Jared C. Roach, MD, PhD, Institute for Systems Biology, Seattle, WA, discusses the importance and necessity of using systems biology based multimodal trial approaches for Alzheimer’s disease (AD). The results of the COCOA trial (NCT03424200), assessing personalized lifestyle interventions and cognitive training, show that there is a sustained improvement in the intervention arm- at 18 months there is a 60% reduction in cognitive decline- and is significantly different from the standard of care arm. These results demonstrate that multimodal interventions are an effective treatment for AD. By collecting robust quantitative data and improving mechanistic understanding of AD, the wider picture of what molecules are correlated with cognitive improvement can be observed. For example, the COCOA study demonstrated the involvement of the immune system in mediating cognition and how immune molecules are also related to diet and exercise. By collecting dense data from multimodal trials, future trials will be more effective and our understanding of how different interventions work will be improved. This interview took place at the Clinical Trials on Alzheimer’s Disease Congress 2022 in San Francisco.
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