The way we live impacts our brain health as we age. The People's Pharmacy interviews Dale Bredesen, MD
“Our hope is to develop treatments that will successfully reset the imbalance in the memory-making, memory-breaking processes that we believe leads to Alzheimer’s disease.” - Dale Bredesen, MD
What have we learned about Alzheimer's disease in the 100 plus years since the eponymous diagnosis was first made? If clinical trial success was a measure we would be seriously disappointed. Out of 244 clinical trials all have failed with only 1 considered moderately effective in managing symptoms. And still no effective treatment or cure on the horizon.
The research discussed by Dr Bredesen hopefully will lead a trend away from looking at single mono-therapy regimens. Most of us are aware that complex chronic diseases often require combination therapies (HIV, heart disease etc...). If you are skeptical because of the potential confirmation bias of an interview with an audience receptive to the benefits of whole health and supplementation Dr Bredesen also presented to the California State Assembly citing most of the same findings... Reversal of cognitive decline: A novel therapeutic program and Next generation therapeutics for Alzheimer’s disease provide more of the background and clinical components of a multi-modal platform for patients at risk for or diagnosed with Alzheimer's disease. Data from a table pulled from the latter does a great job of summarizing features that would need explaination by any accurate "breakthroughs" in dementia research:
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Here is an example of what a "plasticity" balancing framework looks like for an actual patient.
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As noted above, and following an extended discussion of the components of the therapeutic program, the patient began on some but not all of the system: (1) she eliminated all simple carbohydrates, leading to a weight loss of 20 pounds; (2) she eliminated gluten and processed food from her diet, and increased vegetables, fruits, and non-farmed fish; (3) in order to reduce stress, she began yoga, and ultimately became a yoga instructor; (4) as a second measure to reduce the stress of her job, she began to meditate for 20 minutes twice per day; (5) she took melatonin 0.5mg po qhs; (6) she increased her sleep from 4-5 hours per night to 7-8 hours per night; (7) she took methylcobalamin 1mg each day; (8) she took vitamin D3 2000IU each day; (9) she took fish oil 2000mg each day; (10) she took CoQ10 200mg each day; (11) she optimized her oral hygiene using an electric flosser and electric toothbrush; (12) following discussion with her primary care provider, she reinstated HRT (hormone replacement therapy) that had been discontinued following the WHI report in 2002; (13) she fasted for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime; (14) she exercised for a minimum of 30 minutes, 4-6 days per week.
The bolded emphasis is my own and represent behaviors that I have integrated into my lifestyle over the last 5 years. I strongly view Alzheimer's disease as a diffuse clinical syndrome where brain aging or normal senescence evolves into a pathologic continuum. Neuroplasticity of the brain has been studied and the associated biochemistry drives the positive balance of brain plasticity. As a medical writer with a specific interest in optimal aging I don't see anything highlighted in the detailed patient algorithms that I haven't read or heard about though other research or clinical trials. It is beyond the scope here to attempt a comprehensive overview but briefly reminding ourselves of the research that seems to demonstrate a link between obesity, diabetes, poor nutrition, head trauma, early hysterectomy and increased risk of Alzheimer's Disease should spark interest in a multi-model platform that identifies measures such as family history, genetics, imaging study findings, cognitive testing, laboratory findings, as contributors seems to be a more realistic approach. Let's face it, our current magic bullet approach has done nothing but drive healthcare costs to stratospheric levels.
More Brain Info from BigThink...
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So what does this all mean? I have noticed, at least among my female friends, that we all seem to be taking vitamin D supplements once our low levels are discovered during routine health examinations. You might wonder why. My "n of 1" experience made me think of the low fat diets that were all the rage for so many years. This would definitely cause vitamin D levels to tank. Now we are urged to ditch the carbs in favor of a healthy good fat ratio, monitor our inflammation, avoid farmed-fish, improve our sleep hygiene and get exercising--all good practices for optimal health and likely to be preventative of chronic diseases as we age.
I remain hopeful that similar findings will translate into neuroprotective brain health and encourage clinical trials that can continue the promising work of Dr. Bredesen. This will require a new framework for evaluating multi-modal platforms with synergistic health benefits that do not conform to a classical randomized control trial. If we are looking at biochemical abnormalities at the individual level it will be impossible to measure covariants to mirror the current medical model of clinical effectiveness. Perhaps we don't need medicalization of a natural progression of aging. Perhaps what we need to do is ignore the signals from society that demand short-cuts to health, packaged foods, minimal nutrient levels vs. maximum health, and the siren song of couch sitting.
You can imagine that there are challenges from the medical model that are justified in wanting more research especially when it comes to supplementation. But the one mention of the high cost of vitamins in the outlined protocol because it could reach $200/month was laughable. Doesn't he know what it costs to diagnose, monitor and manage chronic disease? The cost of a healthier way of life that targets whole health? Priceless...
I remain hopeful that similar findings will translate into neuroprotective brain health and encourage clinical trials that can continue the promising work of Dr. Bredesen. This will require a new framework for evaluating multi-modal platforms with synergistic health benefits that do not conform to a classical randomized control trial. If we are looking at biochemical abnormalities at the individual level it will be impossible to measure covariants to mirror the current medical model of clinical effectiveness. Perhaps we don't need medicalization of a natural progression of aging. Perhaps what we need to do is ignore the signals from society that demand short-cuts to health, packaged foods, minimal nutrient levels vs. maximum health, and the siren song of couch sitting.
You can imagine that there are challenges from the medical model that are justified in wanting more research especially when it comes to supplementation. But the one mention of the high cost of vitamins in the outlined protocol because it could reach $200/month was laughable. Doesn't he know what it costs to diagnose, monitor and manage chronic disease? The cost of a healthier way of life that targets whole health? Priceless...