Precision Medicine Approach to Alzheimer’s Disease: Rationale and Implications

Authors

Dale E. Bredesen, University of California, Los AngelesFollow
Kat Toups, Bay Area Wellness, Walnut Creek, CA, USA
Ann Hathaway
Deborha Gordon, Northwest Memory Center, Ashland, OR, USA
Henrianna Chung, Quesgen Systems, Burlingame, CA, USA
Cyrus Raji, Washington University School of Medicine
Alan Boyd, CNS Vital Signs, Morrisville, NC, USA
Benjamin D. Hill, University of South AlabamaFollow
Sharon Hausman-Cohen, IntellxxDNA, Austin, TX, USA
Mouna Attarha, Posit Science, San Francisco, CA, USA
Won Jong Chwa, St. Louis University
Alexei Kurakin, University of California, Los Angeles
Michael Jarrett, Quesgen Systems, Burlingame, CA, USA

Document Type

Article

Publication Title

Journal of Alzheimer’s Disease

Abstract

The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer’s disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review the rationale for a precision medicine approach in prevention and treatment of cognitive decline associated with AD. Results and implications from recent proof-of-concept clinical trials are presented. Randomized controlled trials, with much larger patient numbers, are likely to be significant to establishing precision medicine protocols as a standard of care for prevention and treatment of cognitive decline. Furthermore, combining this approach with the pharmaceutical approach offers the potential for enhanced outcomes. However, incorporating precision medicine approaches into everyday evaluation and care, as well as future clinical trials, would require fundamental changes in trial design, IRB considerations, funding considerations, laboratory evaluation, personalized treatment plans, treatment teams, and ultimately in reimbursement guidelines. Nonetheless, precision medicine approaches to AD, based on a novel model of AD pathophysiology, offer promise that has not been realized to date with monotherapeutic approaches.

First Page

429

Last Page

437

DOI

10.3233/JAD-230467

Publication Date

2023

Department

Department of Psychology

Comments

This article was published by IOS Press and can also be read on their website at the following DOI link: 10.3233/JAD-230467.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Bredesen DE, Toups K, Hathaway A, Gordon D, Chung H, Raji C, Boyd A, Hill BD, Hausman-Cohen S, Attarha M, Chwa WJ, Kurakin A, Jarrett M. Precision Medicine Approach to Alzheimer's Disease: Rationale and Implications. J Alzheimers Dis. 2023;96(2):429-437. doi: 10.3233/JAD-230467. PMID: 37807782; PMCID: PMC10741308.