Prevention Of Alzheimer S Disease From Cognitive Reserve To Precision Medicine

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Societies around the world are concerned about dementia and the other forms of cognitive impairment that affect many older adults. We now know that brain changes typically begin years before people show symptoms, which suggests a window of opportunity to prevent or delay the onset of these conditions. Emerging evidence that the prevalence of dementia is declining in high-income countries offers hope that public health interventions will be effective in preventing or delaying cognitive impairments. Until recently, the research and clinical communities have focused primarily on understanding and treating these conditions after they have developed. Thus, the evidence base on how to prevent or delay these conditions has been limited at best, despite the many claims of success made in popular media and advertising. Today, however, a growing body of prevention research is emerging. Preventing Cognitive Decline and Dementia: A Way Forward assesses the current state of knowledge on interventions to prevent cognitive decline and dementia, and informs future research in this area. This report provides recommendations of appropriate content for inclusion in public health messages from the National Institute on Aging.

Precision Medicine in Neurodegenerative Disorders, Part Two, Volume 193 in the Handbook of Clinical Neurology deals with the "How" in the reconfiguration of our approach to slow accelerated brain aging. The book rethinks animal models on which therapies are tested, outlines the progress and expected changes in biological subtyping efforts using lysosomal, endosomal, mitochondrial, immune dysregulation, and inflammatory mechanisms of disease pathophysiology, and the growing role of microbiome in shaping disease. The volume separates the potentially disease-modifying neurorescue and neurorestoration, (e.g., gene therapy and cell replacement therapy) from true precision "medicine"–matching biology with the mechanism of intervention of interest. Specific chapters are dedicated to the promise and challenges of extracellular vesicles for both diagnosis and treatment, the growing application of digital measures and other evaluations of clinical response, the nuts and bolts of novel adaptive clinical trial designs, and the regulatory changes needed to facilitate drug development for disease-modification purposes. Summarizes theory and research on precision medicine in neurodegenerative disorders Covers basic biology, clinical trials and therapeutics Includes disease mechanisms, genetic subtypes, and more

It is almost 120 years since Alzheimer’s disease (AD) was first reported, and the concept of modifiable risk factors associated with the disease has been present from the outset. Thus, the idea of preventing AD is not new, with reference to strategies noted as early as the 1990s. This subfield of AD research has matured in recent years, with the number of modifiable risk factors – the AD preventome – rising from the 7 initially identified to the current 12, with an estimated contribution to dementia cases worldwide of about 40%. This book, the Handbook of Prevention and Alzheimer’s Disease, introduces physicians, scientists, and other stakeholders to this subfield of AD research. It investigates the AD preventome, which will continue to expand as the understanding of new factors and related biomarkers is refined. Optimizing this preventome leads to an improvement in overall brain health, an outcome which reduces the risk of developing AD and improves quality of life. The book goes on to examine other domains of prevention, from vascular risk factors to social engagement and from sleep health to spirituality. If the journey to end AD can be likened to a long and arduous challenge, understanding every possible part of the overall toolkit of approaches for disease prevention and intervention is essential. Together with its companion volume on intervention, the book provides a comprehensive overview of strategies for tackling Alzheimer’s disease, and will be of interest to all those working in the field. Cover illustration: White matter tracts showing sex differences in connectivity in men versus women as a function of increasing body mass index. Reprinted with permission from Rahmani F, Wang Q, McKay NS, Keefe S, Hantler N, Hornbeck R, Wang Y, Hassenstab J, Schindler S, Xiong C, Morris JC, Benzinger TLS, Raji CA. Sex-Specific Patterns of Body Mass Index Relationship with White Matter Connectivity. J Alzheimers Dis. 2022;86(4):1831-1848. doi: 10.3233/JAD-215329. PMID: 35180116; PMCID: PMC9108572.

The instant New York Times and Wall Street Journal bestseller A groundbreaking plan to prevent and reverse Alzheimer’s Disease that fundamentally changes how we understand cognitive decline. Everyone knows someone who has survived cancer, but until now no one knows anyone who has survived Alzheimer's Disease. In this paradigm shifting book, Dale Bredesen, MD, offers real hope to anyone looking to prevent and even reverse Alzheimer's Disease and cognitive decline. Revealing that AD is not one condition, as it is currently treated, but three, The End of Alzheimer’s outlines 36 metabolic factors (micronutrients, hormone levels, sleep) that can trigger "downsizing" in the brain. The protocol shows us how to rebalance these factors using lifestyle modifications like taking B12, eliminating gluten, or improving oral hygiene. The results are impressive. Of the first ten patients on the protocol, nine displayed significant improvement with 3-6 months; since then the protocol has yielded similar results with hundreds more. Now, The End of Alzheimer’s brings new hope to a broad audience of patients, caregivers, physicians, and treatment centers with a fascinating look inside the science and a complete step-by-step plan that fundamentally changes how we treat and even think about AD.

It is almost 120 years since Alzheimer’s disease (AD) was first reported, and the concept of managing some of the modifiable risk factors associated with the disease has been present from the outset. Intervening to manage risk factors as a way of tackling AD is not new, but optimizing brain health as a way of minimizing risk and maximizing the potential benefits of revolutionary new treatments for AD is becoming increasingly important. This book, the Handbook of Intervention and Alzheimer’s Disease, presents 47 papers exploring factors which may either inspire or inform future treatment and clinical trials. While novel interventions such as anti-amyloid immunotherapy present great opportunities, they may also increase the risk of brain bleeds and edema, which in turn may lead to adverse clinical outcomes. Such adverse outcomes are demonstrably more likely to occur in persons with poor brain health, so improved management of the risk factors which make up the AD preventome will also minimize the risks associated with such novel therapies. The papers in this volume can therefore be thought of as offering insight into those factors that can optimize brain health or providing key insights into interventions which may achieve such outcomes. Together with its companion volume on prevention, the book provides a comprehensive overview of strategies for tackling Alzheimer’s disease, and will be of interest to all those working in the field. Cover illustration: Improved hypoperfusion (resolving blue colors) on ASL MRI Z-score maps superimposed on structural MRI scans at baseline and one year in a PET amyloid-positive research participant with cognitive complaints undergoing one year of multi-domain personalized brain health interventions (vascular disease management, dietary optimization, sustained physical activity etc.). Permission to use this figure was granted both by the study P.I. Dr. David Merrill, MD, PhD, of the Pacific Neuroscience Institute and the research participant.

This compelling text provides an overview of the available technology for early detection and therapeutic management of vascular risk factors to Alzheimer’s before severe cognitive impairment symptoms appear. Chapters bring the reader from the trackless clinical research that has characterized Alzheimer’s progress for the last 20 years, to a nexus of new ideas and concepts that can change our outlook of this dementia. In-depth examinations of various hypotheses, preventive measures, current and prospective treatments are openly and clearly explored. The author discusses in depth his proposal of the vascular hypothesis of Alzheimer's disease which has become a mother-lode for basic and clinical studies and a key approach to the prevention of this dementia.Alzheimer’s Turning Point offers professionals, students and those looking to learn more about this disorder a fresh clinical perspective of this devastating disease.