Personalized Interventions Show Promise in Alzheimer’s Risk

In a groundbreaking study led by researchers at UC San Francisco and Kaiser Permanente Washington, a novel approach to mitigating memory loss in higher-risk older adults has emerged. The research, spanning two years and involving 172 participants, unveils the significant impact of personalized health and lifestyle changes on cognitive well-being. The study, known as SMARRT (Systematic Multi-Domain Alzheimer’s Risk Reduction Trial), focused on personalized coaching tailored to individual participants. Those who received guidance in areas associated with Alzheimer’s risk, such as uncontrolled diabetes and physical inactivity, experienced a remarkable 74% improvement in cognitive testing compared to the non-intervention group.


 Beyond cognitive enhancements, participants exhibited notable improvements in risk factors and quality of life, boasting approximately 145% and 8% advancements, respectively. These findings published in JAMA IM on Nov. 27, 2023, challenge previous conflicting results from health and lifestyle interventions by emphasizing a personalized and comprehensive approach.


 The study sheds light on the motivation of older adults to make lifestyle modifications, citing the SMARRT trial as the first personalized intervention targeting multiple cognitive domains. Lead investigator Kristine Yaffe emphasizes the effectiveness of tailoring risk factor targets based on a participant’s risk profile, preferences, and priorities, envisioning a departure from a generic one-size-fits-all strategy.

 Kristine Yaffe, said, “not only did we find a significant reduction in risk factors, this is one of only a few trials that has shown a benefit in cognition that likely translates to lower dementia risk. 


Participants aged 70 to 89 and enrolled in Kaiser Permanente Washington, exhibited at least two of eight dementia risk factors. The intervention involved personalized coaching sessions with a nurse and health coach, allowing participants to select specific risk factors for addressal. Goals ranged from managing hypertension to incorporating daily physical activity, fostering a tailored and participant-driven intervention.


 Remarkably, the positive effects of the trial endured despite the challenges posed by the pandemic. Unlike the cognitive toll experienced by many due to social distancing measures, intervention group participants demonstrated cognitive resilience and reduced risk factors during the pandemic.


 In contrast to costly anti-amyloid medications, risk-reduction programs offer a cost-effective and accessible alternative. Lead investigator Yaffe envisions a future where Alzheimer’s management mirrors cardiovascular disease, combining risk reduction strategies with targeted drugs designed for specific disease mechanisms.

This groundbreaking research not only highlights the efficacy of personalized interventions in mitigating memory loss but also underscores the potential for a paradigm shift in Alzheimer’s and dementia management.


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