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.
Publication Title
Journal of Alzheimer's disease : JAD
Authors
Jennifer Bramen, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.; Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.;Translational Neurosciences, Saint John's Cancer Institute, Santa Monica, CA, USA.Follow
Prabha Siddarth, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.Follow
Emily S Popa, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.Follow
Gavin T Kress, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.
Molly Rapozo, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.;Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
John F Hodes, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.;Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Aarthi Ganapathi, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. 2\Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
William M Sparks
Ynez M Tongson, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Andrea M Torres
Somayeh Meysami, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.; Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.;Translational Neurosciences, Saint John's Cancer Institute, Santa Monica, CA, USA.Follow
Colby B Slyapich, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.Follow
Ryan M. Glatt, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Kyron P Pierce, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Karen J Miller, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Shannel H Elhelou, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Verna R Porter, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA. Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA. Translational Neurosciences, Saint John's Cancer Institute, Santa Monica, CA, USA.Follow
Claudia L Wong, Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Mihae Kim, Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.Follow
Stella Panos, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.; Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.;Translational Neurosciences, Saint John's Cancer Institute, Santa Monica, CA, USA.Follow
Daniel A Hirsch, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.
Cyrus A Raji, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.
Susan Y Bookheimer, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.
Leroy Hood, Institute for Systems Biology, Seattle, WA, USA.Follow
Jared C Roach, Institute for Systems Biology, Seattle, WA, USA.Follow
David A Merrill, Pacific Neuroscience Institute Foundation, Santa Monica, CA, USA.; Pacific Brain Health Center, Providence Saint John's Health Center Santa Monica, Santa Monica, CA, USA.;Translational Neurosciences, Saint John's Cancer Institute, Santa Monica, CA, USA.Follow
Publication Date
12-1-2025
Keywords
Humans; Male; Alzheimer Disease; Female; Cerebrovascular Circulation; Aged; Diabetes Mellitus; Magnetic Resonance Imaging; Life Style; Middle Aged; Exercise Therapy; Combined Modality Therapy; Aged, 80 and over; Exercise; california; santa monica; psjhc; washington; isb
Abstract
BackgroundMedical 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.ObjectiveThis 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.MethodsThe 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.ResultsThe active arm (n = 18) showed greater post-trial CBF in regions related to exercise, cardiovascular, diabetic, and AD risk, compared to control (n = 20), 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.ConclusionsIn 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.
Area of Special Interest
Neurosciences (Brain & Spine)
Area of Special Interest
Kidney & Diabetes
Specialty/Research Institute
Neurosciences
Specialty/Research Institute
Endocrinology
Specialty/Research Institute
Nephrology
DOI
10.1177/13872877251388933
