原文記事 How the Alzheimer’s Prevention Clinic Used Body Composition to Improve Patient Outcomes
Weill Cornell Medical College is one of the top ranked clinical and medical research centers in the country. Richard Isaacson, M.D. currently serves as director of the Alzheimer’s Prevention Clinic, Weill Cornell Memory Disorders Program, and Neurology Residency Training Program. He’s also the author of two best-selling books, Alzheimer’s Treatment Alzheimer’s Prevention: A Patient & Family Guide and The Alzheimer’s Prevention & Treatment Diet.
Dr. Isaacson’s interest in Alzheimer’s prevention is personal: he’s watched many family members suffer through the disease. Because of this, he decided to focus his life’s work on prevention-based treatment methods. The Alzheimer’s Prevention Clinic is the first in the nation to focus on lifestyle intervention measures in a real-world clinical setting. Dr. Isaacson’s treatment approach has evolved rapidly over the last several years. While tracking body composition wasn’t even on his radar a few years back, it’s now one of the key strategies in his approach to help patients improve cognitive function and brain health.
The Alzheimer’s Prevention Clinic’s Challenge
Most people don’t know that Alzheimer’s disease begins in the brain 20-30 years before the first symptom of memory loss. Therefore, there is ample time for people to make brain-healthy lifestyle and dietary choices for this “pre-clinical,” or “pre-symptomatic,” stage, in an effort to delay onset. Patients who come to Dr. Isaacson’s Alzheimer’s Prevention Clinic have a history of Alzheimer’s and are in one of two stages: early intervention, where they haven’t shown any symptoms yet, or secondary intervention, when the disease has already begun. That’s why Dr. Isaacson focuses mainly on prevention. There are several randomized studies that show a combination of interventions such as exercise and diet can delay cognitive decline and improve brain health. Exercise, in particular, has been shown in clinical studies to help you dispose of amyloid proteins (“bad proteins”) that build up in the brain.
But like any good scientist, he realized there were newer, more reliable approaches than the standard genetic and metabolic markers that would help his team understand the impact of the exercise regimens and dietary changes they were prescribing in patients.
Moving Beyond the Scale
Dr. Isaacson shared an interesting story about how when they first started the clinic, they went on Amazon and bought a $60 body fat scale in an effort to track changes in patients’ body fat percentages. According to Dr. Isaacson, “Variability was all over the place.” As they began to look for new, evidenced-based ways to monitor the health of patients in their clinic, accurate, reliable body composition analysis became a key goal.
The Alzheimer’s Prevention Clinic team quickly learned that arbitrary measures like weight and BMI can only tell you so much. Body composition was the advanced analytics solution they were looking for to track patients’ progress.
How InBody Helped the Alzheimer’s Prevention Clinic Improve Patient Outcomes
“What better way to improve body metabolism by improving body composition and tracking body composition over time and getting a person to know their numbers.”
Dr. Isaacson first learned about InBody after visiting a patient in L.A. and seeing a printout of the patient’s body composition analysis results. His team was trying out 6-7 different machines at the time but wanted to make sure they chose the one that was the most reliable. So he opted for a slightly unconventional approach: becoming a human guinea pig.
After using the InBody 770 on himself, he had a “bit of a wake-up call.” Although he was a runner and always thought of himself as physically fit, his body composition numbers told him otherwise. After changing his exercise regimen to include more weight training/HIIT, he watched his body fat level drop from 23 to 21 to 17.3.
They decided to try the InBody 770 with patients for two main reasons: 1)It was reliable. 2)It measured phase angle, which they suspected could potentially be correlated with overall health.
Dr. Isaacson and his team found the InBody body composition analysis device simple to use and informative. Patients liked it because it was easy and quick. Dr. Isaacson noted: “InBody was the quickest and easiest and provided the most graphically educational information for clinician and patient. There’s a lot of options out there, but this was the best one for us.”
Patient Success Stories
Dr. Isaacson said that body composition analysis has been a “bolt of lightning” that has become a new standard in how they measure success of treatment approaches. “I put people on this machine and it gave me a totally different window into a person’s body.” He cites two outputs that he uses frequently with the InBody: percentage of body fat and lean body mass. The Body Fat – Lean Body Mass Control chart has also been a valuable tool to help patients understand how many recommended pounds of fat they need to lose and muscle they could stand to gain.
He’s seen many success stories since bringing body composition analysis into his clinic. For example, a recent patient lost 7 inches from her waist and dropped her body fat percentage 8% in 6 months. A 65-year-old patient drove through the night on her birthday to visit the clinic when her Medicare coverage kicked in. She was a size 16, had diabetes, and struggled with losing weight. Dr. Isaacson prescribed a lifestyle modification program, complete with regular body composition assessments. Today, she’s a size 6 and healthier than ever. Dr. Isaacson even had a personal “body fat off” with another patient, which inspired both him and his patient to lose fat and gain lean body mass, which they were able to measure with the InBody.
Dr. Isaacson went on to say: “It makes people feel good. Their clothes fit better. They see that body fat percentage and weight going down. They feel better about themselves.”
At the Alzheimer’s Prevention Clinic, the approach is simple: talk to the patient and learn their history, analyze the current data, and formulate a unique treatment approach. That data now includes a “triangle” of moving parts: 1)Labs/blood work 2)Cognitive assessment 3)Body composition
When Dr. Isaacson began focusing on body composition measures, he immediately realized that there was a direct correlation between building and maintaining lean body mass and brain health. He noted that adding body composition analysis has led to memory stabilization in an impressive 90% of patients who come into the clinic.
As to the future of Alzheimer’s prevention and the potential role body composition analysis may play, Dr. Isaacson had this to say: “Body composition a couple years from now (I hope) will be standard of care when it comes to managing a person for brain health.”