Alzheimer’s Prevention: Reversal of Cognitive Decline Dale Bredesen, MD

Is there a cure for Alzheimer's Disease? 

Can anyone prevent cognitive decline? 

Neurologist Dale Bredesen, MD, along with 20 of his colleagues, has published a case series called Reversal of Cognitive Decline: 100 Patients. Bredesen is the bestselling author of The End of Alzheimer's and The End of Alzheimer's Program. 

Bredesen's group is seeking to teach patients how to prevent Alzheimer's disease. 

The first survivor of Alzheimer's . . .

A 2019 video produced by The Alzheimer's Association says ". . . the first survivor of Alzheimer's is out there." But the video makes it clear that the organization does not believe anyone has survived Alzheimer's yet.

Another video, produced by the FDA, warns people to "Watch out for false promises about so-called Alzheimer's cures." That's because there are a lot of charlatans, hawking unproven cures for Alzheimer's and every other disease.

Dementia treatment has run into a lot of roadblocks over the past few decades.

Drugs for Alzheimer's

The FDA has approved a small handful of drugs to treat Alzheimer's Disease. However, none of these drugs change the course of the disease. Most of them offer only marginal improvement in some symptoms for some patients. Some of the approved treatments for dementia may make the disease progress faster with them than without them.

I've posted a video about the latest Alzheimer's wonder drug, aducanumab. It's not surprising that aducanumab is more of a hype than a hope for patients and caregivers.

There's definitely no cure for dementia in the form of a medication.

Pfizer recently announced that it's completely thrown in the towel on Alzheimer's drug research. The largest drug company in the world has had ZERO success spending millions developing a drug to treat cognitive decline. Because of these failures, they've decided not to throw good money after bad.

In his case series report, Bredesen explains why clinical trials for drugs to treat Alzheimer's have been such miserable failures.

Amyloid Hypothesis

Alzheimer's clinical trials have worked from a theory called the "amyloid hypothesis."

Amyloidosis is the buildup of specific types of toxic proteins in various organs. The most prominent theory in Alzheimer's medicine focuses on removing these proteins from the brain. That's because many researchers believe the proteins, called beta amyloid, cause the disease.

Several medications have shown promise in getting rid of amyloid beta in the brain. But those drugs have failed to reduce Alzheimer's symptoms or slow the progression of dementia.

A completely different disease model views amyloid in the brain as a symptom, rather than a cause of Alzheimer's.

Alzheimer's Sub-Types

Five different sub-types of Alzheimer's Disease have different main causes, according to Bredesen:

Alzheimer's prevents buildup of nerve connections in the brain. Bredesen calls brain building "synaptoblastic" activity. On the other hand, "synaploclastic" activity tears down brain tissues. Each of these underlying issues upset the balance between nerve building and nerve destroying. Too much nerve destruction and not enough nerve building kills both the brain and the patient.

Bredesen and his group don't believe it's possible to treat Alzheimer's disease with a single drug. This is because there are usually multiple factors at play all at the same time. Instead of looking for a single magic bullet, they've tried to treat as many of these cognitive risk factors as possible.

A Roof with 36 Holes

If your roof has 36 holes in it . . . how many would you want to get fixed?

Bredesen uses this analogy to explain the multiple factors that appear to cause cognitive decline.

Most people would say they'd want all 36 holes fixed.

A magic bullet drug, even if it were successful, might only solve 1 problem and leave 35 more untreated.

The Bredesen Protocol involves a multi-step, multi-system approach. His team looks to patch all 36 of those holes in the roof. At least they are trying cover as many of the holes as possible.

Dementia Risk Factors

This approach looks to treat risk factors that include:

ApoE4 - Genetic Cognitive Risk

Genetic mapping has identified the apoE4 gene as a key risk factor for Alzheimer's. It's a genetic marker that's been mapped to Alzheimer's disease. That means it's associated with increased cognitive risks.

More Copies of ApoE4 = More Risk

One copy of the apoE4 gene increases Alzheimer's risk by 30-50% when compared to patients without any apoE4 gene copies.

If a person has 2 apoE4 genes, they're called "homozygous." Two copies of apoE4 increases risk by 50-90%. They're more likely to experience Alzheimer's or dementia. Two apoE4 genes introduces much higher risk for early-onset dementia, before age 60 or so.

The increased risk from having 1 or 2 copies of apoE4 doesn't mean those patient will get Alzheimer's Disease. But it makes them more likely to get it.

Bredesen Protocol

Twenty-one healthcare providers in multiple locations applied The Bredesen Protocol to their patients. Each patient had some degree of cognitive decline.

• Mild Cognitive Impairment (MCI) - pre-Alzheimer's
• Subjective Cognitive Impairment (SCI)
• Alzheimer's Disease (AD)

Cognoscopy

Each of these patients was evaluated using Bredesen's "Cognoscopy." A colonoscopy scopes out the health of the colon.  A cognoscopy checks out the "other" end of the patient. The cognoscopy includes:

After labs are drawn, the patient is put on the Bredesen protocol. The protocol is personalized for each patient. If a patient is low on a hormone or nutrient, prescriptions, dietary changes, or brain health supplements shore up their levels. Optimal levels are monitored to make sure they stay in-range. If a patient shows signs of insulin resistance, providers encourage a diet that increases insulin sensitivity. In this respect, the protocol is customized, based on individual patients' needs.

Bredesen Protocol

The patient is instructed on:

Cognitive Testing

The patient gets a recognized, validated cognitive test like

Case Reports

After being on the personalized Bredesen Protocol for up to 12 months, the patient receives a second cognitive exam to determine if their dementia has progressed, stayed the same, or improved. Out of 100 patients in the case series, over 70 showed significant improvements in their memory. In addition to a table listing all 100 patients, Bredesen explains details on 3 of them:

Patient 1

• Went from a MoCA score of 24 (Mild Cognitive Impairment) to 30 (Normal) over 17 months
• symptoms improved markedly
• MRI showed hippocampal volume improved from 14th to 28th percentile - brain growth

Patient 2

• was unable to find her way back to her seat when she went to the restroom at a restaurant
• her significant other described her memory as "disastrous"
• after 12 months on the protocol, memory returned to normal
• cognitive assessment improved from 9th percentile to 97th percentile

Patient 3

• BMI went from 24 to 21.8
• fasting blood glucose dropped from 101mg/dl to 87 mg/dl
• A1C 6.1% to 5.2% - reversing insulin resistance
• MoCA score went from 20 to 28
• was able to reopen her business

This short and sweet paper provides a glimpse into the Bredesen Protocol and some of the success this group has had treating patients

Can you prevent Alzheimer's?

Dale Bredesen and his group reversed dementia in 100 patients. Based on those results, the protocol may be used to prevent dementia in patients who are at risk. This may especially help those with the apoE4 gene.

Take a close look at this case series. It will take less than an hour to read thoroughly. There are definite limitations to the comprehensive, personalized approach Bredesen and his colleagues take to Alzheimer's medicine. Because it's not a clinical trial, it doesn't meet the expectations of many researchers. Bredesen has struggled to get funding and approval for a clinical trial, simply because there are too many variables. That hesitancy makes sense.

What also makes sense is that we need to do something about the third leading cause of death in this country. Alzheimer's is a disease with devastating consequences for patients, caregivers, and families. It's a disease without effective treatment or, until now, prevention.

A comprehensive protocol that treats multiple risk factors is definitely a novel approach to avoiding Alzheimer's. But there are no effective treatments available yet. The upside to diet and lifestyle approaches is that they have very little downside.

Mainstream Medicine

This TED Talk by Dr. Bredesen has been "flagged" by TEDx Talks as "outside the content guidelines."  In spite of promising preliminary results, mainstream medicine has pushed back about the very assertion that Alzheimer's can be reversed or prevented at all.

Many of us are dealing with a parent who's at risk for Alzheimer's Disease. But here is a glimmer of hope about cognitive decline. This case series identifies factors that may contribute to memory loss. Maybe we can reduce our own risk by plugging as many of those holes in the roof as possible. Although it might be too late for some of our parents or loved ones, there may still be a possibility that Alzheimer's prevention could brighten our cognitive future.

Click the link below if you're interested in finding help with Alzheimer's prevention.