Dear Carol: My mom had younger-onset Alzheimer’s and my dad had Lewy body dementia, so I’ve spent years as a dementia caregiver. I don’t regret what I did for them, but I don’t want to put that worry on my own kids. I’m 60 years old and try to live a healthy lifestyle, but every time I misstate an idea, forget a word or neglect to do something routine, I wonder, is this it? Is this the first sign? I can even see the concern in my kids’ faces when I do something a little off. I know that others with this genetic risk have the same fears. How do they handle this obsession? — JK.

Dear JK: Most people who have crossed into later middle age and beyond have similar thoughts, but those who have watched a parent go through younger-onset Alzheimer’s are often the most concerned, and with good reason.

You sound like a person who has kept up with research enough to understand some of the risks, so I’m not going to brush off your worry. Some people have genetic testing done, but others don’t since as of now there is no proven pharmaceutical intervention or cure. Still, there are continuing studies being conducted on potential drugs so if being in a study would make you feel more proactive, you could consider that.

Research suggests that everyone — but particularly those most at risk — should exercise, eat well, get quality sleep, avoid stress and take care of their emotional health. All of these are considered helpful in that they have the potential to at least stave off some of the worst symptoms of dementia even for those who carry high-risk genes.

Be aware that while there are all kinds of “diets” now aimed at staying healthy, it’s generally best to stay away from extremes. The same goes for exercise. Finding something in both categories that you can stick with is most likely going to be more helpful than becoming obsessed with one strategy only to harm yourself or simply burn out.

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Remember, too, that some things we can only control to a degree. For example, there are multiple studies revealing how bad the lack of sleep can be for our brains. In fact, there’s so much that people lose sleep over the worry (true)!

So, as with exercise, try to find a sleep pattern that works for you. You know the drill, of course. Wind down in the evening. Don’t use technology too late. Eat a lighter evening meal. Much advice is available, but you need to do what works for you. If sleep is a serious challenge, be sure to talk to your doctor.

Lastly, while it’s natural for you to be concerned about this, stress itself adds to your risk. You wouldn’t be the first to see a counselor so you could talk this out enough to keep the fear from stealing the pleasure you could be having in life right now. Wishing you good things. You’ve certainly earned some.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at She can be reached through the contact form on her website.