Journal article
A multi-modal medical management and lifestyle intervention increase cerebral blood flow and lowers diabetic risk in persons with early Alzheimer's disease: Mid-trial results from the PREVENTION trial
Journal of Alzheimer's disease, v 108(4), pp 1819-1833
01 Dec 2025
PMID: 41243261
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Medical and lifestyle management are crucial for Alzheimer's disease (AD). Cerebral blood flow (CBF), vital for brain health, and influenced by modifiable risk factors, is reduced in AD and may become uncoupled from metabolism due to neurovascular dysfunction in later stages. Objective: This mid-trial analysis tested the hypothesis that a coached, multi-modal intervention (PREVENTION) improved ASL-MRI-measured CBF and diabetic risk (QUICKI) in patients with early AD. Methods: The control arm received recommendations and medical management for one year; the active arm additionally received coaching, exercise training, and supplementation. We hypothesized that those in (1) the active arm and (2) with higher intervention adherence would have improved post-trial QUICKI and CBF, particularly in regions relevant to exercise, cardiovascular, diabetic, and AD risk. Post-trial CBF was analyzed using a linear model including arm, baseline CBF, adherence, age, education, and depressive symptoms. Change in QUICKI was analyzed using mixed effects general linear models, including arm, adherence, time, and interactions between time and treatment group and time and adherence, controlling for age. Results: The active arm (n = 18) showed greater post-trial CBF in regions related to exercise, cardiovascular, diabetic, and AD risk, compared to control (n = 20), but did not differ in global CBF, QUICKI, or adherence. Higher adherence scores were associated with greater regional post-trial CBF and improvement in QUICKI, but not global CBF. Conclusions: In this small sample, we found evidence that a multi-modal intervention focused on medical management, exercise, and a carbohydrate-restricted diet improved diabetic risk and CBF in patients with AD.
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Details
- Title
- A multi-modal medical management and lifestyle intervention increase cerebral blood flow and lowers diabetic risk in persons with early Alzheimer's disease: Mid-trial results from the PREVENTION trial
- Creators
- Jennifer E. Bramen - Saint John's Health CenterPrabha Siddarth - Pacific Heart InstituteEmily S. Popa - Saint John's Health CenterGavin T. Kress - Pacific Heart InstituteMolly K. Rapozo - Saint John's Health CenterJohn F. Hodes - Saint John's Health CenterAarthi S. Ganapathi - University of Southern CaliforniaWilliam M. Sparks - Saint John's Health CenterYnez M. Tongson - Saint John's Health CenterAndrea M. Torres - Saint John's Health CenterSomayeh Meysami - Saint John's Health CenterColby B. Slyapich - Pacific Heart InstituteRyan M. Glatt - Saint John's Health CenterKyron Pierce - Saint John's Health CenterKaren J. Miller - Saint John's Health CenterShannel H. Elhelou - Saint John's Health CenterVerna R. Porter - Saint John's Health CenterClaudia Wong - Saint John's Health CenterMihae Kim - Saint John's Health CenterStella Panos - Saint John's Health CenterDaniel A. Hirsch - Pacific Heart InstituteCyrus A. Raji - Washington University in St. LouisSusan Y. Bookheimer - Pacific Heart InstituteLeroy Hood - Buck Institute for Research on AgingJared C. Roach - Institute for Systems BiologyDavid A. Merrill - University of California, Los Angeles
- Publication Details
- Journal of Alzheimer's disease, v 108(4), pp 1819-1833
- Publisher
- Sage
- Number of pages
- 15
- Grant note
- N/A / Barbara and John McLoughlin Family N/A / Providence St. Joseph Health P41EB015909 / National Institute for Basic Biology; National Institutes of Natural Sciences (NINS) - Japan
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001617194700001
- Scopus ID
- 2-s2.0-105023142260
- Other Identifier
- 991022197329204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neurosciences