Abstract
Clinical informatics platforms are improving the treatment of individuals with chronic diseases that have complex pathologies. The pathology drivers of Alzheimer's disease (AD) are highly complex and exist simultaneously, with different etiologies for every individual. Muses Labs has developed an informatics platform that generates multi-modal treatment protocols for individuals at risk for AD or those with mild AD. The MEND Protocol implemented by Muses Labs uses a data-analytics engine to deliver treatment recommendations, supported by research, to slow or reverse AD disease drivers. Computer inputs comprise genomics, bio-specimen measurements, imaging results, medical histories, medications, allergies, comorbidities, and neuropsych tests. Algorithms compare an individual's 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. A combination therapy for AD – customized to each individual – is proposed as a viable approach. Software implements the protocol, and generated recommendations are delivered to physicians. Health coaches motivate individuals' adherence. A baseline of treatment support of 76 individuals has been completed (58% female, mean age 66 years, mean 17 years of education, mean BMI 24.5). 100+ blood serum tests were collected for each. Genome raw data files from 23andMe were obtained, 66% with ApoE4. Approximately 40% of the individuals on the protocol for 6 months have improved memory function, based on standard neuropsych tests. An informatics-based platform enables rapidly-processed combination therapy for AD treatment approaches. 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. This pilot has demonstrated that individuals comply with the recommendations and can achieve the short-term goals. 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.
Published Version
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