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Issue title: Alzheimer's Disease: Detection, Prevention, and Preclinical Treatment
Guest editors: Jack C. de la Torre
Article type: Review Article
Authors: de la Torre, Jack C.; *
Affiliations: Department of Psychology, University of Texas at Austin, Austin, Texas, USA
Correspondence: [*] Correspondence to: Jack C. de la Torre, MD, PhD, Department of Psychology, University of Texas at Austin, 1 University Station, Austin, Texas 78712-0187, USA. Tel.: +1 512 475 7596; E-mail: jcdelatorre@comcast.net.
Abstract: The incidence rate in Alzheimer's disease (AD) is expected to quadruple worldwide by 2050. To limit this impending socio-medical calamity, a fulcrum change from how AD is presently managed is crucial. The present approach has not averted the stress of AD on medical resources nor reduced the already cost-strained government health care programs. Since substantial evidence indicates that sporadic AD is directly associated with vascular risk factors, a strategic plan is proposed to target this association and markedly reduce the onset of AD. This plan would establish in-house heart-brain clinics devoted to identifying, detecting, and preventing the progression of vascular risk factors that predispose to cognitive impairment and development of AD. The heart-brain clinics would be staffed with a multidisciplinary group of neurologists, psychologists, neuroradiologists, cardiovascular specialists, and technical personnel Their goal would be to apply and interpret non-invasive, cost-effective multidiagnostic testing of heart and brain function in outpatient asymptomatic and symptomatic patients at risk of dementia. Multidiagnostic testing would permit better risk stratification, medical decision-making, and a tailored intervention of patients at-risk of dementia than the present monotherapeutic approach. Personalized intervention, moreover, should achieve better patient compliance and outcome through periodic follow-up visits to the clinics where the medical plan of action could be monitored and modified as needed. Multidisciplinary heart-brain clinics will be costly at first but eventually should become cost-effective while providing an invaluable medical service to an aging population and possibly extending years of full-health lived in those at risk of dementia.
Keywords: Alzheimer's disease, cognitive impairment, detection, heart-brain clinics, multidiagnostic testing, prevention, vascular risk factors
DOI: 10.3233/JAD-141560
Journal: Journal of Alzheimer's Disease, vol. 42, no. s4, pp. S431-S442, 2014
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