I worry about dementia onset too. My Gran spent the last decade of her life in a dementia ward of a nursing home. She didn't have Alzheimer's, though. She suffered a series of mini-strokes over the years. These days, they call that TIAs (transient ischemic attacks). She began having these in her 50s. My mother, her daughter, never suffered them. And, I'm turning 60 in June and have yet to show signs of any TIAs.
Gran had pretty serious hypertension that was never well controlled – I guess they couldn't adequately control it in the 1970s and 80s. Her TIAs were always in response to sudden, wildly high blood pressure spikes during times of stress.
Mother had high blood pressure too, but it was better controlled; it would have been well controlled if she'd adhered to the dietary restrictions and physical activity advice. I have high blood pressure, but it's well controlled because I do adhere to dietary restrictions and and try to follow physical activity advice.
Still, it's one of my deepest fears… losing myself in pieces until I don't know my own mind or loved ones. And, the idea of my son watching me decline as I watched my Gran decline hurts to think about.