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Therefore, increasing data set size to include the potential contributors to cognitive decline for each patient, and addressing the identified potential contributors, may represent a more effective strategy. Twenty-five patients with dementia or mild cognitive impairment, with Montreal Cognitive Assessment MoCA scores of 19 or higher, were evaluated for markers of inflammation, chronic infection, dysbiosis, insulin resistance, protein glycation, vascular disease, nocturnal hypoxemia, hormone insufficiency or dysregulation, nutrient deficiency, toxin or toxicant exposure, and other biochemical parameters associated with cognitive decline.

Brain magnetic resonance imaging with volumetrics was performed at baseline and study conclusion. No serious adverse events were recorded. MRI volumetrics also improved. Based on the cognitive improvements observed in this study, a larger, randomized, controlled trial of the precision medicine therapeutic approach described herein is warranted. Unfortunately, therapeutic approaches to date have not led to sustainable improvements, and the best results from recent clinical trials have been to slow cognitive decline rather than improve cognition or halt decline [ 2 ].

In the field of oncology, a personalized, precision medicine approach, in which the presumptive molecular drivers of the disease process are targeted therapeutically, has improved outcomes in at least some studies [ 3 ]. However, this strategy has not been applied successfully to neurodegenerative diseases. These anecdotal reports have provided support for the execution of a proof-of-concept trial, the results of which are presented herein.