Publication Type Academic Article
Authors Isaacson R, Hristov H, Saif N, Hackett K, Hendrix S, Melendez J, Safdieh J, Fink M, Thambisetty M, Sadek G, Bellara S, Lee P, Berkowitz C, Rahman A, Meléndez-Cabrero J, Caesar E, Cohen R, Lu P, Dickson S, Hwang M, Scheyer O, Mureb M, Schelke M, Niotis K, Greer C, Attia P, Mosconi L, Krikorian R
Journal Alzheimers Dement
Volume 15
Issue 12
Pagination 1588-1602
Date Published 10/31/2019
ISSN 1552-5279
Keywords Alzheimer Disease, Cognitive Dysfunction, Health Education, Patient Compliance, Prodromal Symptoms, Risk Reduction Behavior
Abstract 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.
DOI 10.1016/j.jalz.2019.08.198
PubMed ID 31677936
PubMed Central ID PMC6925647
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