COMMENTARY

Can Data Tracking Help Prevent Alzheimer's?

Richard S. Isaacson, MD 

Disclosures

March 23, 2016

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My name is Richard Isaacson, and I am the director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and New York Presbyterian Hospital.

So, what is Alzheimer prevention? How does one practice it in a real-life clinical setting? Since 2013, we have been seeing patients without memory problems or cognitive complaints but who have a family history of Alzheimer disease.

We see patients, talk to them, get their family and clinical history, and take a very deep dive. We also look at their potential risk factors and then order a variety of lab tests, including nutritional, cholesterol, inflammatory, and other markers that help us risk-stratify the patient.

We also do a series of baseline cognitive tests that include computer-based as well as traditional pen-and-paper tests. On the basis of these findings and the results of the lab tests, we then try to intervene by creating an evidence-based and safe personalized plan. The patient returns every 6 months and we try to see how their cognition and lab results change.

To do this, we enter their numbers into a variety of cardiovascular and Alzheimer disease risk scales and track how lifestyle, as well as other changes that we recommend, can possibly lower their potential lifetime risk.

We also track whether this process will make a change in biomarkers. This requires ongoing studies to determine whether our plan will reduce amyloid levels in the brain or whether there will be improved glucose metabolism in the brain.

But I think that in 2016, we can practice Alzheimer prevention in the clinical setting. We don't have all the answers and there is not a magic pill or potion to prevent or cure Alzheimer disease, but I do think that physicians can give specific, actionable, and personalized recommendations to patients in order to help them feel empowered and also help them lower their risk. Thank you.

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