Abstract Details

Title Degree of Adherence to Brain Health Recommendations in Patients Pursuing Anti-Amyloid Antibody Therapy for Alzheimer’s Disease

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) S23 - Innovations in Dementia Treatment (1:24 PM-1:36 PM)

Poster/Presentation
Number 003

Background Patients seeking AATs are willing to commit considerable time and resources to alter their trajectory of AD. It is unknown how well these very motivated patients follow consensus recommendations regarding modifiable risk factors for cognitive decline and dementia.

Objective To determine the degree to which patients with early Alzheimer disease (AD) being evaluated for anti-amyloid antibody therapies (AATs) adhere to optimal brain-health/lifestyle recommendations.

Design/Methods

To date, 84 patients with MCI or mild dementia due to AD being evaluated for AATs were assessed on 15 modifiable risk factors by questionnaire and review of electronic medical record (EMR) data. The 15 factors included physical activity, cognitive activity, social engagement, mood/stress, vision, LDL cholesterol level, and HbA1c, among others. Scores (0-2) for each factor reflected degree of adherence to recommended guidelines: 0=not met; 1=partially met/room for growth; 2=optimally met.

Results For 7 factors, >40% of patients were not optimally following recommended guidelines: blood pressure (64%), HbA1c (63%), BMI (62%), physical activity (62%), mood/stress (57%), LDL (46%), and cognitive activity (41%). For 4 factors, 67-74% of patient were optimally following guidelines: sleep (67%), hearing (68%), social engagement (69%), and diet (74%). For 4 factors, >75% were optimally following guidelines: smoking (99%), alcohol (88%), vision (86%), and purpose in life (78%). No recent data (>1.5 years) were found in the EMR for LDL or HbA1c in >40% of patients.

Conclusions

A combination of pharmacologic and lifestyle optimization is likely critical for best outcomes in AD. A substantial portion of this sample of highly motivated AD patients are not optimally following guidelines for reducing risk of cognitive decline. Healthcare systems need to develop programs and offer concrete interventions to address modifiable risk factors. Additionally, procedures are needed to ensure that critical, individual data linked to brain health (e.g., LDL and HbA1c) are obtained and updated in the EMR.

Authors/Disclosures
Kirk R. Daffner, MD, FAAN (Brigham & Women's Hospital - Harvard Medical School) PRESENTER	The institution of Dr. Daffner has received research support from Azheimer's Association.
Kayla Riera, BS	Miss Riera has nothing to disclose.
Seth Gale, MD (Brigham and Womens Hospital)	Dr. Gale has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cowen. The institution of Dr. Gale has received research support from Brigham And Women's Hospital.
George Ryan Ghorayeb, MA	Mr. Ghorayeb has nothing to disclose.
Brittany M. McFeeley	Mrs. McFeeley has nothing to disclose.

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