The clinical practice of risk reduction for Alzheimer's disease: A precision medicine approach. Issue 12 (13th November 2018)

• Record Type: Journal Article
• Authors: Isaacson, Richard S.; Ganzer, Christine A.; Hristov, Hollie; Hackett, Katherine; Caesar, Emily; Cohen, Randy; Kachko, Robert; Meléndez‐Cabrero, Josefina; Rahman, Aneela; Scheyer, Olivia; Hwang, Mu Ji; Berkowitz, Cara; Hendrix, Suzanne; Mureb, Monica; Schelke, Matthew W.; Mosconi, Lisa; Seifan, Alon; Krikorian, Robert
• Is Part Of: Alzheimer's & dementia. Volume 14:Issue 12(2018)
• Page Start: 1663
• Page End: 1673
• Publication Date: 2018-11-13
• Subjects: Alzheimer's disease prevention -- Clinical precision medicine -- Alzheimer's precision medicine -- Multidomain interventions -- Alzheimer's Prevention Clinic -- Personalized medicine -- APOE -- Preclinical Alzheimer's disease; Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1016/j.jalz.2018.08.004
• Languages: English
• ISSNs: 1552-5260

Abstract

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.