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

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