Precision Medicine for Alzheimer’s Disease Prevention

Abstract

Precision medicine is an approach to medical treatment and prevention that takes into account individual variability in genes, environment, and lifestyle and allows for personalization that is based on factors that may affect the response to treatment. Several genetic and epigenetic risk factors have been shown to increase susceptibility to late-onset Alzheimer’s disease (AD). As such, it may be beneficial to integrate genetic risk factors into the AD prevention approach, which in the past has primarily been focused on universal risk-reduction strategies for the general population rather than individualized interventions in a targeted fashion. This review discusses examples of a “one-size-fits-all” versus clinical precision medicine AD prevention strategy, in which the precision medicine approach considers two genes that can be commercially sequenced for polymorphisms associated with AD, apolipoprotein E (APOE), and methylenetetrahydrofolate reductase (MTHFR). Comparing these two distinct approaches provides support for a clinical precision medicine prevention strategy, which may ultimately lead to more favorable patient outcomes as the interventions are targeted to address individualized risks.

Cross-Cultural Adaptation and Validation of a French Version of the Genetic Counseling Satisfaction Scale (GCSS) as an Outcome Measure of Genetic Counseling for Hereditary Breast and Ovarian Cancer

“…With the exception of genetic testing for Huntington’s disease, several systematic reviews concur that the genetic testing process might not be as stressful as medical and scientific communities initially feared [ 16 , 17 , 18 ]. As genetic testing and genomic medicine are finding their way into the mainstream of cancer care trajectories [ 19 ] and becoming recommended practice for an increasing number of chronic diseases, e.g., [ 20 , 21 ], feelings of stress may be even less frequent and intense in the future. Although the purpose of this work was to produce a reliable French version of the GCSS consistent with the original scale, and that we consequently chose to keep the term “stress”, it would be interesting in future work to compare the performance of the GCSS with a version where the term “stress” would be replaced by another less emotionally charged term.…”

Exploring Alzheimer’s Disease Molecular Variability via Calculation of Personalized Transcriptional Signatures

“…Various clinical fields such as oncology [41], cardiology [42], and neurology [43,44] have refocused their efforts from a traditional "one-size-fit-all approach" to explore more personalized-based approaches. Accordingly, the classification of disease subtypes is currently a key challenge.…”

Integration of GWAS and brain transcriptomic analyses in a multiethnic sample of 35,245 older adults identifies DCDC2 gene as predictor of episodic memory maintenance

“…The identification of DCDC2 gene as a predictor of memory maintenance in older adulthood provides the possibility of identifying population subgroups at risk of memory decline and dementia, paving the way for precision medicine intervention 32,61–63 . Compared to the universal “one‐size‐fits‐all” approach (generalized prevention strategies for all individuals), a precision medicine approach offers the opportunity to personalize interventions that hold the promise of advancing memory decline prevention strategies 64 . To be used as a diagnostic system and more efficient treatment of age‐related memory impairment, it will require (1) defining groups of individuals for whom a cognitive intervention is warranted and (2) developing and testing novel treatments and interventions that can be applied with a degree of specificity to distinct subpopulations of individuals 65 .…”