{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:19:12Z","timestamp":1793276352250,"version":"4.5.0"},"reference-count":67,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100006324","name":"National Institute for Basic Biology","doi-asserted-by":"publisher","award":["P41EB015909"],"award-info":[{"award-number":["P41EB015909"]}],"id":[{"id":"10.13039\/501100006324","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Barbara and John McLoughlin Family","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Barbara and John McLoughlin Family","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"Providence St. Joseph Health","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical and lifestyle management are crucial for Alzheimer's disease (AD). Cerebral blood flow (CBF), vital for brain health, and influenced by modifiable risk factors, is reduced in AD and may become uncoupled from metabolism due to neurovascular dysfunction in later stages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This mid-trial analysis tested the hypothesis that a coached, multi-modal intervention (PREVENTION) improved ASL-MRI-measured CBF and diabetic risk (QUICKI) in patients with early AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The control arm received recommendations and medical management for one year; the active arm additionally received coaching, exercise training, and supplementation. We hypothesized that those in (1) the active arm and (2) with higher intervention adherence would have improved post-trial QUICKI and CBF, particularly in regions relevant to exercise, cardiovascular, diabetic, and AD risk. Post-trial CBF was analyzed using a linear model including arm, baseline CBF, adherence, age, education, and depressive symptoms. Change in QUICKI was analyzed using mixed effects general linear models, including arm, adherence, time, and interactions between time and treatment group and time and adherence, controlling for age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The active arm (n\u2009=\u200918) showed greater post-trial CBF in regions related to exercise, cardiovascular, diabetic, and AD risk, compared to control (n\u2009=\u200920), but did not differ in global CBF, QUICKI, or adherence. Higher adherence scores were associated with greater regional post-trial CBF and improvement in QUICKI, but not global CBF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this small sample, we found evidence that a multi-modal intervention focused on medical management, exercise, and a carbohydrate-restricted diet improved diabetic risk and CBF in patients with AD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251388933","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T06:25:20Z","timestamp":1763360720000},"page":"1819-1833","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["A multi-modal medical management and lifestyle intervention increase cerebral blood flow and lowers diabetic risk in persons with early Alzheimer's disease: Mid-trial results from the PREVENTION trial"],"prefix":"10.1177","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8967-0008","authenticated-orcid":false,"given":"Jennifer E","family":"Bramen","sequence":"first","affiliation":[{"name":"Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA"},{"name":"Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA"},{"name":"Translational Neurosciences, Saint John's Cancer Institute, Santa Monica, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabha","family":"Siddarth","sequence":"additional","affiliation":[{"name":"Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA"},{"name":"Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-0888","authenticated-orcid":false,"given":"Emily 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