title: ARAC--The Montreal Jewish General Hospital Alzheimer Risk Assessment Clinic.
abstract: BACKGROUND
  In parallel with robust efforts world-wide to develop effective neuroprotection for established disease, resources are being mobilized to delineate risk factors and implement preventive measures in a concerted effort to forestall the anticipated Alzheimer disease (AD) epidemic. A review of heritable and 'acquired' dementia risk factors, many operating at midlife, is presented in a companion paper.
  
  
  OBJECTIVE
  In 2009, an Alzheimer Risk Assessment Clinic (ARAC) was established at the Jewish General Hospital (Montreal) to address the concerns increasingly being voiced by active middle-aged individuals at risk for AD. A positive family history of AD and/or perceived changes in personal cognitive function (predominantly short-term memory) are main reasons for referral. The primary objectives of ARAC are to (i) ascertain, inform and mitigate the risks of developing AD in cognitively-healthy persons aged 40-65 based on best available medical and epidemiological evidence, (ii) conduct scientific research on midlife dementia risk and prevention in this population and (iii) provide instruction in dementia risk assessment and management to health professionals, clinical/research fellows, medical residents and students. ARAC infrastructure, evaluation protocol, risk profile classification scheme, interventions, knowledge dissemination program, case vignettes, and seminal research projects are described.
  
  
  CONCLUSIONS
  It is hoped that ARAC and similar initiatives will help prevent or delay dementia by innovating effective interventions based on increasingly nuanced estimation of modifiable AD risk in presymptomatic persons.
authors.affiliation: Centre for Neurotranslational Research, Lady Davis Institute for Medical Research, Jewish General Hospital, Department of Neurology & Neurosurgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Hyman M
authors.initials: HM
authors.lastname: Schipper
authors.forename: Adrienne
authors.initials: A
authors.lastname: Liberman
authors.forename: Nora
authors.initials: N
authors.lastname: Kelner
authors.forename: Lennie
authors.initials: L
authors.lastname: Babins
authors.forename: Lynda
authors.initials: L
authors.lastname: Fried
authors.forename: Melanie
authors.initials: M
authors.lastname: Bilbul
authors.forename: Rachel
authors.initials: R
authors.lastname: Goodman
mesh_terms: D000328:Adult; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D002170:Canada / Q000453:epidemiology; D006769:Hospitals, General; D006777:Hospitals, Proprietary; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D011795:Surveys and Questionnaires