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Individualized clinical management of patients at risk for Alzheimer's dementia.

TitleIndividualized clinical management of patients at risk for Alzheimer's dementia.
Publication TypeJournal Article
Year of Publication2019
AuthorsIsaacson 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
JournalAlzheimers Dement
Volume15
Issue12
Pagination1588-1602
Date Published2019 12
ISSN1552-5279
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.

DOI10.1016/j.jalz.2019.08.198
Alternate JournalAlzheimers Dement
PubMed ID31677936
PubMed Central IDPMC6925647
Grant ListP01 AG026572 / AG / NIA NIH HHS / United States
R01 AG057931 / AG / NIA NIH HHS / United States
UL1 TR002384 / TR / NCATS NIH HHS / United States

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