Individualized clinical management of patients at risk for Alzheimer's dementia
This new study of ~150 people of various ages indicates that lifestyle interventions can reduce risk, delay onset by at least several years, and in some cases improve cognition. The better one follows the lifestyle recommendations, the better the outcome.
It's curious how this article does not reference Dale Bredeson's publications, which seem to be some of the most closely related studies. I sense some sort of "distancing" by this group, like there is some sort of professional disagreement perhaps? The study design, interventions, and even the phrasing seem similar to Bredeson's prior work published in the journal Aging. Not that I want to get involved in a spat, but clearly there is something going on.
Multidomain intervention for Alzheimer's disease (AD) risk reduction is an emerging therapeutic paradigm.
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.
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.
Individualized multidomain interventions may improve cognition and reduce AD/cardiovascular risk scores in patients at-risk for AD dementia.