From Fear to Agency: Rethinking Dementia Prevention with Dr Ashanthi Gajaweera

Send us Fan MailDementia is one of the biggest fears people carry quietly, and the hardest part is not knowing what to do with that fear. We sit down with Dr Ashanthi Gajaweera, a neurologist with more than two decades in traditional practice, to unpack why she stepped outside the insurance-based model and founded HealthSpan Neurology, a preventative neurology clinic built around cognitive longevity and dementia risk reduction long before symptoms show up. We talk through what a real dementia prevention programme looks like when you finally have time to do it properly: longer visits, a clear sequence of assessment and testing, and a stepwise plan that prioritises what matters most for the individual rather than dumping “a million things” on one to-do list. Shashanti shares how she thinks about mechanisms that drive cognitive decline such as metabolic health and inflammation, how she sets expectations for patients who feel subtle change, and why empowerment and agency are just as important as lab results. A standout thread is menopause and brain health. Ashanthi explains why hormonal change can intersect with memory, mood, migraines, and overall neurological resilience and why women deserve prevention guidance that takes menopause seriously instead of treating it as an afterthought. We also get candid about the “jungle” of brain health claims, how to avoid pseudoscience without becoming cynical, and what it takes to market a prevention service that many people do not even realise exists. If you care about evidence-based brain health, cognitive longevity, and practical dementia prevention, subscribe, share this with someone who worries about their future, and leave us a review with your biggest takeaway.Guest BiographyDr Ashanthi Gajaweera is a neurologist and founder of Healthspan Neurology, a preventative practice focused on dementia prevention and cognitive longevity. After 20+ years in traditional medicine, she transitioned away from the insurance-based model to create a more proactive, patient-centred approach to brain health.Her work centres on helping individuals understand and reduce their risk of cognitive decline before symptoms appear, using an evidence-informed and personalised framework. With certification in menopause care, she brings a unique perspective to how hormonal changes in midlife impact brain health.Known for her clear, data-driven approach and her stance against pseudoscience, Dr Gajaweera empowers patients to move from fear to agency, with practical strategies to take control of their long-term cognitive health.LinksWebsite: healthspanneurology.com LinkedIn: https://www.linkedin.com/in/drgajaweera/About Dr Andrew GreenlandDr Andrew Greenland is a UK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. With dual training in conventional and root-cause approaches, he helps individuals optimise health, performance, and longevity — with a focus on cognitive resilience and healthy ageing.Voices in Health and Wellness features meaningful conversations at the intersection of medicine, lifestyle, and human potential — with clinicians, scientists, and thinkers shaping the future of care.💌 Join the mailing list for new episodes and exclusive reflections: https://subscribe.voicesinhealthandwellness.com