Seifan A, Isaacson R
Department of Neurology, Division of Memory Disorders, Weill Cornell Medical College / New York-Presbyterian Hospital, New York, NY, USA.
J Prev Alzheimers Dis. 2015;2(4):254-266. doi: 10.14283/jpad.2015.81. Epub 2015 Oct 1.
In July 2013, Weill Cornell Medical College founded the first Alzheimer's Prevention Clinic (APC) in the United States, providing direct clinical care to family members of patients with Alzheimer's disease (AD) as part of the Weill Cornell Memory Disorders Program. At the APC, patients seeking to lower their AD risk undergo a comprehensive assessment, receive a personalized plan based on rapidly evolving scientific evidence, and are followed over time using validated as well as emerging clinical and research technologies. The APC approach applies the principles of pharmacogenomics, nutrigenomics and clinical precision medicine, to tailor individualized therapies for patients. Longitudinal measures currently assessed in the clinic include anthropometrics, cognition, blood biomarkers (i.e., lipid, inflammatory, metabolic, nutritional) and genetics, as well as validated, self-reported measures that enable patients to track several aspects of health-related quality of life. Patients are educated on the fundamental concepts of AD prevention via an interactive online course hosted on Alzheimer's Universe (www.AlzU.org), which also contains several activities including validated computer-based cognitive testing. The primary goal of the APC is to employ preventative measures that lower modifiable AD risk, possibly leading to a delay in onset of future symptoms. Our secondary goal is to establish a cohort of at-risk individuals who will be primed to participate in future AD prevention trials as disease-modifying agents emerge for testing at earlier stages of the AD process. The clinical services are intended to lower concern for future disease by giving patients a greater sense of control over their brain health.
2013年7月,威尔康奈尔医学院在美国设立了首个阿尔茨海默病预防诊所(APC),作为威尔康奈尔记忆障碍项目的一部分,为阿尔茨海默病(AD)患者的家庭成员提供直接临床护理。在APC诊所,寻求降低AD风险的患者会接受全面评估,根据快速发展的科学证据获得个性化方案,并随着时间推移使用经过验证的以及新出现的临床和研究技术进行跟踪。APC的方法应用了药物基因组学、营养基因组学和临床精准医学的原理,为患者量身定制个性化治疗方案。目前在诊所评估的纵向指标包括人体测量学、认知、血液生物标志物(即脂质、炎症、代谢、营养)和遗传学,以及经过验证的、患者自我报告的指标,这些指标使患者能够跟踪健康相关生活质量的多个方面。通过阿尔茨海默病天地(www.AlzU.org)上的互动在线课程,患者接受AD预防的基本概念教育,该课程还包含多项活动,包括经过验证的基于计算机的认知测试。APC的主要目标是采取预防措施,降低可改变的AD风险,可能导致未来症状发作延迟。我们的次要目标是建立一组有风险的个体,随着疾病修饰药物在AD病程早期出现用于测试,这些个体将准备好参与未来的AD预防试验。临床服务旨在通过让患者更好地控制自己的大脑健康,降低对未来疾病的担忧。