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

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
Fiver
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New paper: Individualized clinical management of patients at risk for Alzheimer's dementia

Postby Fiver » Wed Oct 30, 2019 1:02 pm

Individualized clinical management of patients at risk for Alzheimer's dementia
https://www.alzheimersanddementia.com/article/S1552-5260(19)35368-3/fulltext

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.


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.
Concerned, but hopeful. Introverted, but will talk about science.

broiler_x
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Re: New paper: Individualized clinical management of patients at risk for Alzheimer's dementia

Postby broiler_x » Fri Nov 01, 2019 7:47 am

This is a very promising study and the first clinical study to show cognitive improvement via lifestyle changes in those at risk for Alzheimer's. Here's a an article about the study written more for the lay person:

https://www.cnn.com/2019/10/30/health/alzheimers-lifestyle-changes-improved-memory-wellness/index.html

And if you don't want to read anything, but just want to know what those lifestyle changes are that resulted in the improved cognition? It should come to no surprise to this group: exercise, intermittent fasting and/or reduced carbohydrate intake and good sleep.


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