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Precision Medicine Approach to Alzheimer's Disease: Rationale and Implications
Bredesen Dale E, Toups Kat, Hathaway Ann, Gordon Deborah, Chung Henrianna, Raji Cyrus, Boyd Alan, Hill Benjamin D et al.. Journal of Alzheimer's disease : JAD, 2023-10-09
Topic: Amyloid, tau and blood-test diagnosis
The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer's disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review the rationale for a precision medicine approach in prevention and treatment of cognitive decline associated with AD. Results and implications from recent proof-of-concept clinical trials are presented. Randomized controlled trials, with much larger patient numbers, are likely to be significant to establishing precision medicine protocols as a standard of care for prevention and treatment of cognitive decline. Furthermore, combining this approach with the pharmaceutical approach offers the potential for enhanced outcomes. However, incorporating precision medicine approaches into everyday evaluation and care, as well as future clinical trials, would require fundamental changes in trial design, IRB considerations, funding considerations, laboratory evaluation, personalized treatment plans, treatment teams, and ultimately in reimbursement guidelines. Nonetheless, precision medicine approaches to AD, based on a novel model of AD pathophysiology, offer promise that has not been realized to date with monotherapeutic approaches.
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APA 7th
Bredesen Dale, E., Kat, T., Ann, H., Deborah, G., Henrianna, C., Cyrus, R., et al. (2023). Precision Medicine Approach to Alzheimer's Disease: Rationale and Implications. Journal of Alzheimer's disease : JAD. https://doi.org/10.3233/jad-230467
Vancouver
Bredesen Dale E, Kat T, Ann H, Deborah G, Henrianna C, Cyrus R, et al. Precision Medicine Approach to Alzheimer's Disease: Rationale and Implications. Journal of Alzheimer's disease : JAD. 2023. doi:10.3233/jad-230467. PMID: 37807782.
BibTeX
@article{bredesendale2023-37807782,
author = {Bredesen Dale, E. and Kat, Toups and Ann, Hathaway and Deborah, Gordon and Henrianna, Chung and Cyrus, Raji and Alan, Boyd and Hill Benjamin, D. and others},
title = {{Precision Medicine Approach to Alzheimer's Disease: Rationale and Implications}},
journal = {Journal of Alzheimer's disease : JAD},
year = {2023},
doi = {10.3233/jad-230467},
pmid = {37807782},
url = {https://doi.org/10.3233/jad-230467}
}
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Key findings
- Here we review the rationale for a precision medicine approach in prevention and treatment of cognitive decline associated with AD.
- Results and implications from recent proof-of-concept clinical trials are presented.
- Randomized controlled trials, with much larger patient numbers, are likely to be significant to establishing precision medicine protocols as a standard of care for prevention and treatment of cognitive decline.
Why it matters
This review argues that a precision medicine approach, which identifies and addresses multiple individual contributors to cognitive decline, may be more effective than single-target treatments, based on recent proof-of-concept trials. The authors state that much larger randomized controlled trials are needed before precision medicine can be established as a standard of care for prevention and treatment.
Study details
- Evidence strengthHigh
How this study scored 49/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited and senior author's track record, so those were left out: it earned 33 of the 68 points we could judge it on, which is 49 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Alzheimer's disease : JAD) |
| Journal's citation record | 2 / 4 | Journal of Alzheimer s Disease: journal h-index 218 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | Citation count not trusted: 5 of 7 library studies citing it were published more than a year before it - a sign OpenAlex merged several works under this DOI — left out of this score |
| Citations per year | — / 5 | Citation count not trusted (see above) — left out of this score |
| Impact for its field and year | — / 6 | Citation count not trusted (see above) — left out of this score |
| Cited by studies here | — / 6 | Library citations not trusted (see above) — left out of this score |
| Still being cited | — / 4 | Citation count not trusted (see above) — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 2 / 3 | Washington University in St. Louis: institution h-index 1,947 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37807782) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 33 / 68 | Scored on 14 of 20 parts. We have no data for the rest, so they are left out: 33 of the 68 points we could judge it on is 49 out of 100. |
| Total | 49 / 100 | — |
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