Individualized clinical management of patients at risk for Alzheimer's dementia.
Alzheimers Dement
; 15(12): 1588-1602, 2019 12.
Article
en En
| MEDLINE
| ID: mdl-31677936
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Educación en Salud
/
Cooperación del Paciente
/
Conducta de Reducción del Riesgo
/
Enfermedad de Alzheimer
/
Disfunción Cognitiva
/
Síntomas Prodrómicos
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Alzheimers Dement
Año:
2019
Tipo del documento:
Article