Dietary Intervention to Prevent and Slow Memory Loss due to Alzheimer’s (DIPLOMA)

The Alzheimer’s Prevention Clinic (APC) at Weill Cornell Medical College/NewYork-Presbyterian Hospital treats patients (aged 25+) witha family history of AD to lower their risk for dementia. Longitudinal,evidence-based clinical care is personalized with respect to risk factorssuch as genetics, medical conditions, anthropometrics, laboratorymarkers (lipid, inflammatory, metabolic, and nutritional) and neuropsychologicalfunction with assessments every 6 months. Patients areinstructed on multi-modal pharmacological and non-pharmacologicalmanagement strategies, are comprehensively educated via an onlinepatient education and education/behavioral research portal (www.AlzU.org), and use the AD-Nutrition Tracking System, an online databaseand lifestyle management tool. Patients may participate in the Dietary Intervention to Prevent and Slow Memory Loss due to Alzheimer’s(DIPLOMA) study. This prospective cohort study currently follows>150 cognitively normal patients, >30 possible pre-clinical AD patients(based on preliminary clinical diagnosis) with objective cognitive impairmentbut no or minimal subjective memory loss, and >30 patientswith mild cognitive impairment due to AD. We apply emerging principlesof pharmacogenomics, nutrigenomics, and clinical precision medicineto tailor individualized therapies. A principal hypothesis underlyingour approach is that glucose hypometabolism promotes AD brainpathology, and targeted interventions to address distinctive nutritionaland/or metabolic requirements will support mitochondrial efficiencyand reduce oxidative damage, thereby contributing to neuroprotection.Our primary goal is to investigate whether pharmacogenomic/nutrigenomic interventions will produce differential, risk-reducing responsesin our subpopulations (e.g., APOE/MTHFR status). We recentlyexpanded neuroimaging to include FDG-PET, Amyloid-PET and MRI/MR spectroscopy, and plan a six-month randomized controlled clinicaltrial based on initial data obtained (early 2016).