Looking behind the hype — and potential — of a lifestyle approach to Alzheimer’s Date: 07/29/19
By Linda Marsa
Big Pharma has spent tens of millions of dollars searching for a drug to halt Alzheimer's, and the huge dollars spent greatly influenced the direction of research into treatments. However, most of these drugs have flopped miserably in clinical trials.
But an entirely other story has been quietly emerging from longitudinal population studies that shed light on what may be a better way to slow or halt the progression of the disease. The approach includes aggressively treating the underlying risks factors for Alzheimer's, such as diabetes, heart disease, chronic stress, poor health habits, exposure to infectious agents or environmental toxins, can slow the disease's progression.
There have been numerous studies – news of which had been eclipsed by the dominance of drug company-sponsored research – that confirmed this. As a consequence, a handful of physicians at top academic centers, such as UCLA, Weill Cornell and the University of Alabama, were experimenting with prescribing strict lifestyle regimens to patients in early stages of the disease, with some positive results.
My December 2018 article for Discover, Alzheimer’s Under Attack, was a very research-intensive piece. Almost all of the previous stories about Alzheimer's treatments focused on clinical trials of anti-amyloid drugs that sought to halt the production of the barnacle-like proteins in the brain that are believed to cause the disease. But physician-researchers at academic institutions across the country were becoming frustrated by this approach and felt they were doing little to help their patients.
But they realized there was a growing body of evidence that lifestyle changes – even a daily exercise regimen – could help slow the progression of cognitive impairment. Others were looking at the underlying causes of Alzheimer's – including insulin resistance, heart disease and poor health habits – and seeing how that spurred disease progression.
It took quite a bit of research to piece this all together and uncover an entirely new story emerging from these long-term studies, and determine whether there was sufficient rigorous scientific evidence to support this new theory of how to treat Alzheimer's. But there was a preponderance of evidence that, at the very least, these scientists were on the right track and that aggressively treating the risk factors for Alzheimer's could help.
Confirming a source’s credibility
I began this as a profile of UCLA neurologist Dale Bredesen, M.D. He had written a controversial 2017 book, The End of Alzheimer's, which outlined his belief that lifestyle changes could prevent cognitive decline. Scientific research over the course of several decades that had led him to this conclusion.
Bredesen’s book also included profiles of several patients who had followed his regimen with positive results. But before I interviewed him and talked with my editors about doing the story, I investigated to see if he was considered a reputable researcher.
I talked with several top scientists, including Leroy Hood, M.D., who has been at the forefront of many paradigm-changing technologies such as the human genome project and the use of big data in medicine. I also consulted Lawrence Steinman, M.D., a neurologist at Stanford and member of the National Academy of Sciences, and Michael Merzenich, Ph.D., a neurologist at UCSF, NAS member and a winner of the Kavli Prize. They all believed Bredesen to be a reputable researcher.
I then interviewed eight of the patients with documented early-stage Alzheimer's and who after following Bredesen's protocol, greatly improved. I looked at their medical records and I talked to each of them to confirm all of this. Bredesen was testing each person individually and used big data to devise a personalized treatment protocol to deal with each patient's specific deficits. But my editor at Discover felt that because this was so controversial we needed to find other scientists also doing this to give the story additional credibility and heft.
We found that there are about a half a dozen other physician-scientists at leading academic institutions using intensive lifestyle prescriptions that seem to be helping their patients. It also turned out that there was a wealth of research from legitimate studies to support this approach.
Since the story published, additional studies have emerged that support this approach. In addition the Alzheimer's research establishment, including the Alzheimer's Association, are sponsoring studies looking at lifestyle changes to treat this disease. This represents a huge paradigm shift in the way we approach the treatment of Alzheimer's.
Journalist Linda Marsa received third place honors in AHCJ’s Awards for Excellence in Health Care Journalism for her December 2018 story, Alzheimer’s Under Attack, published in Discover magazine.