Nutritional interventions for Alzheimer's prevention: a clinical precision medicine approach.
Alzheimer's disease (AD) is a major source of morbidity and mortality, with the disease burden expected to rise as the population ages. No disease-modifying agent is currently available, but recent research suggests that nutritional and lifestyle modifications can delay or prevent the onset of AD. However, preventive nutritional interventions are not universally applicable and depend on the clinical profile of the individual patient. This article reviews existing nutritional modalities for AD prevention that act through improvement of insulin resistance, correction of dyslipidemia, and reduction of oxidative stress, and discusses how they may be modified on the basis of individual biomarkers, genetics, and behavior. In addition, we report preliminary results of clinical application of these personalized interventions at the first AD prevention clinic in the United States. The use of these personalized interventions represents an important application of precision medicine techniques for the prevention of AD that can be adopted by clinicians across disciplines.
Department of Neurology, Weill Cornell Medicine, New York, New York.
Matthew W
MW
Schelke
Department of Neurology, Weill Cornell Medicine, New York, New York.
Katherine
K
Hackett
Department of Neurology, Weill Cornell Medicine, New York, New York.
Jaclyn L
JL
Chen
Department of Neurology, Weill Cornell Medicine, New York, New York.
Chiashin
C
Shih
Department of Neurology, Weill Cornell Medicine, New York, New York.
Jessica
J
Shum
Nutrition, NewYork-Presbyterian/Weill Cornell Medical Center, New York, New York.
Mary E
ME
Montgomery
Department of Neurology, Weill Cornell Medicine, New York, New York.
Gloria C
GC
Chiang
Department of Neurology, Weill Cornell Medicine, New York, New York.
Cara
C
Berkowitz
Neurology, Compass Health Systems, Miami, Florida.
Alon
A
Seifan
Department of Psychiatry, University of Cincinnati Academic Health Center, Cincinnati, Ohio.
Robert
R
Krikorian
Department of Neurology, Weill Cornell Medicine, New York, New York.
Richard Scott
RS
Isaacson
D000544:Alzheimer Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D009752:Nutritional Status / Q000502:physiology*; D018384:Oxidative Stress / Q000502:physiology; D057285:Precision Medicine / Q000379:methods* / Q000639:trends; D040242:Risk Reduction Behavior
Alzheimer's prevention; clinical precision medicine; insulin resistance; nonpharmacological management; nutrigenomics; preclinical Alzheimer's disease