Alzheimer’s could be prevented by gender-based personalised medicine, study says

A new study has found Alzheimer’s - which disproportionately affects women - could be prevented by gender-based personalised medicine.

The lead author of the study, Dr Richard Isaacson, of Florida Atlantic University, says that women account for two-in-three patients - with incidence twice as high even after accounting for longer lifespans.

"Population-attributable risk models suggest that managing risk factors can prevent up to one-third of dementia cases, highlighting the immense potential that lies in addressing modifiable risk factors,” Dr Isaacson says.

He says there are simple steps we can take every single day to strengthen our brains and reduce the risk of Alzheimer’s.

The disease starts in the brain 20 to 30 years before the first signs of memory loss. We should all be thinking about prevention - including eating, exercising and sleeping well.

The study is the first to show how sex significantly affects cognitive outcomes in people who follow individually-tailored, multi-domain clinical interventions. It also found the risk of developing cardiovascular disease and Alzheimer’s was also affected by gender.

Other studies have focused on the role of hormones and sex-specific risk factors. But none have explored if the interventions result in differences in real-world clinical practice.

The number of dementia cases worldwide are set to triple to more than 150 million by 2050. In the absence of a cure, there is an increasing focus on preventive lifestyle factors such as a healthy diet and exercise.

The study analysed data from the Comparative Effectiveness Dementia & Alzheimer’s Registry (CEDAR) trial launched in 2015.

It has already demonstrated individualised, multiple interventions improved cognition and reduced Alzheimer’s risk in both women and men.

Dr Isaacson and colleagues evaluated results in 80 higher-compliance participants from the original cohort of 154.

The findings in the Journal of Prevention of Alzheimer’s Disease showed risk reduction care led to greater cognitive improvements in women than men.

Dr Isaacson said: "While care in an Alzheimer’s Prevention Clinic setting is equally effective at improving cognitive function in both women and men, our personally-tailored interventions led to greater improvements in women compared to men across Alzheimer’s and cardiovascular disease risk scales, as well blood biomarkers of risk such as blood sugar, LDL cholesterol, and the diabetes test HbA1C."

To carry out the study, volunteers from the outset, underwent medical checks including a detailed clinical history, physical examination, anthropometrics, blood biomarkers, apolipoprotein-*4 (APOE-e4) genotyping and cognitive assessment.

Patients in the CEDAR study were given individually-tailored, multi-domain intervention recommendations informed by these clinical and biomarker data.

Recommendation categories included patient education/genetic counselling and individualised pharmacological approaches (medications/vitamins/supplements.

They also got advice on exercise, diet, vascular risk reduction, sleep hygiene, cognitive engagement, stress reduction, general medical care and other evidence-based interventions.

Dr Isaacson said: "Our latest results suggest the individualised management approach used by the CEDAR study in a real-world clinic may offer equal cognitive benefits to both women and men, as well as better mitigation of calculated Alzheimer’s disease and cardiovascular disease risk in women compared to men.

"Our work also highlights the need for larger studies focusing on sex differences in Alzheimer’s-related cognitive trajectories, as the existing body of knowledge lacks conclusive evidence on this issue."

The researchers are planning trials involving larger cohorts to further define sex differences in Alzheimer’s risk reduction.

They hope to launch a multi-site international study soon to draw more definitive conclusions.

Alzheimer’s and other forms of dementia affect more than 920,000 people in the UK. That figure will rise to 2 million in the next three decades.

Additional reporting by SWNS