On ‘Conversations With Cam’: Can a Scratch-and-Sniff Test Predict Early Signs of Brain Damage?

The memory loss and movement issues tied to Alzheimer’s or Parkinson’s aren’t the beginning of these diseases—they’re the final act of a process that started decades earlier. “These diseases start 30 years before the first obvious symptom presents,” explains Dr. Kellyann Niotis, one of only two preventative neurologists today. If that timeline sounds alarming, it should. But it also represents hope: The early you start protecting your brain, the better your chances of avoiding neurological decline altogether.

On a recent episode of Conversations With Cam, host Cameron Rogers sits down with her old sorority sister, whose career path has taken a groundbreaking turn. Dr. Niotis’s mission is as ambitious as it is personal: to stop brain diseases before they start.

For Rogers, the subject matter hits close to home. She opens up about living with the aftermath of concussions, postpartum memory lapses, and a family history of Alzheimer’s. “My grandfather had Alzheimer’s, and I’ve always felt super protective over my brain after my car accident,” she shares. That admission opens the door for a discussion on how lifestyle, genetics, and even small daily habits play a role in shaping brain health.

Prevention can’t wait

One of the biggest misconceptions about brain health is that you don’t need to think about it until problems arise. Dr. Niotis is quick to point out why that approach can be dangerous. By the time memory loss or movement issues appear, the disease process has already been underway for decades.That’s why she encourages people to pay attention in their 30s and 40s, when preventive steps can make the greatest impact. “That means in your 30s and 40s that’s the time to start caring, not when symptoms have started,” she says. With advances in testing, including bloodwork and smell assessments, it’s now possible to detect risk factors long before noticeable decline. The earlier someone understands their genetic profile, lifestyle risks, or subtle changes in brain function, the better chance they have of slowing or even avoiding disease progression altogether.

The power of smell tests and bloodwork

Brain health testing doesn’t always look like what you’d expect. One of the first steps in Rogers’s assessment with Dr. Niotis was a scratch-and-sniff booklet. Losing your sense of smell is one of the earliest signs of a neurodegenerative process. “This can happen 20 to 30 years before,” Dr. Niotis explains. While conditions like concussions, sinus issues, or COVID can also affect smell, tracking changes over time can reveal early neurological shifts.

Alongside the sniff test, Dr. Niotis uses extensive bloodwork to look for genetic and biological markers of risk. One of the most important is the APOE gene. “The one form called APOE4 in particular is linked to a higher risk of both Alzheimer’s and Lewy body dementia,” she notes. Identifying the gene allows her to personalize recommendations, from diet changes to supplement choices. “What’s good for the heart is good for the brain,” she adds, stressing the connection between cholesterol levels and long-term cognitive health.

Sleep and mental health are non-negotiables

When it comes to rest, the research is clear. “Sleep is where we consolidate our memories…and clear these toxic proteins that are related to Alzheimer’s and Parkinson’s from our brain,” Dr. Niotis explains. Consistently getting less than six hours doubles the risk of dementia and even raises the risk of early death. The key, she says, is to focus on quality as well as quantity. Alcohol or sleep aids may help someone fall asleep, but they disrupt the restorative cycles the brain depends on.

Mental health is just as important. Untreated depression and anxiety aren’t simply emotional burdens—they can raise the risk of neurological disease. “Letting mental health go unchecked is just such a missed opportunity,” Dr. Niotis stresses. She urges listeners not to shy away from treatment, reminding them that mood disorders often reflect changes in brain chemistry, not personal weakness.

Lifestyle choices that can affect brain health

Beyond genetics, daily habits play a powerful role in protecting the brain. Dr. Niotis highlights several areas where simple changes can have lasting impact:

1. Prioritize exercise
“Exercise might be the most important lever to pull for health collectively,” Dr. Niotis says. She recommends a mix of cardio and strength training, emphasizing that lifting heavier weights is especially important for women to build muscle mass and prevent falls later in life.

2. Eat a Mediterranean-based diet
When it comes to food, she encourages a focus on whole, unprocessed meals. “We’re really thinking about a more Mediterranean-based diet,” she explains, pointing to fatty fish, olive oil, fruits, and vegetables as staples, while limiting processed carbs and sugars.

3. Supplement where needed
Blood tests often reveal gaps that diet alone can’t fill. “Omega-3s, vitamin D, and vitamin B12 are the big ones I see most often,” she said. For many people, a daily supplement can help cover what food may not provide.

4. Cut back on alcohol
While often socially accepted, alcohol can significantly harm brain health over time. “Excessive alcohol use is a risk factor,” Dr. Niotis stresses, noting that for women, more than one drink per day is considered too much.

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