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Clinical Trial
. 2023;94(3):993-1004.
doi: 10.3233/JAD-230004.

Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline

Heather Sandison  1 , Nini G L Callan  2 , Rammohan V Rao  3 , John Phipps  2 , Ryan Bradley  2   4
Affiliations
Clinical Trial

Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline

Heather Sandison et al. J Alzheimers Dis. 2023.

Abstract

Background: 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.

Objective: 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.).

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: Alzheimer’s disease; Cambridge Brain Sciences; Montreal Cognitive Assessment; clinical trial; dementia; mild cognitive impairment.

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Conflict of interest statement

This manuscript is not under consideration by another journal, nor has it been published. Dr. Heather Sandison is the owner of a medical clinic and senior living facility. All the other authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Identifying and addressing potential contributors to cognitive decline with a multimodal, individualized medicine therapeutic approach is supportive of cognitive health. Shown in the figure are the baseline strategies and treatment plans for reversal of OCI and optimizing brain health, prior to testing and individualized treatment.
Fig. 2
Fig. 2
MoCA test scores of participants (n = 23) at baseline and 6 months after initiating treatment. MoCA test scores ranged from 12–23 at baseline and were statistically significantly different at Month 6 (p = 0.013, Wilcoxon signed rank test).
See this image and copyright information in PMC

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