Abstract
Clinical informatics platforms are improving the treatment of individuals with chronic, complex diseases. The pathologic drivers of Alzheimer's disease are numerable and active simultaneously, with different etiologies for every individual. Muses Labs has deployed an informatics platform that integrates large datasets measuring different parameters of individuals to generate personalized, multi-modal treatment protocols for those at risk or in early stages of AD. The AD1 Protocol implemented by Muses Labs uses a data-analytics engine to optimize research-supported treatment recommendations to slow or reverse multiple factors associated with AD simultaneously. Data inputs comprise genomics, bio-specimen measurements, imaging results, medical histories, medications, allergies, immunizations, comorbidities, and results of cognitive evaluations. Algorithms compare the status of multiple physiological and lifestyle states known to be contributors to cognitive decline against desired normative states. We observe that AD disease drivers are interlocked, comprising modifiable feedback loops. Software algorithms implement the protocol, and generated recommendations are delivered to physicians. Health coaches motivate individuals' adherence and ongoing data collection. One to five iterations of protocols were generated for self-selected individuals (n=183, 52% pre-MCI, 58.5% female, mean age 66.7 years, mean 17.6 years of education, mean BMI 24.6). Genome data files were obtained with patient consent (65.4% ApoE4 carriers). 100+ serum blood tests were collected in each iteration. Approximately 60% of individuals on the protocol for 6 months have improved memory function, as measured on standardized cognitive evaluations. An informatics-based platform enables an actionable combination therapy for AD. This allows the testing of the hypothesis that recommended intervention protocols for physician usage can consistently modulate a large number of factors. From an IT perspective, well-established, big-data analytics techniques are utilized, including prioritizing, weightings, probabilities, and partial differential equations. Diagnosis, treatment recommendations and ongoing tracking is extensible. Health coaches are essential to adherence, providing guidance and influencing individuals' compliance. Individuals comply with the recommendations and can achieve the short-term goals leading to measurable cognitive improvements. Longer-term studies are needed to show that addressing multiple disease drivers simultaneously can be an effective path to improve cognitive function, and to delay or prevent AD.
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