Reversing Dementia

by | Jun 9, 2016 | Anti-aging, Articles, Conditions, General Interest, Neurologic

UCLA professor Dale Bredesen does a study showing nearly complete resolution of dementia symptoms with a functional medicine approach:  Optimize diet, increase and improve sleep, reduce stress, exercise regularly, stimulate brain function, analyze and replete nutrients including antioxidants and mitochondrial function, replace hormones including sex hormones and notably T3 in the elderly, remove heavy metals…  The full article is long, but definitely check out the summary table link below.

Based on this initial research, Dr Bredesen has a book titled “The End of Alzheimers” and a formal treatment protocol called ReCODE has been developed which provides a comprehensive personalized program designed to improve cognition and reverse the cognitive decline.

Reversal of cognitive decline: A novel therapeutic program

Aging (Albany NY). 2014 Sep; 6(9): 707–717.

Published online 2014 Sep 27.

PMCID: PMC4221920

Author:  Dale E Bredesen

Abstract

This report describes a novel, comprehensive, and personalized therapeutic program that is based on the underlying pathogenesis of Alzheimer’s disease, and which involves multiple modalities designed to achieve metabolic enhancement for neurodegeneration (MEND).

The first 10 patients who have utilized this program include patients with memory loss associated with Alzheimer’s disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI). Nine of the 10 displayed subjective or objective improvement in cognition beginning within 3-6 months, with the one failure being a patient with very late stage AD. Six of the patients had had to discontinue working or were struggling with their jobs at the time of presentation, and all were able to return to work or continue working with improved performance. Improvements have been sustained, and at this time the longest patient follow-up is two and one-half years from initial treatment, with sustained and marked improvement.

These results suggest that a larger, more extensive trial of this therapeutic program is warranted. The results also suggest that, at least early in the course, cognitive decline may be driven in large part by metabolic processes.  Furthermore, given the failure of monotherapeutics in AD to date, the results raise the possibility that such a therapeutic system may be useful as a platform on which drugs that would fail as monotherapeutics may succeed as key components of a therapeutic system.

Therapeutic System 1.0
GoalApproachRationale and References
Optimize diet: minimize simple CHO, minimize inflammation.Patients given choice of several low glycemic, low inflammatory, low grain diets.Minimize inflammation, minimize insulin resistance.
Enhance autophagy, ketogenesisFast 12 hr each night, including 3 hr prior to bedtime.Reduce insulin levels, reduce Aβ.
Reduce stressPersonalized—yoga or meditation or music, etc.Reduction of cortisol, CRF, stress axis.
Optimize sleep8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea.[36]
Exercise30-60′ per day, 4-6 days/wk[37, 38]
Brain stimulationPosit or related[39]
Homocysteine <7Me-B12, MTHF, P5P; TMG if necessary[40]
Serum B12 >500Me-B12[41]
CRP <1.0; A/G >1.5Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygieneCritical role of inflammation in AD
Fasting insulin <7; HgbA1c <5.5Diet as aboveType II diabetes-AD relationship
Hormone balanceOptimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol[5, 42]
GI healthRepair if needed; prebiotics and probioticsAvoid inflammation, autoimmunity
Reduction of A-betaCurcumin, Ashwagandha4345
Cognitive enhancementBacopa monniera, MgT[46, 47]
25OH-D3 = 50-100ng/mlVitamins D3, K2[48]
Increase NGFH. erinaceus or ALCAR[49, 50]
Provide synaptic structural componentsCiticoline, DHA[51].
Optimize antioxidantsMixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid[52]
Optimize Zn:fCu ratioDepends on values obtained[53]
Ensure nocturnal oxygenationExclude or treat sleep apnea[54]
Optimize mitochondrial functionCoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine[55]
Increase focusPantothenic acidAcetylcholine synthesis requirement
Increase SirT1 functionResveratrol[32]
Exclude heavy metal toxicityEvaluate Hg, Pb, Cd; chelate if indicatedCNS effects of heavy metals
MCT effectsCoconut oil or Axona[56]

CHO, carbohydrates; Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan

 

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