| Title | Individualized clinical management of patients at risk for Alzheimer's dementia. |
| Publication Type | Journal Article |
| Year of Publication | 2019 |
| Authors | Isaacson RS, Hristov H, Saif N, Hackett K, Hendrix S, Melendez J, Safdieh J, Fink M, Thambisetty M, Sadek G, Bellara S, Lee P, Berkowitz C, Rahman A, Meléndez-Cabrero J, Caesar E, Cohen R, Lu P-L, Dickson SP, Hwang MJi, Scheyer O, Mureb M, Schelke MW, Niotis K, Greer CE, Attia P, Mosconi L, Krikorian R |
| Journal | Alzheimers Dement |
| Volume | 15 |
| Issue | 12 |
| Pagination | 1588-1602 |
| Date Published | 2019 12 |
| ISSN | 1552-5279 |
| Abstract | INTRODUCTION: Multidomain intervention for Alzheimer's disease (AD) risk reduction is an emerging therapeutic paradigm. METHODS: Patients were prescribed individually tailored interventions (education/pharmacologic/nonpharmacologic) and rated on compliance. Normal cognition/subjective cognitive decline/preclinical AD was classified as Prevention. Mild cognitive impairment due to AD/mild-AD was classified as Early Treatment. Change from baseline to 18 months on the modified Alzheimer's Prevention Cognitive Composite (primary outcome) was compared against matched historical control cohorts. Cognitive aging composite (CogAging), AD/cardiovascular risk scales, and serum biomarkers were secondary outcomes. RESULTS: One hundred seventy-four were assigned interventions (age 25-86). Higher-compliance Prevention improved more than both historical cohorts (P = .0012, P < .0001). Lower-compliance Prevention also improved more than both historical cohorts (P = .0088, P < .0055). Higher-compliance Early Treatment improved more than lower compliance (P = .0007). Higher-compliance Early Treatment improved more than historical cohorts (P < .0001, P = .0428). Lower-compliance Early Treatment did not differ (P = .9820, P = .1115). Similar effects occurred for CogAging. AD/cardiovascular risk scales and serum biomarkers improved. DISCUSSION: Individualized multidomain interventions may improve cognition and reduce AD/cardiovascular risk scores in patients at-risk for AD dementia. |
| DOI | 10.1016/j.jalz.2019.08.198 |
| Alternate Journal | Alzheimers Dement |
| PubMed ID | 31677936 |
| PubMed Central ID | PMC6925647 |
| Grant List | P01 AG026572 / AG / NIA NIH HHS / United States R01 AG057931 / AG / NIA NIH HHS / United States UL1 TR002384 / TR / NCATS NIH HHS / United States |