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Hope not Fear: Ending Alzheimer’s

November 13, 2018

 

You may have recently read that Sandra Day O‘Connor, the first female Supreme Court Justice, is stepping down from public life due to a diagnosis of Alzheimer’s.   I was saddened to learn this and couldn’t help but think about both my grandmother and my father, who also suffered from dementia. This disease not only steals the lives of those it hits directly, but it is devastating to their entire family and community of friends.    It slowly hollows the person from the inside out, leaving a shell of a stranger in its wake.

 

The Center for Disease Control and Prevention estimates that the population of patients with Alzheimer’s disease will double to 13.9 million by 2060.  This was based on a study published this week in the Alzheimer’s Association’s Journal of Alzheimer’s Dementia.

 

It is one of the most feared diseases in the world.   Experts recommend that early diagnosis is key, but without any real treatments available, the reticence over losing one’s independence may keep those at risk from seeking help.   Losing our mind is a greater fear than any other in our life: more than cancer or heart disease, more than

just about anything.   And that fear is often compounded because there has not been anything we could do about it.  

 

Until just very recently.

 

There is a growing body of science that supports non-pharmaceutical, lifestyle-based interventions that can both prevent this disease as well as improve and reverse mild to moderate cognitive impairment.  Medications have existed for some time that may be able to slow down the progression of Alzheimer’s, but no pharmacological approach has been able to improve or reverse the disease. 

 

In the recent work by Dr. Dale Bredesen - highlighted in his book “End of Alzheimer’s” - he reviews his research findings which demonstrates the protocols that have been shown to improve mild to moderate cognitive decline.   The current medical paradigm that operates out of an acute infectious illness model is not working for this complicated multifactorial disease.  Thus, his protocols are based on the idea that a multifactorial approach is necessary.  

 

Dr. Bredesen uses this following analogy:  Imagine that your roof is leaking from 36 different locations and you plug one of those holes without knowing there were other holes.   The other holes are still leaking and need to be plugged.   That is equivalent to the current approach to treating Alzheimer’s.  The “one pill” thinking is very effective when we are working in an infectious diseases model: have a bacterial infection, take an antibiotic.  This simplex model does not work in a very complex disease like Alzheimer’s and many other chronic diseases.  We know that Alzheimer’s is a complicated, multifactorial disease, and that many of the pathways that contribute to the disease turn out to be the exact pathways utilized to reverse the disease.

 

But how can something like a simple lifestyle intervention make a change?    That just seems ridiculous, right?

 

Did you know that exercise can improve memory?    In one study published in the Proceedings of the National Academy of Sciences · February 2011, two groups of older adults were randomized to either a group that did regular aerobic exercise or a group that did only stretching for a period of a year.  The group that did the regular aerobic exercise was found to improve hippocampus volume, which is directly related to improvements in memory performance.   

 

Even as we hear the predictions of an increased Alzheimer’s population, there is reason for hope of slowing it down, and much of that lies with the choices we make every day:   What we are eating? How much are we moving? How much are we sitting?  How do we manage our stress and emotions?  Do we get well rested at night?  What environmental exposures might we facing? 

 

But, are we seeing success with this strategy?  We are:

 

Kay is a 66 year old woman who developed memory problems and felt a loss of sharpness in her mental ability.  She repeatedly lost her car in parking lots, was failing to recognize people she had met once before, frequently lost her train of thought, and was having challenges with word retrieval, making work difficult.

 

She had some signs of metabolic issues and insulin resistance, as well as elevated stress levels which showed up in higher cortisol level measurements.  She then started Dr. Bredesen’s ReCODE protocol, and after four sustained months, her memory related symptoms seemed to resolve themselves, and her metabolic status improved.  

 

The current paradigm of non-reversible cognitive impairment is changing. If you are interested in learning more, I recommend Dr. Bredesen’s book “The End of Alzheimer's.”  Now, you can educate yourself and look forward to a future with less fear of dementia.   I am hoping to create a program that will be available next year, modelled on this protocol – watch this space!

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Polly Halpern