The statistics are sobering. More than five million Americans have Alzheimer’s disease, and that toll could rise to 16 million by 2050. Perhaps the scariest fact: every 66 seconds, someone in the US develops Alzheimer’s.
It doesn’t have to be so says Dale E. Bredesen, MD, whose new book, “The End of Alzheimer’s,” bears the bold subtitle, “The First Program to Prevent and Reverse Cognitive Decline.”
His Alzheimer’s prevention program is based on lifestyle changes to guard against or even reverse the disease—and it runs counter to prevailing wisdom in the medical community.
Bredesen is well known in his field. He’s a professor of neurology at UCLA and the founding president of the Buck Institute on Aging.
The basis of his book and his long years of research is his belief that Alzheimer’s is not one condition, as people think, but three distinct types of condition that may be caused by any number of imbalances (types 1 and 2) or toxicity from exposure to mercury or biotoxins, for example (type 3).
Bredesen’s concept of how Alzheimer’s develops differs from the traditional view. For decades, he says, many experts have clung to the amyloid hypothesis. They believe that Alzheimer’s disease occurs when sticky plaques made up of a protein known as amyloid-beta accumulate in the brain. In this model of the disease process, the amyloid-beta destroys the synapses, which are crucial in helping nerve cells communicate. But Bredesen believes that amyloid is only produced after the brain is invaded by pathogens. The amyloid buildup is simply a protective mechanism, he says, and when its production goes into overdrive, the synapses are destroyed and Alzheimer’s develops.
The goal, then, is to prevent the invasion of the brain by pathogens—or to reverse it if it’s already started.
How can we protect our brains? Bredesen says cognitive decline can be the result of any of three dozen factors—or ”holes in the roof,” as he terms them. By abandoning the one-size-fits-all approach to Alzheimer’s, we can guard against many of these factors on an individual level through lifestyle practices such as better sleep, lower stress levels, more activity and changes to diet. We can also correct imbalances when they occur.
In his program, Bredesen evaluates each person individually. He runs tests to identify the factors that may be affecting the person—such as inflammation, hormonal status, vitamin levels and potential toxins. The personalized regimen he then recommends is based on lifestyle adjustments. It is meant to both prevent brain decline and to restore brain functioning by correcting imbalances.
In “The End of Alzheimer’s” he spells out his method and describes the adjustments—diet is critical among them—that can fix those holes in the roof.
For more details, Senior Planet caught up with Bredesen by phone.
Senior Planet: When did you begin to think of Alzheimer’s in this way?
Dale Bredesen: I was very interested as a neurologist in learning and memory, and what goes wrong when you have cognitive decline. This was in the ‘80s. Neurologists are wonderful diagnosticians but are very poor at making people better. So I left clinical practice and went full time to the lab.
For 28 years in the lab, we’ve been looking at the basic nature of the degenerative process. We’ve found 36 factors that feed into this crucial brain balance. How you eat, how you live your life, are you overweight, are you sedentary…. There is more and more evidence that these are absolutely crucial for your cognition.
Senior Planet: Your first publication, in 2014 in the Journal Aging, showed that 9 of 10 patients on your program had cognitive improvement within three to six months. Can you describe someone who had success in this early group?
Dale Bredesen: A woman who I call Patient Zero was told she had early onset Alzheimer’s—she was in memory care. Luckily she wasn’t too far along in the process of cognitive decline. She had a number of the 36 factors.
Three months after she started the program, I got a call at home, and she said, “I am back to normal.” She has addressed 12 of the 36 factors, and she’s 73 now.
Senior Planet: You say that optimal hormone levels are critical to brain balance and you recommend bioidentical hormones for women you think need HRT. It’s one aspect of the program that’s controversial—you acknowledge that experts debate the wisdom of this, with studies linking an increased risk of breast cancer with HRT. Are you saying that breast cancer is ”not as bad” as getting Alzheimer’s?
Dale Bredesen: Hormones levels play a critical role in cognition. Yes, this can mean that you may have to choose between cognitive decline and the risk for hormone-associated cancer. One husband said that he and his wife would monitor her status regarding cancer, but that they’d both rather do that than continue to watch her cognitive decline.
Senior Planet: The regimen isn’t simple. For instance, one woman who shared her routine in the book gets seven or eight hours’ sleep religiously, avoids toxins in cosmetics, takes a variety of supplements, walks an hour a day, does yoga twice a week, fasts for 15 hours a night, does brain training and has a no-frills diet rich in vegetables. Will people follow this?
Dale Bredesen: When people start getting very mild cognitive impairment, they’ll have the incentive. Right now what keeps people away is thinking they can do nothing.
Senior Planet: What’s next?
Dale Bredesen: Over 1,000 people are on the program now, and about 150 of these are being followed actively. Many other physicians now have their own patients on the protocol—we’ve trained 450 practitioners from seven countries and all over the US.
We’re now putting together a manuscript on 50 of the 150 who are being followed, to be published in a medical journal. And we’re working on starting a randomized clinical trial.
What do others think of this upstart view? Michael Merzenich, PhD, is professor emeritus at UC San Francisco, the winner of the Kavli Prize in Neuroscience and an expert on brain plasticity. He says that the book ”should provide much of the basis for a revolution in brain health medicine.” Merzenich, who is working with Bredesen’s team, tells Senior Planet: “I think he’s onto something big, for several reasons.” Among them, he says, is that measurements of chemical indicators in the blood that reflect brain health are easy to do, and the deficiencies can be fixed. And although there is no randomized clinical trial—science’s gold standard—he points out that Bredesen has had good results both in patients with early Alzheimer’s and in those with mild cognitive impairment, which precedes AD.
The Alzheimer’s Association is less enthused but doesn’t write off Bredesen’s program. Citing small numbers of patients so far, Maria C. Carrillo, PhD, the association’s chief science officer, urges caution. But she adds that this type of approach is “intriguing” because it suggests possibilities for the value of a healthy lifestyle to maintain cognition—something the association promotes.