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The clinical practice of risk reduction for Alzheimer's disease: A precision medicine approach.

TitleThe clinical practice of risk reduction for Alzheimer's disease: A precision medicine approach.
Publication TypeJournal Article
Year of Publication2018
AuthorsIsaacson RS, Ganzer CA, Hristov H, Hackett K, Caesar E, Cohen R, Kachko R, Meléndez-Cabrero J, Rahman A, Scheyer O, Hwang MJi, Berkowitz C, Hendrix S, Mureb M, Schelke MW, Mosconi L, Seifan A, Krikorian R
JournalAlzheimers Dement
Volume14
Issue12
Pagination1663-1673
Date Published2018 12
ISSN1552-5279
KeywordsAdult, Aged, Aged, 80 and over, Alzheimer Disease, Cognition, Female, Humans, Male, Middle Aged, Precision Medicine, Risk Reduction Behavior
Abstract

Like virtually all age-related chronic diseases, late-onset Alzheimer's disease (AD) develops over an extended preclinical period and is associated with modifiable lifestyle and environmental factors. We hypothesize that multimodal interventions that address many risk factors simultaneously and are individually tailored to patients may help reduce AD risk. We describe a novel clinical methodology used to evaluate and treat patients at two Alzheimer's Prevention Clinics. The framework applies evidence-based principles of clinical precision medicine to tailor individualized recommendations, follow patients longitudinally to continually refine the interventions, and evaluate N-of-1 effectiveness (trial registered at ClinicalTrials.gov NCT03687710). Prior preliminary results suggest that the clinical practice of AD risk reduction is feasible, with measurable improvements in cognition and biomarkers of AD risk. We propose using these early findings as a foundation to evaluate the comparative effectiveness of personalized risk management within an international network of clinician researchers in a cohort study possibly leading to a randomized controlled trial.

DOI10.1016/j.jalz.2018.08.004
Alternate JournalAlzheimers Dement
PubMed ID30446421
PubMed Central IDPMC6373477
Grant ListP01 AG026572 / AG / NIA NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States

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