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Memory loss associated with Alzheimer's reversed: Small trial succeeds using systems approach to memory disorders
Myriam
Posted: Tuesday, September 30, 2014 5:29 PM
Joined: 12/6/2011
Posts: 3326


Patient one had two years of progressive memory loss. She was considering quitting her job, which involved analyzing data and writing reports, she got disoriented driving, and mixed up the names of her pets. Patient two kept forgetting once familiar faces at work, forgot his gym locker combination, and had to have his assistants constantly remind him of his work schedule. Patient three's memory was so bad she used an iPad to record everything, then forgot her password. Her children noticed she commonly lost her train of thought in mid-sentence, and often asked them if they had carried out the tasks that she mistakenly thought she had asked them to do. 

 

Since its first description over 100 years ago, Alzheimer's disease has been without effective treatment. That may finally be about to change: in the first, small study of a novel, personalized and comprehensive program to reverse memory loss, nine of 10 participants, including the ones above, displayed subjective or objective improvement in their memories beginning within three to six months after the program's start. Of the six patients who had to discontinue working or were struggling with their jobs at the time they joined the study, all were able to return to work or continue working with improved performance. Improvements have been sustained, and as of this writing the longest patient follow-up is two and one-half years from initial treatment. These first ten included patients with memory loss associated with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI; when a patient reports cognitive problems). One patient, diagnosed with late stage Alzheimer's, did not improve. 

 

The study, which comes jointly from the UCLA Mary S. Easton Center for Alzheimer's Disease Research and the Buck Institute for Research on Aging, is the first to suggest that memory loss in patients may be reversed, and improvement sustained, using a complex, 36-point therapeutic program that involves comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry. 

 

The findings, published in the current online edition of the journal Aging, "are very encouraging. However, at the current time the results are anecdotal, and therefore a more extensive, controlled clinical trial is warranted," said Dale Bredesen, the Augustus Rose Professor of Neurology and Director of the Easton Center at UCLA, a professor at the Buck Institute, and the author of the paper. 

 

In the case of Alzheimer's disease, Bredesen notes, there is not one drug that has been developed that stops or even slows the disease's progression, and drugs have only had modest effects on symptoms. "In the past decade alone, hundreds of clinical trials have been conducted for Alzheimer's at an aggregate cost of over a billion dollars, without success," he said. 

 

Other chronic illnesses such as cardiovascular disease, cancer, and HIV, have been improved through the use of combination therapies, he noted. Yet in the case of Alzheimer's and other memory disorders, comprehensive combination therapies have not been explored. Yet over the past few decades, genetic and biochemical research has revealed an extensive network of molecular interactions involved in AD pathogenesis. "That suggested that a broader-based therapeutics approach, rather than a single drug that aims at a single target, may be feasible and potentially more effective for the treatment of cognitive decline due to Alzheimer's," said Bredesen. 

 

While extensive preclinical studies from numerous laboratories have identified single pathogenetic targets for potential intervention, in human studies, such single target therapeutic approaches have not borne out. But, said Bredesen, it's possible addressing multiple targets within the network underlying AD may be successful even when each target is affected in a relatively modest way. "In other words," he said, "the effects of the various targets may be additive, or even synergistic." 

 

The uniform failure of drug trials in Alzheimer's influenced Bredesen's research to get a better understanding of the fundamental nature of the disease. His laboratory has found evidence that Alzheimer's disease stems from an imbalance in nerve cell signaling: in the normal brain, specific signals foster nerve connections and memory making, while balancing signals support memory loss, allowing irrelevant information to be forgotten. But in Alzheimer's disease, the balance of these opposing signals is disturbed, nerve connections are suppressed, and memories are lost. 

 

The model of multiple targets and an imbalance in signaling runs contrary to the popular dogma that Alzheimer's is a disease of toxicity, caused by the accumulation of sticky plaques in the brain. Bredesen believes the amyloid beta peptide, the source of the plaques, has a normal function in the brain -- as part of a larger set of molecules that promotes signals that cause nerve connections to lapse. Thus the increase in the peptide that occurs in Alzheimer's disease shifts the memory-making vs. memory-breaking balance in favor of memory loss. 

 

Given all this, Bredesen thought that rather than a single targeted agent, the solution might be a systems type approach, the kind that is in line with the approach taken with other chronic illnesses -- a multiple-component system. 

 

"The existing Alzheimer's drugs affect a single target, but Alzheimer's disease is more complex. 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." 

 

Bredesen's approach is personalized to the patient, based on extensive testing to determine what is affecting the plasticity signaling network of the brain. As one example, in the case of the patient with the demanding job who was forgetting her way home, her therapeutic program consisted of some, but not all of the components involved with Bredesen's therapeutic program, and included: 

 

(1) eliminating all simple carbohydrates, leading to a weight loss of 20 pounds; 

(2) eliminating gluten and processed food from her diet, with increased vegetables, fruits, and non-farmed fish; 

(3) to reduce stress, she began yoga; 

(4) as a second measure to reduce the stress of her job, she began to meditate for 20 minutes twice per day; 

(5) she took melatonin each night; 

(6) she increased her sleep from 4-5 hours per night to 7-8 hours per night; 

(7) she took methylcobalamin each day; 

( she took vitamin D3 each day; 

(9) fish oil each day; 

(10) CoQ10 each day; 

(11) she optimized her oral hygiene using an electric flosser and electric toothbrush; 

(12) following discussion with her primary care provider, she reinstated hormone replacement therapy that had been discontinued; 

(13) she fasted for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime; 

(14) she exercised for a minimum of 30 minutes, 4-6 days per week. 

 

The results for nine of the 10 patients reported in the paper suggest that memory loss may be reversed, and improvement sustained with this therapeutic program, said Bredesen. "This is the first successful demonstration," he noted, but he cautioned that the results are anecdotal, and therefore a more extensive, controlled clinical trial is needed. 

 

The downside to this program is its complexity. It is not easy to follow, with the burden falling on the patients and caregivers, and none of the patients were able to stick to the entire protocol. The significant diet and lifestyle changes, and multiple pills required each day, were the two most common complaints. The good news, though, said Bredesen, are the side effects: "It is noteworthy that the major side effect of this therapeutic system is improved health and an optimal body mass index, a stark contrast to the side effects of many drugs." 

 

The results for nine of the 10 patients reported in the paper suggest that memory loss may be reversed, and improvement sustained with this therapeutic program, said Bredesen. "This is the first successful demonstration," he noted, but he cautioned that the results need to be replicated. "The current, anecdotal results require a larger trial, not only to confirm or refute the results reported here, but also to address key questions raised, such as the degree of improvement that can be achieved routinely, how late in the course of cognitive decline reversal can be effected, whether such an approach may be effective in patients with familial Alzheimer's disease, and last, how long improvement can be sustained," he said. 

 

Cognitive decline is a major concern of the aging population. Already, Alzheimer's disease affects approximately 5.4 million Americans and 30 million people globally. Without effective prevention and treatment, the prospects for the future are bleak. By 2050, it's estimated that 160 million people globally will have the disease, including 13 million Americans, leading to potential bankruptcy of the Medicare system. Unlike several other chronic illnesses, Alzheimer's disease is on the rise--recent estimates suggest that AD has become the third leading cause of death in the United States behind cardiovascular disease and cancer. 

 

Story Source: 

The above story is based on materials provided by University of California, Los Angeles (UCLA), Health Sciences. Note: Materials may be edited for content and length. 


Journal Reference: 

  1. Dale E. Bredesen. Reversal of cognitive decline: A novel therapeutic program.Aging, September 2014 
 

Mimi S.
Posted: Tuesday, September 30, 2014 6:39 PM
Joined: 11/29/2011
Posts: 7027


Wow!  Some of that may be going on for those able to follow Best Practices.
Lane Simonian
Posted: Tuesday, September 30, 2014 9:14 PM
Joined: 12/12/2011
Posts: 4998


A wow from me, too.  I think there are multiple approaches to partially reversing Alzheimer's disease, including many of the items mentioned in this study.  I see the beginnings of a seed/sea change in how people think about Alzheimer's disease.  
Serenoa
Posted: Wednesday, October 1, 2014 6:02 AM
Joined: 4/24/2012
Posts: 484


 

Thank you for the post Myriam. I found the journal abstract and link (see below). As far as I can tell this seems like serious research done by high-level scientists at reputable institutions.  I have no doubt that this program works and will be a game changer for dealing with degenerative disease, because this therapy deals with the causes of the disease. It is not focused on addressing the resulting malfunctions only. 

  

 Reversal of cognitive decline: A novel therapeutic program

Abstract

This report describes a novel, comprehensive, and personalized therapeutic program that is based on the underlying pathogenesis of Alzheimer's disease, and which involves multiple modalities designed to achieve metabolic enhancement for neurodegeneration (MEND). The first 10 patients who have utilized this program include patients with memory loss associated with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI). Nine of the 10 displayed subjective or objective improvement in cognition beginning within 3-6 months, with the one failure being a patient with very late stage AD. Six of the patients had had to discontinue working or were struggling with their jobs at the time of presentation, and all were able to return to work or continue working with improved performance. Improvements have been sustained, and at this time the longest patient follow-up is two and one-half years from initial treatment, with sustained and marked improvement. These results suggest that a larger, more extensive trial of this therapeutic program is warranted. The results also suggest that, at least early in the course, cognitive decline may be driven in large part by metabolic processes. Furthermore, given the failure of monotherapeutics in AD to date, the results raise the possibility that such a therapeutic system may be useful as a platform on which drugs that would fail as monotherapeutics may succeed as key components of a therapeutic system.

 

http://www.impactaging.com/papers/v6/n9/abs/100690a.html

 

 

 

 

 


alz+
Posted: Wednesday, October 1, 2014 6:07 AM
Joined: 9/12/2013
Posts: 3608


I had a very Bad Day yesterday, this was the first thing I read today and my spirits are really lifted!

 

Yes - we all know how we feel better after doing just ONE of the recommended things. A good nights sleep, temporary fasting, being able to move walk dance work out - really thankful this article was placed on boards!

 

 


Vita99
Posted: Wednesday, October 1, 2014 7:55 AM
Joined: 9/4/2012
Posts: 469


What an inspiring study.  And not that hard to follow for many of us who are already trying to do most of the things on the list.  Thank you, thank you Myriam for posting this.  Great way for me to start the day as my life is getting very much more stressful with mom.  


I must admit I have the most difficulty with #13, which means no after dinner snack.  Often the knowledge that I get to eat again keeps me from eating too much for dinner!  And the hormone replacement therapy is full of pitfalls too.


Serenoa
Posted: Wednesday, October 1, 2014 6:03 PM
Joined: 4/24/2012
Posts: 484


The entire research paper is available for download at:

 http://www.impactaging.com/papers/v6/n9/pdf/100690.pdf

 

I have reviewed it and am impressed with the hypothesis the authors are putting forth. However, there are two short comings in the study. First, most patients don't have a solid diagnosis. No consistency in the diagnostic requirements for the participants. No MRIs or evaluation by a physician participating in the study to confirm the diagnoses. Second, there was no quantitative measure of cognitive improvement. No before and after test. For example, what were their scores on the Mini-Mental Exam or other standard measures of cognitive impairment. They say up front that the evidence is anecdotal, but the inclusion of a cognitive test before and after would have been nice to reinforce their findings.

 

Maybe someone else look at this and confirm that I have not misunderstood information?

 

Lane, does their basic tenants and hypothesis concur with all the evidence you have found?


Serenoa
Posted: Wednesday, October 1, 2014 6:23 PM
Joined: 4/24/2012
Posts: 484


The author in a youtube video. I like this guy.

 

 http://www.youtube.com/watch?v=nsuBWZ6WPWw


Lane Simonian
Posted: Thursday, October 2, 2014 12:34 AM
Joined: 12/12/2011
Posts: 4998


Thanks for the post, Myriam and thanks for the additional information and commentary Serenoa.

Yes, just about all of this fits what I (and others) have found.

Carbohydrates increase myo-inositol levels and tryosine receptor kinase activity both of which lead to oxidative stress.

Gluten in people with Celiac disease activates an enzyme (zonulin) responsible for oxidative stress.

Vegetables and fruits contain polyphenol anti-oxidants.  Omega 3-fatty acids in fish oil may at least reduce the risk of Alzheimer's disease, although its impact on people with Alzheimer's disease is still being debated.

Yoga reduces psychological stress and thus oxidative stress and provides physical benefits.

The first part for meditation as well.

Melatonin is an antioxidant; one negative side effect in some people is nightmares.

Methylcobolamin (B12) is an antioxidant.

Vitamin D3 is an antioxidant.

Coenzyme Q10 is an antioxidant.

Good dental hygiene reduces bacterial infections that may contribute to oxidative stress.

Moderate exercise increases the neuroprotective phosphatidylinositol 3-kinase/Akt pathway.

I have seen studies indicating that almost all of these may be of at least some benefit in the treatment of Alzheimer's disease.

The two I am not sure are needed are fasting and hormone replacement therapy.  I think a low carbohydrate, low sugar diet is sufficient at least in terms of reducing the risk of Alzheimer's disease and may help some with the disease.  Estrogen reduces myo-inositol levels and can act as an antioxidant but it also increases a g protein-coupled receptor which may moderately increase the risk of Alzheimer's disease in older women.  So good for awhile, bad for awhile, and then perhaps good again.

Despite the limitations of the study, it points in the right direction.  With the appropriate treatments and regimen, Alzheimer's disease is a partially reversible disease.




Serenoa
Posted: Thursday, October 2, 2014 5:43 AM
Joined: 4/24/2012
Posts: 484


Thanks Lane. I agree that all the research I have seen supports what they are prescribing (with possible exception of hormone replacement). And, I have seen significant evidence supporting fasting as beneficial. Plus, humans are adapted/created to go long periods (at least 12 hours) without food. Think hunter-gatherer lifestyle. This has been "normal" for most of human history and our bodies have probably come to depend on it to be healthy. Only in the last few hundred years have most people been able to eat three meals or more a day on a regular basis. Food has never been abundant historically, and it still isn't in many places

.



Lane Simonian
Posted: Thursday, October 2, 2014 9:27 AM
Joined: 12/12/2011
Posts: 4998


Very good, Serenoa.  I didn't realize until today how many studies there were suggesting that fasting may help reduce the risk of Alzheimer's disease.  
Serenoa
Posted: Tuesday, October 7, 2014 5:33 AM
Joined: 4/24/2012
Posts: 484


Here is more detailed theory from a previously published article from the same resercher. I think what he is saying makes a lot of sense. Cut and past link below for entire article (can't figure out how to hyperlink).

Next generation therapeutics for Alzheimer's disease

"Is it possible that the therapeutic failure to date in AD may have resulted, at least in part, from an incomplete understanding of the etiology and pathogenesis of AD? Any accurate theory of AD must explain a number of features (Table 1): for example, why is AD risk increased by such disparate factors as the ApoE ε4 allele, early oophorectomy (ovarian removal, for example as part of a total hysterectomy), metabolic syndrome, head trauma, inflammatory processes and hyperhomocysteinemia? What is the physiological role(s) of Aβ peptides, and how does it relate to the pathophysiology of AD? Moreover, recent results from a number of sources must be taken into account by any new theory: for example, both Aβ and tau may function as prions (de Calignon et al, 2012; Eisele et al, 2009; Yang et al, 1995). The four peptides derived from the amyloidogenic processing of β-amyloid precursor protein (APP) – sAPPβ, Aβ, Jcasp and C31 – have been shown to mediate neurite retraction, synaptic inhibition, caspase activation and programmed cell death (Bertrand et al, 2001; Lu et al, 2000, 2003; Nikolaev et al, 2009); whereas the two peptides derived from the non-amyloidogenic processing of APP – sAPPα and αCTF – support neurite extension, inhibit Aβ production, inhibit caspase activation and inhibit programmed cell death (Deyts et al, 2012; Guo et al, 1998; Tian et al, 2010). Thus, APP appears to function as a molecular switch, mediating plasticity-related processes and AD is associated, whether causally or incidentally, with an increase in the ratio of the neurite-retractive peptides to the neurite-extending peptides. Reducing this ratio, whether by affecting BACE (β-site APP cleaving enzyme) or other cleavage of APP, appears to mitigate the AD severity (Bredesen et al, 2010; Galvan et al, 2006; Jonsson et al, 2012)".

 

 http://onlinelibrary.wiley.com/doi/10.1002/emmm.201202307/full


Vita99
Posted: Tuesday, October 7, 2014 6:25 AM
Joined: 9/4/2012
Posts: 469


Fasting has actually reversed type 2 diabetes.  It is referred to as the Newcastle diet and consists of 800 calories per day for 8 weeks.  Participants gained control of their blood sugar and did not revert back diabetic sugars once they went off the diet.  Pretty remarkable and perhaps there is a link between cognition & very low calorie intake which needs further study.     
Vita99
Posted: Wednesday, October 8, 2014 7:46 AM
Joined: 9/4/2012
Posts: 469


Here is a bit more detail on each person in the study and how they individually followed the program. 

 

http://impactaging.com/papers/v6/n9/full/100690.html


Iris L.
Posted: Saturday, November 15, 2014 8:29 PM
Joined: 12/15/2011
Posts: 17544


Myriam wrote:

 

 

(1) eliminating all simple carbohydrates, leading to a weight loss of 20 pounds; 

(2) eliminating gluten and processed food from her diet, with increased vegetables, fruits, and non-farmed fish; 

  

 
 
 
 
These first two are the recommendations of Dr. David Perlmutter in his book Grain Brain.  He recommends limiting sugars and eating a low glycemic load, and avoiding gluten.  I have not read this book but I ordered his book and his program after watching a program on PBS.

 
Iris L.   

Dd197
Posted: Wednesday, November 19, 2014 5:54 AM
Joined: 9/11/2013
Posts: 1085


Mariam, have you considered trying Bredesen's therapeutic program? We are already gluten free so following it sounds like it wouldn't take too much effort.
Dd197
Posted: Wednesday, November 19, 2014 10:40 AM
Joined: 9/11/2013
Posts: 1085


Sorry about spelling of your name. Have to figure out how to turn off auto correct.
Myriam
Posted: Friday, November 21, 2014 12:42 PM
Joined: 12/6/2011
Posts: 3326


It's easy to misspell my name! I'm mostly a vegetarian, but eat a little fish (mostly salmon) and little meat. Unfortunately, I'm addicted to ice cream
Mimi S.
Posted: Friday, November 21, 2014 2:53 PM
Joined: 11/29/2011
Posts: 7027


Likewise!
Dd197
Posted: Saturday, November 22, 2014 10:57 AM
Joined: 9/11/2013
Posts: 1085


When my husband was diagnosed with Alzheimer's disease , he was also diabetic, unbeknownst to us. He went on the "visual plate method" - 1/2 of dinner plate veggies, 1/4 carbohydrate, and 1/4 meat/protein . He lost 40 lbs and was no longer diabetic. He does not take meds for diabetes. He also exercised one hour a day and we did reading, puzzles, etc...When he went back to neurologist 6 months later and his dr. Did an hour test to determine if he was declining, he actually improved cognitively. This was two years ago. He got a little lazy, gained back 15 lbs. and did not exercise daily or do any type of reading even if I kept after him. At his last appt the neuro said that he has declined. His doctor told him that if he continues on this lazy path he will continue to  decline. So we are now back on track with diet, exercise, more socialization and brain work.  We have our next neuro appt in 6 month and will see if he has declined or improved. We are slowly working our way to the Bredesen diet therapy . I know I am rambling, but, I do feel that diet, quantities of food consumed, and not eating in between meals plays a part in brain function. This is a lot of work but I will turn over every stone to see if something will help him. His neurologist told us that he should do one hour of aerobic exercise and one hour of brain work per day to maintain the skills he still has. He is about an early stage 4. So, will any of this help? We will see in 6 months.
Mimi S.
Posted: Saturday, November 22, 2014 11:06 AM
Joined: 11/29/2011
Posts: 7027


Hi Dd,

So much that you write about is so true. Overweight patients often reduce their need for insulin by dieting. Unfortunately thin folks also develop diabetes.
There are several of us on these boards who have following Best Practices for years. We too have seen the cognitive improvement and better overall health.
My internist reacting to improvement in my heart stats commented that there was no way the improvement was solely due to meds. The exercise was so important.
Keep it up.
And for others, give it a try. 

scma_2007
Posted: Wednesday, January 7, 2015 12:36 PM
Joined: 9/13/2013
Posts: 112


  

Some of the discussions in the article are rehash of earlier post. 

The added stuff - 1) A person with APOE-e4 gene 2) the similarities of Dr. Bredesen's approach to Dr. Perlmutter's  3) DR. B talked about his further research plan and his thoughts on the application of his therapeutic methods as early prevention even.  

 

http://www.cnn.com/2014/12/08/health/alzheimers-reversal/ 

 

We may be able to reverse signs of early Alzheimer's disease

(CNN)The woman at the department store bounded toward Julie Gee.  

"Julie! Hi! How have you been?" she asked. Gee, 49, stared blankly at her. A few uncomfortable seconds passed. 

"I have no idea who this woman is," Gee* thought. She felt herself slipping into a sort of cognitive abyss. 

"Remember, our sons went to school together?" the woman said. "We did playground duty together?" Gee's mind was dark. She began to panic. 

"I tried to act like I sort of knew who she was, became visibly upset and just left the store," she said, recalling the scenario years later. "It was horrible, just terrifying." 

That painful interaction was the first sign of Gee's early stage Alzheimer's disease, which genetic tests later confirmed.  

Her memory lapses mounted: Gee would find herself, for a few seconds at a time, forgetting where she was while driving familiar roads. She would walk away from conversations with her husband mid-sentence. She would be reading and unable to relate, moments later, even a shred of what she had just read. 

The idea of a long, painful descent into Alzheimer's was too much to bear. Gee's initial fear after her diagnosis metastasized to hopelessness.  

"I seriously considered suicide," she said.  

Hope for a hopeless diagnosis 

Alzheimer's disease affects as many as 5 million Americans. It is the sixth leading cause of death in the United States, and there is no cure.  

Yet a very small study out of UCLA is offering a glimmer of hope for those with what is often a hopeless diagnosis. Nine out of the 10 patients involved in the study, who were in various stages of dementia, say their symptoms were reversed after they participated in a rigorous program. The program included things like optimizing Vitamin D levels in the blood, using DHA supplements to bridge broken connections in the brain, optimizing gut health, and strategic fasting to normalize insulin levels.  

A few months after starting the extreme program, patients in the study, aged 55 to 75, noticed their cognition had either improved or returned to normal. Only one patient, a 60 year-old female who was in the late-stages of dementia when she began the program, continued to decline.  

The results, published this fall in the journal Aging, support the idea that addressing the many contributing factors of Alzheimer's disease as a group, rather than one at a time, could potentially reverse the disease's early progression, said study author Dr. Dale Bredesen, director of the Mary S. Easton Center for Alzheimer's Disease Research at UCLA.  

Those factors include 36 potential deficiencies, imbalances and sources of inflammation. 

"Each one of these things contributes a small piece of the puzzle," said Bredesen. "It's like a roof with 36 holes in it. Some people have a big hole in, say, exercise, and maybe a smaller hole in another area."  

The 10 patients in the pilot study underwent a battery of tests, including having their blood drawn and brains scanned, and had neuropsychological evaluations. Bredesen said that most of the study participants had between 10 and 24 problems that needed correcting.  

The effect of focusing on so many targets at once runs counter to what Bredesen said is a prevailing — and flawed — notion of identifying single targets to treat a disease caused by many factors.  

"Drug companies tend to come up with a really good patch for one hole," said Bredesen, founder and CEO of the Buck Institute. "It's not a surprise they don't work." 

Peter*, a patient in Bredesen's pilot study, was 69 years old and had been struggling with progressive memory loss for 11 years when he began the program.  

Around age 58, the normally bright and unflappable medical professional found he was losing his ability to recognize faces. An ability to quickly add up columns of numbers was eluding him. He would be midway through a book before it dawned on him that he'd already read it.  

"One day I went to my locker at the gym, and I could not remember the combination," said Peter. "I stood there, worked on it in my mind, and couldn't remember. Finally, I cut that thing off."  

About a year later, Peter had a brain scan that indicated a pattern of damage consistent with Alzheimer's disease.  

"I thought, 'Crap, I'm going to lose my driver's license in two or three years. I'll be a burden in five,' " he said.  

For years, he hid his symptoms as best he could while mentally preparing for his inevitable decline. By the time he was introduced to Bredesen's program last year, he was considering giving up working.  

The study outlines some of the changes Peter implemented: Eliminating simple carbohydrates and processed foods from his diet; taking probiotics and coconut oil; rigorously exercising; and sleeping as close to eight hours as he could. He added herbs and a raft of supplements to his diet, along with several other changes. 

Between four and six months later, he said, his acuity with numbers and faces returned. And, at age 71, he continues to work.  

"I would say I'm in better shape now, all the way around, than I was a few years ago," said Peter. "I think I'm about as good as I've ever been."  

But anecdotal studies like this one are far from generalizable, and larger studies must be done to prove whether the program will work for more than the scant number of people in this study. 

These study results should be interpreted with a lot of caution, primarily because of the small study group — and because the participants had a range of diagnoses, resulting in different interventions, James Hendrix, director of Global Science Initiatives at the Alzheimer's Association, explained in an email statement. 

"Outside of a supervised research setting, no one should adopt these specific ideas to try to improve their, or a loved one's memory and thinking," he said. "We simply don't know what the effect would be." 

The final straw  

Not long after her memory problems began, Gee found out she carries two copies of the APOE-4 allele. Simply put, this gene hampers her brain's ability to heal itself, dramatically increasing her risk for developing Alzheimer's disease.  

It was the final straw.  

Gee threw herself into reading studies, gathering information and implementing any lifestyle change that might slow down her disease. Later, she said, she sought help from a well-known neurologist, Dr. David Perlmutter, who helped her to refine those changes.  

As it turns out, Perlmutter's advice in many ways mirrored Bredesen's program.  

Gee began by adding fish oil and other supplements to her daily regimen. In several studies, people who took the supplements performed better on memory tests and had bigger brains. She also started meditating twice daily and sleeping seven to eight hours each night; adequate sleep and exercise improve blood flow to the brain and instigate neuron generation. 

Hormone replacement therapy is indicated for women who have a hormonal imbalance that may be affecting brain function, so Gee started that too.  

She fasts for more than 12 hours between dinner and the next day's breakfast, making sure there are at least three hours between dinner and bedtime. The idea behind fasting, said Bredesen, is that with the break the body begins a process called autophagy, which can help destroy amyloid-beta, a problematic protein that builds up in the brains of Alzheimer's patients.  

Gee has also cut out processed foods from her diet, including sugar, grains and other starches, since they can stir up inflammation in the brain. Her rule of thumb: "I don't buy any packaged, boxed or canned food."  

A typical dinner for her includes mostly raw organic vegetables drizzled with extra virgin olive oil and wild caught fish. Occasionally she replaces the fish with grass-fed lean meats. She has integrated more fermented foods into her diet — research is beginning to correlate gut health with brain health.  

"Piece by piece I was going down the protocol," she said. "My mental acuity improved the more (elements of the program) I began doing." 

The overhaul Gee and others did would be dizzying for most people, but Gee said it had the converse effect of simplifying her life. She said cutting out so much processed and other inflammatory foods is freeing.  

Within a few months of beginning the protocol she said she experienced a dramatic cognitive turnaround. Gee had been testing in the 30th percentile on an online brain training website before the program. Months afterward, she was scoring above the 90th percentile.  

"Before this protocol, the notion was you were going to die with this disease," said Gee, who started a website to provide support and hope for others in the same genetic situation. "There was a lack of specificity about what to do. Now we have this prevention protocol."  

Hendrix with the Alzheimer's Association said one sound element of Bredesen's study, given the complexity of Alzheimer's disease, is its focus on addressing multiple risk factors. He cites as an example a two-year, 1,200-person clinical trial out of Finland, the results of which were presented earlier this year at the Alzheimer's Association International Conference.  

Among study participants engaging in nutritional changes, physical activity, brain training, social activities and management of risk factors for heart problems, cognitive performance improved. 

Bredesen stresses that identifying the culprit for early Alzheimer's symptoms must be based on a patient's specific deficits and imbalances. 

He said he will continue testing his protocol on early-stage patients — including members of Gee's APOE-4 online group — to find the ideal stage of cognitive decline to introduce this program and how long improvement can be sustained.  

"We are now looking at what is causing illness in order to make a big impact on it," said Bredesen, who added that many elements of his program could be implemented in asymptomatic people as a prevention strategy.  

"If you're not deteriorating, it's a good idea to do what our moms told us to do: Exercise, get sleep, keep stress down and don't eat junk food." 

He hopes that normalizing early stage Alzheimer's patients cognitively might provide a better platform on which to test future drug-based therapies.  

"One 'silver bullet' drug doesn't work with 36 holes in the roof," said Bredesen. "The argument is maybe you need to patch some of those holes before trying another drug."  


Mimi S.
Posted: Wednesday, January 7, 2015 1:55 PM
Joined: 11/29/2011
Posts: 7027


When I read these reports consisting of only ten people, my thoughts continually go to myself and the other members of this board who have been diagnosed competently and have been holding or slightly progressing for four years or more.
Unfortunately we do not live anywhere near each other.
We are, however, doing a combination of things that are similar to the folks in the study. We are actively leading a very proactive life style, including what we call Best Practices. Most of us are taking various supplements. All of us, judging by what we are saying about ourselves, are very active.
The person who did my last neuro-psych wished someone would do a case study on me. He doesn't know others, but I know there are several  others like me.
I've been told that obviously I'd been misdiagnosed. Sorry, I don't buy that. 
We are not advertisements for Aricept or any other drug, so the drug companies aren't interested.
We need some scientific study, most likely via a case study type, to figure out why we are successful and the vast majority of diagnosed just continue sliding downward at various rates.
I think one factor is that the folks I'm aware of are knowledgeable about our own bodies and did something when deficiencies came into or consciousness. 
What effect does being diagnosed at a very early stage have? I know, we were fortunate that we have time to change our life style.
I know I was fortunate in another way as I read the above literature. When I first went to NYC for treatment of my neurological issues, the neurologist recommended that I also be seen by a friend of his, an internist. The internist was very proactive in fine-tuning all those other, mostly, heart issues that I exhibited. 
Maybe, somehow, the Alzheimer's Association could be the lead in such a study.

Iris L.
Posted: Thursday, January 8, 2015 1:13 AM
Joined: 12/15/2011
Posts: 17544


Mimi, I continue to be encouraged by what I read.  Yes, there are not enough patients in these studies.  I got called on December 31st to be a member of a Clinical Trial for patients with a dx of MCI.  But I reminded them that they would not accept me 2 years ago because I do not have a care partner.  So research is hindered. 

 

IMO, I believe Alzheimer's Disease has auto-immune components, that are ameliorated by lifestyle changes and other measures.  That's why Best Practices works for some of us.  Unfortunately, not more of us.

 
 

I hadn't heard about fasting for 12 hours between dinner and breakfast as a brain-healthy practice.  I'll have to look into this.

Iris L.
 


Mimi S.
Posted: Thursday, January 8, 2015 10:27 AM
Joined: 11/29/2011
Posts: 7027


The fasting at first sounds radical.

 

It basically means no night snacking. 
And I'm not sure following all of their recommendations is necessary. After all, look at so many of s here. We did most, but not all. 
And the article did say that recommendation for individuals were individually tailored to fit the needs of the patient.

scma_2007
Posted: Thursday, January 8, 2015 11:15 AM
Joined: 9/13/2013
Posts: 112


 

Thanks for your input, MimiS!

 

I couldn't agree more about early diagnostics giving you the chance to implement non-drug therapeutic interventions that prevent further decline, and thankfully, have reversed or stabilized your condition, like all others that you know.   

 

I’d like to add that, in my mother’s case (moderate stage), doing all the non-drug therapeutic interventions we can find also showed the same benefits.

 

The two year 1200-person Finland Geriatric study, FINGER, mentioned in the article is a step in this direction. Its results indicate that non-drug therapeutic interventions can work as a prevention. AD is a multi-faceted disease too big to be contained in one clinical trial, as Dr. Bredesen noted. Since the FINGER study results have just been recently announced (July 2014), the scientific details have not yet been published. And it is supposed to be an ongoing study.

 

http://www.ncbi.nlm.nih.gov/pubmed/23332672 

 

http://time.com/2982908/to-prevent-alzheimers-diet-and-exercise-are-effective-large-study-shows/ 

 

The FINGER study is sponsored by the National Institute for Health and Welfare of Finland, operating under the Ministry of Social Affairs and Health - a government body. Our equivalent here is the National Institute of Health under the Department of Health and Human Services. NIH has funded a study on resveratrol headed by Dr. Turner that ended last year. NIH also sponsored Dr. Bredesen’s small study. So this gives us hope. We need to have more effective advocates on non-pharma solutions. It is a monumental task to go through the maze of gathering support for this kind of initiative, especially for us laypeople. Alzheimers Association is a big force here and abroad. I wonder how we can reach the right people.   

 

I hope the momentum for non-drug solutions continues to find its place in a medical world so focused on Beta-amyloid and tau (plaques and tangles) research. If Finland can do it, the United States can do it too. Hope springs eternal.

 

 


Myriam
Posted: Thursday, January 8, 2015 2:27 PM
Joined: 12/6/2011
Posts: 3326


Amen!