1. Individualized clinical management of patients at risk for Alzheimer's dementia
- Author
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Lisa Mosconi, Samuel P. Dickson, Hollie Hristov, Matthew E. Fink, Aneela Rahman, George Sadek, Juan C. Meléndez, Kellyann Niotis, Suzanne Hendrix, Robert Krikorian, Christine Greer, Mu Ji Hwang, Pei-lin Lu, Joseph Safdieh, Richard S. Isaacson, Josefina Meléndez-Cabrero, Olivia Scheyer, Matthew W. Schelke, Sonia Bellara, Katherine Hackett, Paige Lee, Madhav Thambisetty, Emily Caesar, Peter Attia, Cara Berkowitz, Monica Mureb, Nabeel Saif, and Randy Cohen
- Subjects
Male ,medicine.medical_specialty ,Epidemiology ,Psychological intervention ,Prodromal Symptoms ,Disease ,Article ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Cognition ,0302 clinical medicine ,Developmental Neuroscience ,Alzheimer Disease ,Internal medicine ,Intervention (counseling) ,Humans ,Medicine ,Dementia ,Cognitive Dysfunction ,Alzheimer s dementia ,Prospective Studies ,030212 general & internal medicine ,Cognitive decline ,Health Education ,Aged ,business.industry ,Health Policy ,Middle Aged ,medicine.disease ,Psychiatry and Mental health ,Cardiovascular Diseases ,Patient Compliance ,Female ,Neurology (clinical) ,Personalized medicine ,Geriatrics and Gerontology ,business ,Risk Reduction Behavior ,Biomarkers ,030217 neurology & neurosurgery - Abstract
INTRODUCTION: Multi-domain intervention for Alzheimer’s disease (AD) risk reduction is an emerging therapeutic paradigm. METHODS: Patients were prescribed individually-tailored interventions (education/pharmacologic/non-pharmacologic) and rated on compliance. Normal cognition/subjective cognitive decline/preclinical-AD were classified as Prevention. Mild cognitive impairment due to AD/mild-AD were 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: 174 were assigned interventions (age 25–86). Higher-compliance Prevention improved more than both historical cohorts (P=.0012,P
- Published
- 2019