{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:53:14Z","timestamp":1788385994860,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T00:00:00Z","timestamp":1572393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002384"],"award-info":[{"award-number":["UL1TR002384"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["PO1AG026572"],"award-info":[{"award-number":["PO1AG026572"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Multidomain intervention for Alzheimer's disease (AD) risk reduction is an emerging therapeutic paradigm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were prescribed individually tailored interventions (education\/pharmacologic\/nonpharmacologic) and rated on compliance. Normal cognition\/subjective cognitive decline\/preclinical AD was classified as Prevention. Mild cognitive impairment due to AD\/mild\u2010AD was classified as Early Treatment. Change from baseline to 18 months on the modified Alzheimer's Prevention Cognitive Composite (primary outcome) was compared against matched historical control cohorts. Cognitive aging composite (CogAging), AD\/cardiovascular risk scales, and serum biomarkers were secondary outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred seventy\u2010four were assigned interventions (age 25\u201386). Higher\u2010compliance Prevention improved more than both historical cohorts (<jats:italic>P =<\/jats:italic> .0012, <jats:italic>P &lt;<\/jats:italic> .0001). Lower\u2010compliance Prevention also improved more than both historical cohorts (<jats:italic>P =<\/jats:italic> .0088, <jats:italic>P &lt;<\/jats:italic> .0055). Higher\u2010compliance Early Treatment improved more than lower compliance (<jats:italic>P =<\/jats:italic> .0007). Higher\u2010compliance Early Treatment improved more than historical cohorts (<jats:italic>P &lt;<\/jats:italic> .0001, <jats:italic>P =<\/jats:italic> .0428). Lower\u2010compliance Early Treatment did not differ (<jats:italic>P =<\/jats:italic> .9820, <jats:italic>P =<\/jats:italic> .1115). Similar effects occurred for CogAging. AD\/cardiovascular risk scales and serum biomarkers improved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Individualized multidomain interventions may improve cognition and reduce AD\/cardiovascular risk scores in patients at\u2010risk for AD dementia.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.jalz.2019.08.198","type":"journal-article","created":{"date-parts":[[2019,11,3]],"date-time":"2019-11-03T04:11:12Z","timestamp":1572754272000},"page":"1588-1602","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":74,"title":["Individualized clinical management of patients at risk for Alzheimer's dementia"],"prefix":"10.1002","volume":"15","author":[{"given":"Richard S.","family":"Isaacson","sequence":"first","affiliation":[{"name":"Department of Neurology Weill Cornell Medicine and NewYork\u2010Presbyterian New York NY 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