Solcere, Encinitas, CA, USA.
Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA.
J Alzheimers Dis. 2023;94(3):993-1004. doi: 10.3233/JAD-230004.
Alzheimer's disease (AD) is a chronic condition marked by progressive objective cognitive impairment (OCI). No monotherapy has substantially altered disease progression, suggesting the disease is multifactorial and may require a multimodal therapeutic approach.
We sought to determine if cognitive function in a sample with OCI would change in response to a multimodal, individualized care plan based on potential contributors to cognitive decline (e.g., nutritional status, infection, etc.).
Participants (n = 34) were recruited from the San Diego, CA area. The multimodal intervention included lifestyle changes (i.e., movement, diet, and stress management), nutraceutical support, and medications. It was delivered pragmatically over four clinical visits, and outcome measures were gathered at four study visits, occurring at baseline, one, three, and six months (primary endpoint). Study participants received weekly phone calls for nutrition support throughout study participation. Outcome measures included the Cambridge Brain Sciences (CBS) battery, and the Montreal Cognitive Assessment (MoCA).
At 6 months, mean MoCA scores improved from 19.6±3.1 to 21.7±6.2 (p = 0.013). Significant improvement was observed in mean scores of the CBS memory domain [25.2 (SD 23.3) to 35.8 (SD 26.9); p < 0.01] and CBS overall composite cognition score [24.5 (SD 16.1) to 29.7 (SD 20.5); p = 0.02]. All CBS domains improved.
Multiple measures of cognitive function improved after six months of intervention. Our results support the feasibility and impact of a multimodal, individualized treatment approach to OCI, warranting further research.
阿尔茨海默病（AD）是一种以进行性客观认知障碍（OCI）为特征的慢性疾病。没有单一疗法能显著改变疾病进展，这表明该疾病是多因素的，可能需要采用多模式治疗方法。
我们旨在确定在基于认知能力下降的潜在因素（如营养状况、感染等）制定的多模式个体化护理计划的作用下，OCI 患者的认知功能是否会发生变化。
参与者（n=34）从加利福尼亚州圣地亚哥地区招募。多模式干预包括生活方式改变（即运动、饮食和压力管理）、营养支持和药物治疗。该干预措施在四次临床访视中以实用的方式进行，在四个研究访视中（基线、1 个月、3 个月和 6 个月时为主要终点）收集结果。研究参与者在整个研究期间每周都会通过电话获得营养支持。结果评估指标包括剑桥大脑科学（CBS）测试和蒙特利尔认知评估（MoCA）。
6 个月时，MoCA 评分从 19.6±3.1 提高到 21.7±6.2（p=0.013）。CBS 记忆域的平均得分显著提高[25.2（23.3）到 35.8（26.9）；p<0.01]和 CBS 整体认知综合评分[24.5（16.1）到 29.7（20.5）；p=0.02]。所有 CBS 域均得到改善。
干预 6 个月后，多项认知功能测量指标得到改善。我们的结果支持 OCI 的多模式个体化治疗方法的可行性和效果，值得进一步研究。
