A Clinical Precision Medicine Approach Reduces Alzheimer’s, Dementia and Vascular Risk and Improves Cognition: A Prospective Cohort Study (P6.085)

Objective: Assess effectiveness of multi-modal interventions on Alzheimer’s disease (AD), dementia, and vascular risk scales. Secondary outcomes include overall and differential effectiveness of interventions on blood biomarkers and cognition (based on genotype and physician/patient reported adherence). Background: The Alzheimer’s Prevention Clinic at Weill Cornell Medicine provides clinical care to patients who undergo comprehensive assessments and receive evidence-based, individualized interventions applying principles of pharmacogenomics, nutrigenomics and clinical precision medicine. Design/Methods: In this prospective cohort study, patients with family history of AD and no or minimal cognitive complaints (primary prevention), and those meeting criteria for preclinical AD or mild cognitive impairment were recruited to our registry. Clinical evaluations were performed at baseline including cognition (NIH Toolbox Cognition Battery, Verbal Fluency, Trails B, MMSE), anthropometrics, blood biomarkers, and genetics. All patients then received a myriad of clinical precision medicine lifestyle and nutritional recommendations, and were educated on AD prevention via Alzheimer’s Universe (www.AlzU.org). Relevant measures were repeated again at 6-months follow-up. Results: 168 participants met inclusion criteria (mean age 56 ±13.6, 60.2% female). After 6 months, improvements were observed in all six risk scales (CAIDE Midlife, p=.046; MLDRI, p=.006; LLDRI, p Conclusions: These data suggest a clinical precision medicine approach toward AD prevention can reduce AD, dementia and vascular risk and improve cognition. Differential effects were observed based on genotype and adherence. These results are encouraging and warrant further evaluation via randomized trial utilizing AD-specific biomarkers pre vs. post-intervention. Disclosure: Dr. Isaacson has received personal compensation for activities with Accera as a consultant. Dr. Caesar has nothing to disclose. Dr. Hackett has nothing to disclose. Dr. Shih has nothing to disclose. Dr. Hristov has nothing to disclose. Dr. Melendez-Cabrero has nothing to disclose. Dr. Rodriguez has nothing to disclose. Dr. Shum has nothing to disclose. Dr. Mosconi has nothing to disclose. Dr. Cohen has nothing to disclose. Dr. Montgomery has nothing to disclose. Dr. Schelke has nothing to disclose. Dr. Marongiu has nothing to disclose. Dr. Kachko has received personal compensation for activities with InnerSource Health as an employee. Dr. Krikorian has nothing to disclose. Dr. Seifan has received personal compensation for activities with Compass Health Systems.