The clinical practice of risk reduction for Alzheimer's disease: A precision medicine approach
| Autor: | Robert Kachko, Matthew W. Schelke, Olivia Scheyer, Lisa Mosconi, Emily Caesar, Richard S. Isaacson, Robert Krikorian, Suzanne Hendrix, Josefina Meléndez-Cabrero, Alon Seifan, Mu Ji Hwang, Aneela Rahman, Hollie Hristov, Cara Berkowitz, Monica Mureb, Katherine Hackett, Randy Cohen, Christine A. Ganzer |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Epidemiology Alzheimer’s Prevention Clinic Psychological intervention Disease Article law.invention 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine Cognition Developmental Neuroscience Randomized controlled trial law Alzheimer Disease Medicine Humans 030212 general & internal medicine Precision Medicine Alzheimer’s precision medicine Intensive care medicine Risk management Preclinical Alzheimer’s disease Aged Aged 80 and over business.industry Health Policy Multidomain interventions Middle Aged Precision medicine Personalized medicine 3. Good health Psychiatry and Mental health Alzheimer’s disease prevention Female Neurology (clinical) Geriatrics and Gerontology business Risk Reduction Behavior Clinical precision medicine 030217 neurology & neurosurgery APOE Cohort study |
| Zdroj: | Alzheimer's & dementia : the journal of the Alzheimer's Association |
| ISSN: | 1552-5279 |
| Popis: | Like virtually all age-related chronic diseases, late-onset Alzheimer's disease (AD) develops over an extended preclinical period and is associated with modifiable lifestyle and environmental factors. We hypothesize that multimodal interventions that address many risk factors simultaneously and are individually tailored to patients may help reduce AD risk. We describe a novel clinical methodology used to evaluate and treat patients at two Alzheimer's Prevention Clinics. The framework applies evidence-based principles of clinical precision medicine to tailor individualized recommendations, follow patients longitudinally to continually refine the interventions, and evaluate N-of-1 effectiveness (trial registered at ClinicalTrials.gov NCT03687710). Prior preliminary results suggest that the clinical practice of AD risk reduction is feasible, with measurable improvements in cognition and biomarkers of AD risk. We propose using these early findings as a foundation to evaluate the comparative effectiveness of personalized risk management within an international network of clinician researchers in a cohort study possibly leading to a randomized controlled trial. |
| Databáze: | OpenAIRE |
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