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The Power of Lifestyle Medicine: Can A Multimodal Approach Slow or Reverse Alzheimer’s?
Most yoga practitioners will remember the revolutionary findings of Dr. Dean Ornish back in the early 1990s, when he first was able to document that a program of yoga and healthy lifestyle measures had proven effective at not just slowing the progression of coronary heart disease, but reversing it.
Well, fast forward about twenty years, and similar groundbreaking research has now documented the power of lifestyle to reverse some of the most dreaded ailments of aging: memory loss, dementia and Alzheimers.
A recent small clinical trial has demonstrated that the memory loss and cognitive impairment associated with the early stages of Alzheimer’s disease can be reversed using a multimodality program focused around reversing the neurodegenerative processes that ultimately develop into Alzheimer’s or dementia.
Follow-up testing showed that the improvements were sustained, allowing some patients to regain their ability to speak other languages and even return to work; brain matter volume was also shown to increase after only a few months of treatment.
Traditional Medical Approaches to Alzheimer’s Have Failed
The new research comes just as major drug companies have thrown in the towel when it comes to finding effective drugs for Alzheimer’s. Pfizer recently decided to end its research efforts to develop new drugs for Alzheimer's and Parkinson's patients due to discouraging results.
Similarly, Axovant, a pharmaceutical company that develops drugs to treat neurological disorders, abandoned its efforts to develop a new drug for neurodegenerative disorders.
The problem has been that these drugs only address individual symptoms, (and not very well), whereas Alzheimer’s and dementia develop based on numerous individual neurodegenerative processes. As a consequence, the magic bullet approach, in which one drug is developed in an attempt to target the disorder, has proven hopelessly ineffective.
The Bredesen Protocol: A New Memory Loss Treatment Method
So, what did the researchers in the recently published study showing reversal of cognitive impairment do differently? This pioneering study from the Buck Institute for Research on Aging and the UCLA Easton Laboratories for Neurodegenerative Disease, investigated the efficacy of a new treatment method for age-related decline in cognitive abilities.
They introduced an approach name Metabolic Enhancement for NeuroDegeneration, or “MEND.” At its basis, this approach focuses on 36 different factors, including lifestyle habits of sleep, diet and exercise, as well as the integration of vitamins, drugs, and brain stimulation therapy.
The clinical trial included 10 aging patients experiencing cognitive decline. All of these patients had either well-defined mild cognitive impairment, subjective cognitive impairment, or had been diagnosed with Alzheimer’s disease before beginning the program. The pioneering study was headed up by Dr. Dale Bredesen, an expert in the mechanisms of neurodegenerative diseases such as Alzheimer’s disease.
The 10 patients underwent the MEND lifestyle changes and medicinal treatments for 5-24 months. The team of researchers were thrilled to report the life-altering improvements that many of the patients displayed.
According to Dr. Bredesen, "The magnitude of improvement in these 10 patients is unprecedented, providing additional objective evidence that this programmatic approach to cognitive decline is highly effective."
The results of this trial, published in the journal Aging, make this the first study to objectively demonstrate that a sustained improvement of memory loss reversal is a viable possibility for those experiencing age-related cognitive decline.
An Individualized Treatment for Cognitive Impairment and Alzheimer’s
Just as Alzheimer’s manifests differently in each individual experiencing it, the Bredesen Protocol in MEND offers a unique treatment for each patient based on a complex combination of factors specifically catered to them.
One commonality among the trial patients, however, was that 9 of them carried at least one copy of the APOE4 allele, making them at genetic risk for Alzheimer’s disease. Approximately 65% of Alzheimer’s cases in America involve APOE4; there is now a potential benefit for getting tested for this gene, since there is now a viable treatment option for stalling the progression of the disease.
"The old advice was to avoid testing for APOE because there was nothing that could be done about it. Now we're recommending that people find out their genetic status as early as possible so they can go on prevention," said Bredesen.
Trial Patients Show Remarkable Improvements
Publication of the study highlights each of the 10 trial patients as individual case studies: One 66-year old man in the trial was still able to work when his first signs of Alzheimer’s appeared. MRI scans of the his brain betrayed that the volume of his hippocampus had decreased to the 17th percentile for his age, however, after 10 months on the MEND program, it had increased to the 75th percentile. In addition to reports of experiencing improved memory and cognitive ability, he had a physical increase in hippocampal volume of 12 percent. The research team noted, that to their knowledge, “the magnitude of hippocampal volume increase that occurred with this patient has not been reported previously."
A slightly older male patient, 69-years old, had signs of early Alzheimer’s, and after experiencing 11 years of progressive memory loss, he was about to close his business. He too had miraculous results from the MEND treatment. In one cognitive test, he improved his performance from the 3rd percentile, to the 84th percentile, after 22 months on the MEND program. He was able to return to work and even expand his business.
Similarly, a female patient in the trial was hardly able to grocery shop, but after treatment showed “marked improvement” that has been sustained for over 3 years. After 9 months of the MEND treatment, a bilingual patient regained her ability to speak her second language. A year after the program, she remained asymptomatic.
By the end of the trial, the majority of the 10 patients had returned to the normal range for cognitive testing for their age.
Limitations of these Results
It is worth noting that these striking results are not due to a one-time fix. It appears that if patients want their improvements to be sustained, their treatment must be ongoing as well. The researchers noted that as long as the treatment was continued, the improvements were sustained, but as this is the first study of its kind, it’s unknown how long that will last. Of the 10 patients, the longest they’ve been monitoring is 4 years.
While the initial publication lacks a complete analysis of how the MEND program works and why it is so successful, Bredesen suggests that its efficacy lies in its comprehensiveness; it addresses 36 different factors influencing Alzheimer’s progression.
"Imagine having a roof with 36 holes in it, and your drug patched one hole very well - the drug may have worked, a single 'hole' may have been fixed, but you still have 35 other leaks, and so the underlying process may not be affected much," says Bredesen. "We think addressing multiple targets within the molecular network may be additive, or even synergistic, and that such a combinatorial approach may enhance drug candidate performance, as well."
Though the results are promising, 10 patients is a very small sample size, and more research is needed. Plans for a much larger study involving the MEND treatment are already underway. Researchers hope the future will yield more positive results and a brighter outlook for Alzheimer’s prevention and treatment.