Richard Isaacson, MD: Personalized Interventions May Improve Cognition, Reduce Alzheimer Risk


The breakthrough study is a concrete example of the opportunities that precision medicine present in the pursuit to prevent the onset of or worsening of diseases like Alzheimer dementia.

“Clinicians, whether from a subspeciality practice to primary care, can take the learnings from this study and apply them to clinical practice today.”

While there has been several research efforts that explored the utility of multidomain interventions for the prevention of cognitive impairment, until now, no study has adequately examined the effects of those interventions in real life.

In an interview with NeurologyLive, Richard S. Isaacson, MD, director of the Alzheimer's Prevention Clinic, Weill Cornell Memory Disorders Program at Weill Cornell Medical College/New York-Presbyterian Hospital, discussed his landmark study that showed that high compliance with various personalized interventions is associated with improved cognitive function in those with normal cognition to those with mild cognitive impairment (MCI) due to Alzheimer disease (AD) or mild AD.

By using individualized interventions over an 18-month period, including education, pharmacologic, and nonpharmacologic interventions, investigators led by Isaacson sought to evaluate the effects of adherence on outcomes. The study included 174 patients age 25 to 86 who were assigned personalized interventions that addressed their individual risk factors, including hypertension, diabetes, inactivity, and vitamin deficiency, among others. Evaluations of the treatment cohort were compared to 2 historical control cohorts containing more than 40,000 patients. Each patient ultimately received on average of 21 different interventions.

Isaacson and colleagues observed significant benefits in patients in the prevention cohort, with those adhering to greater than 60% of their interventions improving by 4.6 points on the m-APCC, while those who adhered to less than 60% of interventions saw a 4.5-point improvement. Notably, compared to those with low adherence, patients in the early treatment cohort who had good adherence had a statistically significant improvement in m-APCC.

Encouraged by the results, Isaacson hopes that physicians will take these evidence-based findings and apply them in their own practice by helping patients make lifestyle changes that may improve their cognition and reduce their risk for Alzheimer disease and dementia.

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