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Max Lugavere seems an unlikely patient to be sitting in an Alzheimer's clinic.

The fit, 32-year-old, dressed in Converse All-Star sneakers and a white T-shirt, eats a carefullycalibrated diet and exercises regularly. He takes supplements of omega-3 fatty acids and vitamins Band D. He also has zero symptoms of memory or cognitive loss.

"I generally like to feel I have a handle on my health," Mr. Lugavere says during a session withRichard Isaacson, director of the Alzheimer's Prevention Clinic at NewYork-Presbyterian/WeillCornell Medical Center in Manhattan. "My mother is 62 and she has memory loss and cognitivedifficulty.… So when I came across this idea of dementia prevention, it was eye-opening," says Mr.Lugavere, a filmmaker who lives in Los Angeles and New York.

Alzheimer's experts increasingly are researching ways to prevent or delay memory decline instead ofjust focusing on treating patients who have the disease. There have been encouraging results fromsome studies of preventive strategies, including lifestyle interventions in people at risk fordementia. Some 5.2 million people in the U.S. had Alzheimer's in 2014, a number that is expected toabout triple by 2050.

While Alzheimer's prevention is being widely studied, prevention programs at large medical centersare rare. Some of the field's leading experts say there isn't sufficient evidence to support makingrecommendations beyond eating a heart-healthy diet and exercising regularly, advice that everyoneshould heed. There is no cure or particularly effective treatment for Alzheimer's.

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YOUR HEALTH

Alzheimer's Prevention for 30-Somethings With No SymptomsMax Lugavere Exercises, Cuts Out Shellfish, Takes Cocoa Supplements

By Sept. 15, 2014 7:21 p.m. ET

SUMATHI REDDY

Max Lugavere is 32-years-old and is already taking steps to prevent Alzheimer's disease. Mr. Lugavere andWSJ's Sumathi Reddy discuss on Lunch Break with Tanya Rivero. Photo: Cassandra Giraldo for The WallStreet Journal

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"There is growing evidence that lifestyle modifications do have an impact on our cognitive aging,"said Ronald Petersen, director of the Alzheimer's Disease Research Center at Mayo Clinic inRochester, Minn. "But to really say that we can prevent Alzheimer's disease is a bit of a stretch."

Dr. Isaacson, of Weill Cornell Medical, opened the Alzheimer's Prevention Clinic just over a year ago.Many of his patients are in their 30s or 40s, much younger than the typical age of onset for dementia.And many, like Mr. Lugavere, have a family history of dementia.

Dr. Isaacson doesn't believe physicians should wait for additional randomized controlled trialsbefore working with patients on Alzheimer's prevention. He takes a personalized approach thatfactors in age, gender, race, family history and lifestyle, in addition to physiological markers such asinflammation, metabolism and genetics.

During the session with Mr. Lugavere, Dr. Isaacson poses wide-ranging questions: Do you dream?What did you get on your SAT exams? Do you play music? Mr. Lugavere also is tested for his sense ofsmell, and is instructed to touch his nose and tap his feet.

A genetic test found Mr. Lugavere has two gene variations that could put him at increased risk foreventually developing Alzheimer's. Dr. Isaacson says this could explain why Mr. Lugavere'shomocysteine level is slightly elevated and why some of his LDL cholesterol particles are smaller anddenser than optimum, both of which are risk factors for coronary heart disease. The remainder of hislab results look good.

The University of Alabama at Birmingham Hospital started an outpatient Alzheimer Risk

'The idea that I can take steps todaythat could benefit my brain and preventthe onset of any kind of neurologicalissue, I'm all about that,' Mr. Lugavere,left, says. CASSANDRA GIRALDO FORTHE WALL STREET JOURNAL

‘You can't beat all your genes but you can do something. ’

—Dr. Richard Isaacson

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Assessment and Intervention Clinic in July after hearing from relatives of dementia patientsconcerned about their own health. The clinic offers a two-visit program open to people 45 years ofage and older with no symptoms of memory loss. Participants are given a risk assessment as well ascognitive tests and an MRI scan of their brain to look for brain shrinkage or stroke-related damage.

"Rarely a week goes by in my memory-disorder clinic when I'm not counseling a family memberabout risk," said David Geldmacher, medical director for neurology at UAB Hospital. "There'sgrowing evidence that we can delay the onset or reduce an individual's risk," he said.

At the Mayo Clinic, a long-term study is seeking to develop a formula to help predict a person's riskfor Alzheimer's. The study, which involves 4,000 randomly selected people ages 50 to 89, regularlyevaluates the participants' health, mental status and other traits such as gait speed. Genetic testsalso are done.

By following the participants—the study has been under way for 10 years so far—the researchershope to find associations between those who develop Alzheimer's and what physiological and mentalsigns they have exhibited over the years, said the Mayo Clinic's Dr. Petersen. Preliminary results ofthe study are currently under review for publication in a scientific journal, he said.

Weill Cornell's Dr. Isaacson, who is 36, has four relatives who have had Alzheimer's. "I don't want tosay I'm not worried but I'm obviously going to do things" for prevention, he says.

About five years ago Dr. Isaacson decided to get serious about his brain health and made a number oflifestyle changes, including cutting his intake of sugar and carbohydrates. He also began playing bassguitar in a rock band. (Playing a musical instrument on a regular basis is one of his universalrecommendations for people at risk.)

Studies have found playing a musical instrument delays the onset of cognitive and auditory declinebut what goes on in the brain isn't fully understood.

"I do all the things I tell my patients to do," Dr. Isaacson said. "I eat berries like crazy. I drink coffee. I

Max Lugavere, 32 and healthy, but witha family history of dementia, consultswith Dr. Richard Isaacson onAlzheimer's-prevention strategies.CASSANDRA GIRALDO FOR THE WALLSTREET JOURNAL

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have mocha in the morning—CocoaVia, the same [supplement] I tell my patients to use." Dr.Isaacson says there is enough evidence showing that each of these can help protect against cognitivedecline. He also recommends moderate alcohol consumption.

In his session with Mr. Lugavere, Dr. Isaacson tells him mutations in one of his genes changes theway his body metabolizes B vitamins. So the doctor recommends different versions of vitamin B-12and folic acid.

Mr. Lugavere's other genetic variant requires him to be especially careful about elements of his diet,Dr. Isaacson tells him. Copper in his diet, for example, is a no-no. That means cutting out things likeliver, clams and oysters. Fruits and vegetables grown outside of the U.S., if they aren't organic, alsoshould be avoided because of potential DDT residues.

"You can't beat all your genes but you can do something," Dr. Isaacson says.

Other recommendations for Mr. Lugavere include reducing saturated fat in his diet by 10% to 15%while increasing his intake of lean protein. And, because of Mr. Lugavere's genetic makeup, the moreexercise the better, Dr. Isaacson tells him.

"The idea that I can take steps today that could benefit my brain and prevent the onset of any kind ofneurological issue, I'm all about that," Mr. Lugavere says.

Write to Sumathi Reddy at sumathi.reddy@wsj.com