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Individualized clinical management of patients at risk for Alzheimer's dementia.
Isaacson, Richard S; Hristov, Hollie; Saif, Nabeel; Hackett, Katherine; Hendrix, Suzanne; Melendez, Juan; Safdieh, Joseph; Fink, Matthew; Thambisetty, Madhav; Sadek, George; Bellara, Sonia; Lee, Paige; Berkowitz, Cara; Rahman, Aneela; Meléndez-Cabrero, Josefina; Caesar, Emily; Cohen, Randy; Lu, Pei-Lin; Dickson, Samuel P; Hwang, Mu Ji; Scheyer, Olivia; Mureb, Monica; Schelke, Matthew W; Niotis, Kellyann; Greer, Christine E; Attia, Peter; Mosconi, Lisa; Krikorian, Robert.
Affiliation
  • Isaacson RS; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA. Electronic address: rii9004@med.cornell.edu.
  • Hristov H; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Saif N; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Hackett K; Department of Psychology, Temple University, Philadelphia, PA, USA.
  • Hendrix S; Biostatistics, Pentara Corporation, Salt Lake City, UT, USA.
  • Melendez J; Jersey Memory Assessment Service, Health and Community Services, Jersey, United Kingdom.
  • Safdieh J; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Fink M; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Thambisetty M; Clinical and Translational Neuroscience Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA.
  • Sadek G; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Bellara S; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Lee P; College of Letters and Science, University of California Los Angeles, Los Angeles, CA, USA.
  • Berkowitz C; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Rahman A; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Meléndez-Cabrero J; Department of Neurology, Weill Cornell Medicine, San Juan, PR, USA.
  • Caesar E; Loyola School of Medicine, Chicago, IL, USA.
  • Cohen R; Department of Cardiology, Crystal Run Healthcare, Middletown, NY, USA.
  • Lu PL; Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
  • Dickson SP; Biostatistics, Pentara Corporation, Salt Lake City, UT, USA.
  • Hwang MJ; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Scheyer O; School of Law, University of California Los Angeles, Los Angeles, CA, USA.
  • Mureb M; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Schelke MW; Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
  • Niotis K; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Greer CE; Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Attia P; Attia Medical, New York, NY, USA.
  • Mosconi L; Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA.
  • Krikorian R; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Alzheimers Dement ; 15(12): 1588-1602, 2019 12.
Article in En | MEDLINE | ID: mdl-31677936
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.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Health Education / Patient Compliance / Risk Reduction Behavior / Alzheimer Disease / Cognitive Dysfunction / Prodromal Symptoms Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Alzheimers Dement Year: 2019 Type: Article
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Health Education / Patient Compliance / Risk Reduction Behavior / Alzheimer Disease / Cognitive Dysfunction / Prodromal Symptoms Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: Alzheimers Dement Year: 2019 Type: Article