Development of a Multicomponent Intervention to Prevent Alzheimer's Disease
Recent advances in vascular risk management have successfully reduced the prevalence of Alzheimer's Disease (AD) in several epidemiologic investigations. It is now widely accepted that cerebrovascular disease is both directly and indirectly involved in AD pathogenesis. Herein, we review the non...
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doaj-11371e6f97184131b2f5776efe7691482020-11-24T22:19:42ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-05-011010.3389/fneur.2019.00490443385Development of a Multicomponent Intervention to Prevent Alzheimer's DiseaseSatoshi Saito0Satoshi Saito1Satoshi Saito2Yumi Yamamoto3Masafumi Ihara4Department of Neurology, National Cerebral and Cardiovascular Center, Suita, JapanResearch Fellow of Japan Society for the Promotion of Science, Tokyo, JapanDepartment of Pediatric Dentistry, Osaka University Graduate School of Dentistry, Suita, JapanDepartment of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Neurology, National Cerebral and Cardiovascular Center, Suita, JapanRecent advances in vascular risk management have successfully reduced the prevalence of Alzheimer's Disease (AD) in several epidemiologic investigations. It is now widely accepted that cerebrovascular disease is both directly and indirectly involved in AD pathogenesis. Herein, we review the non-pharmacological and pharmacological therapeutic approaches for AD treatment. MIND [Mediterranean and DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay] diet is an important dietary treatment for prevention of AD. Multi domain intervention including diet, exercise, cognitive training, and intensive risk managements also prevented cognitive decline in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study. To confirm these favorable effects of life-style intervention, replica studies are being planned worldwide. Promotion of β-amyloid (Aβ) clearance has emerged as a promising pharmacological approach because insufficient removal of Aβ is more important than excessive Aβ production in the pathogenesis of the majority of AD patients. Most AD brains exhibit accompanying cerebral amyloid angiopathy, and Aβ distribution in cerebral amyloid angiopathy closely corresponds with the intramural periarterial drainage (IPAD) route, emphasizing the importance of Aβ clearance. In view of these facts, promotion of the major vascular-mediated Aβ elimination systems, including capillary transcytosis, the glymphatic system, and IPAD, have emerged as new treatment strategies in AD. In particular, the beneficial effects of cilostazol were shown in several clinical observation studies, and cilostazol facilitated IPAD in a rodent AD model. The COMCID (Cilostazol for prevention of Conversion from MCI to Dementia) trial, evaluating the efficacy of cilostazol for patients with mild cognitive impairment is currently ongoing in Japan. Such therapeutic approaches involving maintenance of cerebrovascular integrity and promotion of vascular-mediated Aβ clearance have the potential to be mainstream treatments for sporadic AD.https://www.frontiersin.org/article/10.3389/fneur.2019.00490/fullAlzheimer's diseasecerebrovascular diseasecerebral amyloid angiopathyMIND dietglymphatic systemIPAD |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Satoshi Saito Satoshi Saito Satoshi Saito Yumi Yamamoto Masafumi Ihara |
spellingShingle |
Satoshi Saito Satoshi Saito Satoshi Saito Yumi Yamamoto Masafumi Ihara Development of a Multicomponent Intervention to Prevent Alzheimer's Disease Frontiers in Neurology Alzheimer's disease cerebrovascular disease cerebral amyloid angiopathy MIND diet glymphatic system IPAD |
author_facet |
Satoshi Saito Satoshi Saito Satoshi Saito Yumi Yamamoto Masafumi Ihara |
author_sort |
Satoshi Saito |
title |
Development of a Multicomponent Intervention to Prevent Alzheimer's Disease |
title_short |
Development of a Multicomponent Intervention to Prevent Alzheimer's Disease |
title_full |
Development of a Multicomponent Intervention to Prevent Alzheimer's Disease |
title_fullStr |
Development of a Multicomponent Intervention to Prevent Alzheimer's Disease |
title_full_unstemmed |
Development of a Multicomponent Intervention to Prevent Alzheimer's Disease |
title_sort |
development of a multicomponent intervention to prevent alzheimer's disease |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2019-05-01 |
description |
Recent advances in vascular risk management have successfully reduced the prevalence of Alzheimer's Disease (AD) in several epidemiologic investigations. It is now widely accepted that cerebrovascular disease is both directly and indirectly involved in AD pathogenesis. Herein, we review the non-pharmacological and pharmacological therapeutic approaches for AD treatment. MIND [Mediterranean and DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay] diet is an important dietary treatment for prevention of AD. Multi domain intervention including diet, exercise, cognitive training, and intensive risk managements also prevented cognitive decline in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study. To confirm these favorable effects of life-style intervention, replica studies are being planned worldwide. Promotion of β-amyloid (Aβ) clearance has emerged as a promising pharmacological approach because insufficient removal of Aβ is more important than excessive Aβ production in the pathogenesis of the majority of AD patients. Most AD brains exhibit accompanying cerebral amyloid angiopathy, and Aβ distribution in cerebral amyloid angiopathy closely corresponds with the intramural periarterial drainage (IPAD) route, emphasizing the importance of Aβ clearance. In view of these facts, promotion of the major vascular-mediated Aβ elimination systems, including capillary transcytosis, the glymphatic system, and IPAD, have emerged as new treatment strategies in AD. In particular, the beneficial effects of cilostazol were shown in several clinical observation studies, and cilostazol facilitated IPAD in a rodent AD model. The COMCID (Cilostazol for prevention of Conversion from MCI to Dementia) trial, evaluating the efficacy of cilostazol for patients with mild cognitive impairment is currently ongoing in Japan. Such therapeutic approaches involving maintenance of cerebrovascular integrity and promotion of vascular-mediated Aβ clearance have the potential to be mainstream treatments for sporadic AD. |
topic |
Alzheimer's disease cerebrovascular disease cerebral amyloid angiopathy MIND diet glymphatic system IPAD |
url |
https://www.frontiersin.org/article/10.3389/fneur.2019.00490/full |
work_keys_str_mv |
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