Prevention of Alzheimer's Disease: Lessons Learned and Applied

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Alzheimer's disease (AD) affects more than 5 million Americans, with substantial consequences for individuals with AD, families, and society in terms of morbidity, mortality, and healthcare costs. With disease-modifying treatment trials unsuccessful at the present time and only medications to treat symptoms available, an emerging approach is prevention. Advances in diagnostic criteria, biomarker development, and greater understanding of the biophysiological basis of AD make these initiatives feasible. Ongoing pharmacological trials using anti-amyloid therapies are underway in sporadic and genetic forms of AD, although a large number of modifiable risk factors for AD have been identified in observational studies, many of which do not appear to exert effects through amyloid or tau. This suggests that prevention studies focusing on risk reduction and lifestyle modification may offer additional benefits. Rather than relying solely on large-sample, long-duration, randomized clinical trial designs, a precision medicine approach using N-of-1 trials may provide more-rapid information on whether personalized prevention plans can improve person-centered outcomes. Because there appear to be multiple pathways to developing AD, there may also be multiple ways to prevent or delay the onset of AD. Even if these precision approaches alone are not successful in preventing AD, they may greatly improve the likelihood of amyloid- or tau-specific therapies to reach their endpoints by reducing comorbidities. Keeping this in mind, dementia may be a disorder that develops over a lifetime, with individualized ways to build a better brain as we age.

Original languageEnglish (US)
Pages (from-to)2128-2133
Number of pages6
JournalJournal of the American Geriatrics Society
Volume65
Issue number10
DOIs
StatePublished - Oct 2017
Externally publishedYes

Keywords

  • Alzheimer's disease
  • dementia
  • lifestyle
  • N-of-1 trials
  • precision medicine
  • prevention
  • risk reduction

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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