Abstract Details

Title A Multidomain Precision Medicine Intervention in Patients at Risk for Dementia due to Alzheimer’s disease

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-006

Objective

This clinical trial investigated the effects of a precision medicine intervention on cognition in asymptomatic and mildly symptomatic patients.

Background

Multidomain approaches to treating modifiable risk factors in Alzheimer’s disease (AD) have shown cognitive benefits for patients at-risk for dementia.

Design/Methods

Patients aged 25–86 were recruited from an Alzheimer’s prevention clinic and categorized into two groups. The prevention group (group 1) included normal cognition, subjective cognitive decline, and preclinical AD patients. The early treatment group (group 2) included predominantly MCI due to AD as well as mild AD dementia patients. Primary outcome was change in performance on a cognitive composite (m-APCC) measuring AD pathology in higher- versus lower-compliance participants at 18 months in groups 1 and 2. We also compared groups versus matched historical controls from NACC/Rush University. Secondary outcome was change in performance on a non-pathological cognitive aging composite (CAC). Trial registered at ClinicalTrials.gov (NCT03687710).

Results

Of 202 participants screened, 178 met inclusion criteria; 154 (87%) had at least one post-baseline assessment and were included in analyses. Group 1 improved on the m-APCC by 0.426 at 18-months (p<0.0001). Similar effects were seen for higher and lower compliance groups (p=0.1467). Group 1 higher-compliance participants improved more than NACC (p=0.0039) and Rush controls (p=0.0133). Group 1 lower compliance participants also improved more than NACC (p=0.0105) and Rush (p=0.0259) controls. In group 2, higher compliance participants improved relative to lower compliance participants (p<0.0001) and NACC (p=0.0069), but not compared to Rush (p=0.3953). For group 1, the CAC improved by 2.67 years for higher-compliance participants and 3.52 years for lower-compliance participants (p=0.4039). Group 2 improved by 2.95 years in the CAC for higher-compliance participants and worsened by 5.06 years for lower-compliance participants (p=0.0004).

Conclusions

Findings suggest a precision medicine multidomain intervention can improve cognitive function. Intervening earlier in the pre-AD dementia diagnostic spectrum led to greater improvements.

Authors/Disclosures
Richard S. Isaacson, MD, FAAN PRESENTER	Dr. Isaacson has stock in Retain Health. The institution of Dr. Isaacson has received research support from National Institutes of Health. The institution of Dr. Isaacson has received research support from Aces for Alzheimer's. The institution of Dr. Isaacson has received research support from BrainMind. Dr. Isaacson has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Suzanne Hendrix, PhD (Pentara)	Dr. Hendrix has received personal compensation for serving as an employee of Pentara Corporation. Dr. Hendrix has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Pentara Corporation. Dr. Hendrix has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pentara Corporation. The institution of Dr. Hendrix has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Pentara Corporation. Dr. Hendrix has or had stock in Pentara.
Joseph E. Safdieh, MD, FAAN (Weill Medical College of Cornell University)	Dr. Safdieh has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. Dr. Safdieh has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Dughi, Hewit & Domalewski, P.C.. Dr. Safdieh has received publishing royalties from a publication relating to health care.
Matthew E. Fink, MD, FAAN (Weill Cornell Medical Center)	Dr. Fink has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Relias LLC.
	No disclosure on file
	No disclosure on file
Sonia S. Bellara, MBBS (SUNY Downstate Medical University)	Dr. Bellara has nothing to disclose.
	No disclosure on file
Emily Caesar	No disclosure on file
	No disclosure on file
	No disclosure on file
Mu Ji Hwang, MD	Dr. Hwang has nothing to disclose.
	No disclosure on file
	No disclosure on file
Lisa Mosconi	No disclosure on file
Alon Seifan, MD (Cognitive Neurology Consultants, Inc. dba the Neuro Well)	Dr. Seifan has received personal compensation in the range of $100,000-$499,999 for serving as a Chief Science Officer with HB Biotech.
	No disclosure on file

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