The Benefits of Individualized Care Interventions
Learn more about IND’s published research findings on individualized clinical management of patients at risk for Alzheimer’s dementia.
In 2019, Dr. Richard Isaacson and his co-authors published the results of a proof-of-concept trial aimed at examining the effects of personalized care interventions on Alzheimer’s risk. 174 people ranging from 25-86 years old, with normal cognition or mild cognitive impairment, and a family history of Alzheimer’s took part in the study. The participants underwent an extensive screening evaluation to determine their clinical history, body composition, APOE status, cognitive status, and levels of blood biomarkers such as glucose, insulin, and total cholesterol.
Based on these data, specific recommendations were made for each participant to follow and implement into their lifestyle. The categories of recommendations included (1) patient education and genetic counseling, (2) pharmacological approaches including medications, vitamins, and/or supplements, and (3) non-pharmacological approaches including exercise, nutrition, vascular risk, sleep, cognitive engagement, stress, and general medical care. The participants were then assessed every 6-months for nearly 3 years and their treatment plans were adjusted as needed.
The participants were grouped for analyses based on cognitive status and compliance to treatment plan. Individuals with mild cognitive impairment or mild Alzheimer’s disease were the “Early Treatment” group and those with preclinical AD, subjective cognitive decline, or normal cognition were the “Prevention” group. Additionally, participants who followed more than 60%of the recommendations given to them were considered “higher-compliance,” while participants who followed less than 60% of the recommendations given to them were considered “lower-compliance.” Participant outcomes were then compared to matched historical control cohorts (data obtained from repositories of similar individuals who did not undergo any interventions) in order to evaluate the impact of treatment.
The results of the study showed that the higher-compliance Prevention group, lower-compliance Prevention group, and higher-compliance Early Treatment groups showed significant improvements compared to controls. However, the lower-compliance Early Treatment group did not differ from the controls. Overall, individualized treatments yielded promising results and higher-compliance to treatment plan did lend to more significant improvements. Individuals with lower-compliance in the Prevention group were still able to benefit from the changes they made, however, higher-compliance is particularly important for those in the early stages of disease to experience benefit.
Dr. Isaacson explains that “in the 2019 study, we individualized a recipe, a plan, based on the person’s risk factors...We showed that cognition improved, not just stabilized or slowed. Cognition actually improved. And their calculated risk, their risk factors improved too significantly, statistically significantly.” The groundbreaking results from this study motivated IND’s current research, and now they are able to show data that individualized treatment interventions also lead to significant improvements in amyloid, tau, and brain volume.
To learn more about IND’s past and present research findings, watch our conversation with Dr. Richard Isaacson in the video above.
By Alicia J. Barber, PhD
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