ALZHEIMER’S — a diagnosis that plunges people into despair, a living death sentence that relentlessly robs the ability to compute and comprehend, to converse, and to connect with everything that makes us human and life meaningful.ALZHEIMER’S — a diagnosis that plunges people into despair, a living death sentence that relentlessly robs the ability to compute and comprehend, to converse, and to connect with everything that makes us human and life meaningful.
Now a US medic, an internationally recognised expert in mechanisms of neurodegenerative disease, is showing that mental decline evident in early Alzheimer’s disease can be stopped in its tracks — and even reversed, so people can once again live a cognitively healthy life.
“I’m the first to publish data showing the reversal of the cognitive decline in Alzheimer patients,” says Dr Dale Bredesen, speaking to
from Los Angeles and citing his two research papers published in 2014 and 2016. While much of medical science considers Alzheimer’s to be a single disease, Bredesen describes it as consisting of three different sub-types.
He has just published his book,
For him, Alzheimer’s is a response to three different processes in the body: Inflammation, sub-optimal nutrition, and exposure to toxins.
He says his wife, a family practitioner, outlined her views on Alzheimer’s 30 years ago — and he should have listened.
“She said we’d find it would have to do with nutrition, sleep, exercise, and use of the brain. Being a scientist, I laughed and said ‘no, we’re going to find one region of one molecule that holds the secret that will allow us to get one drug’.”
Now he understands that Alzheimer’s is a process with many inputs. “When you look at the biochemistry of most people with cognitive decline, they’ll typically have between 10 to 25 different contributors that will need to be addressed if they’re to have optimum outcomes.”
Bredesen’s 2014 paper included three case studies from among 10 patients who’d followed a personalised programme, largely based on diet and lifestyle intervention. All had either memory loss associated with Alzheimer’s, mild cognitive impairment, or subjective cognitive impairment. Nine showed cognitive improvement within three to six months — the one person who didn’t had very late-stage Alzheimer’s.
One case involved a 67-year-old with a demanding job who’d had progressive memory loss for two years. Her job required travel and preparing analytical reports — she was about to quit because she could no longer analyse data or prepare the reports. She’d read one page and have to start again because she’d forget what she’d just read. She was no longer able to remember numbers, had trouble navigating familiar roads, mixed up her pets’ names, and forgot where light switches were.
She took on some elements of Bredesen’s recommended programme, personalised for what was driving her cognitive decline. These included eliminating all simple carbohydrates/gluten/processed food; increasing intake of vegetables/fruit/non-farmed fish; stress reduction through yoga; upping sleep to seven/eight hours nightly; fasting for minimum 12 hours between dinner and breakfast and for at least three hours before bedtime; and exercising for at least 30 minutes, four to six days a week. She also took daily supplements including vitamin D3, fish oil, and CoQ10.
After three months all symptoms had reduced: she was able to navigate without problems, remember phone numbers, prepare reports, and read and retain information. She felt her memory was better than it had been in years. When she developed an acute viral illness and stopped the programme, she noticed a decline but this reversed when she reinstated it.
Another woman was experiencing progressively severe memory loss. She’d leave the cooker on when she went out. She forgot meetings, often arranging several for the same time. Her children said she’d become lost in mid-sentence and was slow with responses. After five months on the programme, the 55-year-old was able to work again, was able to learn Spanish — her children said she answered their questions without hesitation and with normal memory.
“A single pill can’t address the many potential contributors to cognitive decline, so we need a targeted personalised approach,” says Bredesen. “One person might be very low in vitamin D, another might be low on oestradiol, one might test high for inflammatory markers. The picture’s different for each, so we must determine the underlying mechanisms driving the [individual’s] cognitive decline — or their risk for it.”
The Bredesen Protocol targets physiological bio-markers including metabolic issues, inflammation, toxicity, hormone imbalance, gut health, nutrient deficiencies, cognitive stimulation, as well as lifestyle factors: Poor sleep, stress, lack of exercise. In his book, Bredesen says patients presenting with cognitive decline aren’t usually tested for a host of factors he believes impact neuro-degeneration.
With dementia a leading cause of death in the US, Bredesen says medicine’s no longer preoccupied with its 20th-century concern: What’s the diagnosis? “It’s not about what it is but why it is. Why did you get cancer, Parkinson’s, Alzheimer’s? We must look at all the contributors. That will allow us to fashion the optimum
preventative or reversal treatment.”
Bredesen recommends a ‘cognoscopy’ when people hit 45 so they can be told ‘look, these are your greatest risks [for cognitive decline] and this is what you can do’. He advises a simple blood test to assess genetics and biochemistry, as well as a cognitive test like the MoCA (Montreal Cognitive Assessment) to evaluate memory and other cognitive abilities like organising, calculating, and speaking. Find MoCA online: dementia.ie/images/uploads/site-images/MoCA-Test-English_7_1.pdf
Bredesen calls the ApoE4 gene — the strongest known genetic risk factor for Alzheimer’s — a “ticking time-bomb in the DNA”. Carrying one ApoE4 increases lifetime risk to 30%; carrying two pushes it well over 50%. There’s a 9% risk for those without the gene. In a world where there’s no way back from Alzheimer’s, would you want to know whether you have it? Bredesen finds such attitudes outdated. He cites a social network (apoE4.info) that’s helping people prevent their own cognitive decline. The group numbers about 800, 99% are on some variation of the Bredesen Protocol, and they’re hearing “repeated stories of improvement”.
Bredesen himself doesn’t have the gene but follows elements of his own Protocol. “I fast every night for at least 12 hours, usually 14 to 16. I finish my last meal of the day at 7pm and I don’t have my first until 11am/noon. I check with my wife whether I’m having episodes of snoring or sleep apnoea, a contributor to cognitive decline. I eat a high-, good-fat, low-carb diet. I take supplements including vitamin D and magnesium.”
The Bredesen Protocol’s an extensive programme calling for huge lifestyle modification. Bredesen recommends engaging help from a spouse/coach to implement it. “Compared to taking a pill once a day, it’s demanding. It’s demanding like a difficult diet is. But it’s not crazy. It’s much less demanding than living in a nursing home.”
The programme includes a long list of supplements. “There are some that everybody should be on that support synaptic structure — like citicoline and omega-3 fatty acids. Others depend on individual needs. Most people are deficient in magnesium, zinc and iodine.”
Is it safe to take such large amounts of supplements? “These supplements are certainly safer than most medications with side-effects. But if you change your biochemistry too much, it’s always possible you’ll run into trouble.”
Supplement company Cytoplan is collaborating with Bredesen to bring his work on Alzheimer’s over from the US. He’s not worried his work will be hijacked by commercial companies. “If they make good supplements, that’s a good thing.” He acknowledges the programme’s costly — testing, supplementation, organic food — but says it still costs “less than 1% of what a nursing home costs”.
He and his team aren’t functioning as anyone’s doctor — “we’re offering medical information” — and he gives a “yes and no” answer when asked if an individual could pursue the programme without medical guidance. (He recommends working with your primary care provider using the computer algorithm, ReCODE Report).
Thanks to all who supported us handing over our Budget 2018 ‘Building a Community of Care’ petition at Dail Eireann this morning! pic.twitter.com/pf9V0Ll128— The Alzheimer Society of Ireland (@alzheimersocirl) October 5, 2017
When Dublin-based nutritional therapist Edelle O’Doherty-Nickels discovered Bredesen’s 2014 paper, it was a lightbulb moment. “Here was this [albeit] limited study showing 90% reversal of cognitive decline. I thought why isn’t the whole world screaming about this? Here was a neurologist working in a lab for decades looking for a pill that would cure Alzheimer’s and now, knowing all the underlying mechanisms, he’d come around to a holistic, multi-factorial therapy that addresses every aspect of his patients’ lives.”
O’Doherty-Nickels trained with Bredesen at the Buck Institute for Research on Ageing in California (Bredesen’s founding president) in July 2016. Since then, she’s had one client undertake the Protocol. “We managed to stop his decline and he was in the middle of a rapid decline. But it’s difficult to keep people on the programme. It’s a huge lifestyle shift.”
She takes onboard Bredesen’s advice to identify factors easiest for the person to change and work on these first. “Diet’s often hardest, it needs a lot of contact, coaching, and tweaking.”
She was involved with Cytoplan in hosting the Irish Integrative Healthcare Conference last June (Managing Dementia: Are Nutrition and Lifestyle the Key?) with Dr Rangan Chatterjee (BBC Doctor in the House) and Dr Patrick Hanaway (MD at Cleveland Clinic Centre for Functional Medicine). These doctors will lead two clinical studies into the Bredesen Protocol in Britain next year.
Action Against Alzheimer’s (Cytoplan’s preventative programme, incorporating all Bredesen’s findings) practitioner-training took place in September in Stillorgan. Fifteen practitioners from around Ireland attended. They’re undergoing an appraisal process with Cytoplan before being licensed to deliver a public talk about Alzheimer’s and series of eight workshops, covering all elements of the Bredesen Protocol.
The Alzheimer Society of Ireland has regularly called on the Government to adopt public health approaches to reduce dementia prevalence, which affects 55,000 in Ireland. The society points to a recent study in
“[It] highlights key factors that cause damage to the brain including hearing loss, obesity, and smoking. Prevention and health promotion policy has to start including dementia. Current health promotion in Ireland ignores modifiable risk factors for dementia.”
Consultant psychiatrist and director of the Memory Clinic at St James’s Hospital Prof Brian Lawlor says there are no published controlled intervention trials using the Bredesen Protocol that demonstrate efficacy, only a small case series reporting on 10 people. “The idea of improving sleep, diet, exercise, social and cognitive activity, lowering stress, and addressing dementia risk factors is sensible — we recommend it to patients. However, I’d be very cautious in stating there’s evidence this approach can ‘prevent or reverse cognitive decline’ — the data to support this claim is simply not there at the moment.”
Bredesen says the data exists: “We’re writing up the next 50 case studies now.”
Alzheimer’s is a disease that’s killing many, he says. “Are you really going to tell people there’s nothing to be done when there’s hope now that was never there before? It’s easy to be conservative until Alzheimer’s strikes you or your family. We have 1,000 people on the Protocol with very clear evidence of improvement. We’ve trained more than 600 practitioners from seven countries and all over the US.”
For Bredesen, this is not a time to hold back — in true pioneering spirit, he has set himself a bold goal: “We want to make dementia the rare disease that it should be.”
- Action Against Alzheimer’s public talks in Dublin: Wednesday, October 18, and Thursday, November 9, both 6.30pm (contact: firstname.lastname@example.org, remedyclinic.ie, or 01-6855 832); Monday, November 6, 10am (contact email@example.com or 01-8310888).
- The End of Alzheimer’s, Dr Dale Bredesen, Penguin House, €15.74.