Simple Summary

Dale Bredesen, a medical doctor at UCLA, reversed dementia in 9 human subjects using a combination of exercise, diet, brain games, and a dietary supplement.  The 10th subject had advanced Alzheimer’s at the start of treatment and did not show improvement.

More Detail

The paper was published in 2014 and, to my knowledge, introduced Dr. Bredesen’s MEND protocol.  Metabolic enhancement for neurodegeneration (MEND), but more on that later.  January 28, 2018 – I just got Dale’s book An End to Alzheimer’s: The First Program to Prevent and Reverse Cognitive Decline and he is now calling this protocol ReCODE.  I think the protocol is probably the same, he just came up with a snappier name.

Ten patients were assessed for cognitive impairment ranging from mild (MCI) through subjective (SCI) to various stages of Alzheimer’s.  Each was then given extensive blood tests and recommendations were made for each individual based on their results.

From those recommendations, patients were able to choose from several diets, but all diets were low in sugar, grains, and inflammation exciters.  Patients were also able to choose methods for stress reduction and exercise.  Vitamins and supplements were somewhat tailored based on blood test results.  Finally, patients were given brain stimulation exercises.

The results were stunning.  Of the 10 patients, 9 had stopped working or were struggling at work.  Of those, six patients were able to return to work after a few months on the protocol.  Measures of cognitive function increased for 9 of the 10 and positive results had been maintained for months and in a some cases years at the time the results were published.

Into The Weeds

The rationale for the MEND protocol is almost worth it’s own article.  I had read the summary of a follow-up report that came out in 2016, but when I sat down to read in more depth for this article I found myself sitting up straighter and exclaiming “YES!” more than once.

The most important assumption is that Alzheimer’s is complex and monotherapies to date and in development are almost certainly too narrow in their approach to the disease to be effective.  Dr.  Bredesen points out that there are “multiple pathogenetic targets for potential intervention…includ[ing], in addition to amyloid-ß (Aß) oligomers and tau, inflammatory mediators, apolipoproteins and lipid metabolism factors, hormonal mediators, trophic factors and their receptors, calcium regulatory pathways, axoplasmic transport machinery, neurotransmitters and their receptors, prion protein, and a host of other potential targets.”

Based largely on his previous research Dr. Bredesen posits that the Aß precursor protein (APP) undergoes two different processes that produce peptides important to either the growth or death of neurons.  The first process results in peptides that stop or reverse the growth of neurites, inhibit synaptic function, and increase the activation of enzymes that trigger cell death.  The other process produces peptides that promote neurite growth, inhibit Aß production, and inhibit the production of cell death related enzymes.  In other words the processing of APP into peptides results in either neurogenesis or neurodegeneration.  When these processes are in balance our neurons are fine, but in Alzheimer’s “there is a fundamental, age-associated imbalance between these dynamically opposed physiological processes.”   Put most simply, APP acts as a switch.

“There are many inputs to the APP signaling balance (e.g. estrogen, netrin-1, AB, etc.) and the minimal success with each of many potentially therapeutic agents (e.g. estrogen, melatonin, exercise, vitamin D, curcumin, Ashwagandha, etc), the pathobiology of AD dictates a system or program rather than a single targeted agent. ”  –  Amen.

Vitamin D3 alone may “exert only a modest effect on” Alzheimer’s, but “the optimization of a comprehensive set of parameters, which together form a functional network, may have a much more significant effect on pathogenesis and thus on function.”  – Hallelujah.

The MEND protocol seeks to optimize metabolic parameters and not just get them within normal limits (with the first focus apparently on homocystein levels).  The second tenet of MEND is to attack on as many fronts as possible “with the idea that a combination may create an effect that is more than the sum” of its parts.  The third is a rare concession to the reality that a complex solution to a complex disease is hard on the patient and that while patients may not follow “every single step of the protocol, as long as enough steps are followed to exceed the threshold, that should be sufficient.”  And finally, the protocol is to be personalized based on lab results from the initial and follow up testing.

In the case studies section they look at the first three patients and share their therapeutic programs.  Here are some universals from the first 3 case studies:

Diet: All three patients eliminated simple carbs from their diets (one also ate more fruits and vegetables while the other two also eliminated processed foods).

Fasting: All three fasted at least 3 hours before bedtime and at least 12 hours between dinner and breakfast.

Stress Reduction: All three undertook stress reduction strategies such as yoga and/or meditation.

Vitamins and Supplements: All three took melatonin at bedtime.  Each took vitamin D3 and CoQ10.  Many more vitamins and supplements were taken, but there it becomes individualized.

Exercise: All 3 exercised, but the frequency, duration, and types of exercise were different.

Brain Training: Other than stating “Posit or related” there is no mention of the training involved, the frequency, or duration.  However, just a few weeks ago this article was published entitled Speed of processing training results in lower risk of dementia.

Final Thoughts

This is not a controlled study and the sample size is very small, but the efficacy rate is amazing.  Looking at the results from different angles I can’t help but conclude that this protocol works at halting and even reversing Alzheimer’s if applied early enough.  I also believe that the potential side effects of losing weight and improving one’s overall health is absolutely worthwhile.

If you’re looking for a New Year’s Resolution today….