Dietary Intervention to Prevent and Slow Memory Loss due to Alzheimer’s (DIPLOMA)

Speaker: R. S. Isaacson Presented at: 2015 The New York Academy of Sciences

Summary

The Alzheimer’s Prevention Clinic (APC) at Weill Cornell Medical College/ NewYork-Presbyterian Hospital treats patients (aged 25+) with a family history of AD to lower their risk for dementia. Longitudinal, evidence-based clinical care is personalized with respect to risk factors such as genetics, medical conditions, anthropometrics, laboratory markers (lipid, inflammatory, metabolic, and nutritional) and neuropsychological function with assessments every 6 months. Patients are instructed on multi-modal pharmacological and non-pharmacological management strategies, are comprehensively educated via an online patient education and education/behavioral research portal (www. AlzU.org), and use the AD-Nutrition Tracking System, an online database and lifestyle management tool. Patients may participate in the Dietary Intervention to Prevent and Slow Memory Loss due to Alzheimer’s (DIPLOMA) study. This prospective cohort study currently follows >150 cognitively normal patients, >30 possible pre-clinical AD patients (based on preliminary clinical diagnosis) with objective cognitive impairment but no or minimal subjective memory loss, and >30 patients with mild cognitive impairment due to AD. We apply emerging principles of pharmacogenomics, nutrigenomics, and clinical precision medicine to tailor individualized therapies. A principal hypothesis underlying our approach is that glucose hypometabolism promotes AD brain pathology, and targeted interventions to address distinctive nutritional and/or metabolic requirements will support mitochondrial efficiency and reduce oxidative damage, thereby contributing to neuroprotection. Our primary goal is to investigate whether pharmacogenomic/ nutrigenomic interventions will produce differential, risk-reducing responses in our subpopulations (e.g., APOE/MTHFR status). We recently expanded neuroimaging to include FDG-PET, Amyloid-PET and MRI/ MR spectroscopy, and plan a six-month randomized controlled clinical trial based on initial data obtained (early 2016).