What if it was possible to reverse the memory loss and cognitive decline associated with Alzheimer's disease?
Wouldn't that be something?
As our society ages the prevalence of Alzheimer's disease and other forms of dementia continues to increase, with a new diagnosis being made in Australia every six minutes. The burden of living with the disease affects not only the individual, it affects their family, their friends and society as a whole.
While a vast amount of time and effort is being put into continuing research seeking greater understanding of what leads to the pathophysiology and symptoms, and an effective treatment, progress has been frustratingly slow.
Alzheimer's disease is a multifactorial condition that includes genetic and other environmental factors.
From a genetic perspective carrying the ApoE4 allele is a known risk factor.
Carrying two copies of the ApoE4 allele increases your relative risk of developing the disease x 5-12 times. It is possible to test for a person's individual ApoE status but this has been discouraged up until relatively recently because no management strategy had been shown to be effective
I've made reference previously to the findings of the FINGER study, which was the first to demonstrate how following a multi-domain approach of eating healthily, exercising, undertaking cognitive training and managing risk factors for vascular disease could reduce the risk of Alzheimer's Disease in those identified to be at higher risk of cognitive decline.
Now we also have the results of a trial that looked to reverse or halt cognitive decline in those already diagnosed with Alzheimer's disease.
This small clinical trial of 10 people with early Alzheimer's revealed how using an individualised treatment called the MEND protocol (metabolic enhancement for neurodegeneration) that incorporates 36 factors including lifestyle changes to diet, exercise, and sleep patterns along with a mixture of certain drugs, vitamins and brain stimulation therapy could lead to a sustained improvement in cognitive function.
Now before you go dancing off into the street shrieking Eureka! remember this is a very small study, and while the findings are extremely encouraging , it's VERY important to keep things in perspective.
This is NOT a cure for Alzheimer's disease.
What it has shown is that it may be possible to halt or slow down the progression of the disease such that people may be able to continue to function at a useful level for far longer and as such is encouraging. A much larger study is now underway.
Nevertheless, each of the 10 people here improved to the point where they no longer met the criteria for cognitive impairment.
The improvements were demonstrated in a number of different ways:
· An increase in hippocampal brain volume
· An increase in cognitive scores to normal levels
· Being able to return to work
· Improved word finding/improved neuropsychological testing
What isn't known are the long-term implications for this type of therapy. It suggests it buys quality time for those who otherwise would continue to experience the slow progression of worsening cognitive decline.
Based on these initial findings the questions the authors now look to answer include
· Is testing for the ApoE4 allele now justified if this type of protocol has the potential to halt the progression of Alzheimer's disease? Is identifying those at greatest risk now be worthwhile?
· Does the MEND protocol have to be continued indefinitely? The researchers report how one of the ten subjects experienced a rapid decline when he stopped the treatment after three months.
· Will the positive effects of MEND gradually wear off? So far the subjects have been followed up for four years, so it's still early days to know the answer to that one.
· Will it be possible to identify which if not all of the 36 factors included are most relevant to an individual? It's not clear if the positive findings result from the synergistic effect of addressing multiple factors.
The findings from this study adds to the growing amount of evidence that suggests the key to managing Alzheimer's disease and some other forms of dementia will not come from a single source, but through a combination of factors relevant to the individual themselves.
Meanwhile there appears to be nothing to lose and everything to gain from continuing to build our own level of brain fitness as found in NAMESS
Adhering closely to the MIND diet has been associated with a reduction of relative risk of developing Alzheimer's disease by between 34- 53%. It all starts with eating your greens (Mum was right) and enjoying some lean protein in the form of fish, eggs and poultry, adding in some fruit especially blueberries, legumes, seeds and nuts and whole grains, some olive oil, a small glass of red wine and don't forget to stay hydrated with plenty of aqua vita (water).
Attitude and Stress Management
Practising some form of relaxation on a daily basis helps to keep our stress to manageable levels and reduces our risk of mental illness and cognitive decline. Yoga, mindfulness and getting out into the great outdoors to connect with some green space are all great ways to help keep everything in perspective and build stress resilience.
Giving your brain a mental workout helps to maintain better brain health and cognition. Give your brain something new to learn, add to the stretch by making it something you don't expect to be good at, and keep raising the bar.
If the thought of exercise and Lycra brings you out in a cold sweat, create a warm sweat instead with dancing, brisk walking, gardening or even playing with the kids, grandkids or the dog! Moving, or physical activity is what it's all about, so don't worry about not bringing home a Gold medal, it's the participation that counts.
We spend 1/3 of our lives doing it, but too often we try to make do with less or have problems sustaining sleep. Good sleep hygiene starts with a regular schedule, a cool, quiet and dark room and choosing your sleeping partner carefully! The aim is for 7-8 hours of good quality uninterrupted sleep.
Loneliness is a killer and we are hardwired to connect. Getting out to speak with people face to face boosts connection and physical, mental and brainy well-being. Why not volunteer, join a club and reach out regularly to friends and family.
While the question remains "What If", the MEND study is a very encouraging finding that gives hope that we are getting closer to the answer we seek, and that one day soon we will be able to more effectively manage our modern day scourge of memory loss and cognitive decline.