proteins in the blood, such as tau and beta-amyloid. In people with Alzheimer’s, amyloid plaques and tau tangles build up in the brain and begin accumulating years before noticeable symptoms surface.

“Anyone who wants to know their risk should measure these proteins,” Kolton said. “Blood biomarkers often are elevated 15 to 20 years before symptoms. If they are present, it doesn’t mean you are definitely going to get Alzheimer’s, but you may want to reduce your risk by living as healthy a lifestyle as you can.”

In addition to targeted biomarker tests, routine screening blood work can help rule out or identify other treatable conditions that cause dementia-like symptoms.

Genetic testing reveals risk

Genetic testing offers another layer of insight. A standard blood test or cheek swab for the APOE4 gene variant can show your genetic predisposition. Carrying one copy of the APOE4 gene increases the risk of developing Alzheimer’s disease by roughly 2 to 4 times compared to someone without it, while carrying two copies increases risk by roughly 8 to 12 times.

“Having a ‘risk gene’ does not mean a person will definitely develop Alzheimer’s. It just increases your chances,” said Joe Baldelomar, program director for the Alzheimer’s Association in Florida. Some people with APOE4 never develop the disease, he notes.

Beyond genetics, other factors that contribute to dementia risk include family history, unmanaged hearing loss, chronic conditions such as diabetes and liver disease, smoking, and heavy alcohol use. Online calculators and lifestyle questionnaires — which evaluate age, family history, cardiovascular health, diet, and exercise habits — also offer a practical estimate of your overall vulnerability.

Baldelomar emphasizes that having a family history of dementia is not a guarantee of diagnosis. “I try to explain to people that it just increases your chances,” he said.

Age remains the single largest risk factor, with the likelihood of developing Alzheimer’s doubling roughly every five years after age 65. South Florida leads the US in percentage of people with Alzheimer’s.

However, as Kolton noted: “Cognitive decline is not a normal part of aging; it’s a disease, and there is something you can do about it.”

What to do if your risk is high

Knowing you are at increased risk empowers you to make meaningful lifestyle changes.

“You can make a decision if risk is high. It doesn’t mean you won’t get it. If you want to, you can reduce your risk by living as healthy a lifestyle as you can,” Kolton said.

Proactive steps to lower your risk include:

•Manage blood pressure and blood sugar: Uncontrolled hypertension, high cholesterol, and elevated blood sugar damage cerebral blood vessels and accelerate cognitive decline.

•Protect and test your hearing: Unaddressed age-related hearing loss is one of the largest mid-life modifiable risk factors for dementia.

•Engage in regular physical exercise: Aim for at least 150 minutes per week of moderate aerobic activity, supplemented by strength training twice weekly.

•Adopt the MIND Diet: Follow a meal plan combining Mediterranean and DASH diet principles rich in leafy greens, berries and healthy fats.

•Prioritize sleep quality: Target seven to eight hours of restorative sleep nightly, and seek evaluation for conditions like sleep apnea if present.

•Maintain active social connections: Frequent, meaningful social interaction is linked to lower rates of cognitive decline.

“When you apply those things to your daily living, you can reduce your chance of getting Alzheimer’s by as much as 40%,” Baldelomar said.

Getting an accurate diagnosis

To evaluate whether routine memory lapses or behavioral changes point to dementia, South Florida specialists use a combination of personal medical history, cognitive assessments, physical exams and diagnostic imaging.

Dr. Ivan E. Cichowicz, a geriatric psychiatrist with Cognitiva Brain Health in Boca Raton, uses digital screening tools to evaluate core cognitive domains. “It lets you know where you stand compared to peers, measuring short-term recall, attention, focus, executive functioning, visual and verbal memory,” he said.

“I usually tell patients, if you are below the 35th percentile, it’s not where you want your brain to be,” he said.

Cichowicz also conducts thorough in-person evaluations. Neurologists often test reflexes, balance, gait, eye movement and muscle tone to help pinpoint a diagnosis.

While more invasive and costly tests like spinal taps (cerebrospinal fluid draws) and PET scans are still used, Cichowicz and Kolton expect to see them used less often as blood-biomarker testing advances.

Taking action after diagnosis

A diagnosis of dementia or Alzheimer’s does not leave patients without options to manage the disease.

“We use something called TMS or a modified form to stimulate your brain, and that has been shown to help,” Cichowicz said.

For slowing disease progression in its early stages, FDA-approved monoclonal antibody therapies — such as Leqembi and Kisqali — are available.

Kolton said Thema Brain Health currently treats about 100 patients with these infusion therapies. “The data show the earlier you use them, the more effective, and we are seeing that,” he said.

Additionally, numerous clinical trials evaluating promising new therapies are actively enrolling participants across South Florida.

“There are hundreds of drugs in stage 2 and 3 trials to treat various aspects of dementia and aid in deferring the progression that may be going on,” Kolton said. “It’s exciting.”

Because of these treatment and research advances, the Alzheimer’s Association strongly advocates early detection and diagnosis.

“It gives you a chance to see if you qualify for current therapies being tested,” Baldelomar said. “Not everyone qualifies for every trial, but the earlier you know, the more access you may have to treatments and research.”

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