How To Prevent & Reverse Alzheimer’s Disease
“There are steps we can all take now to prevent the cognitive decline that experts have long believed to be unavoidable and irreversible.”
― Dale Bredesen
Alzheimer's disease is the sixth leading cause of death in the United States. This chronic neurodegenerative disease is characterized by a progressive decline in cognitive function, including memory, thinking, and judgment. It’s commonly held that there’s no effective way to treat or reverse Alzheimer's disease, but then comes this new approach.
In his book, The End of Alzheimer's Program: The First Protocol to Enhance Cognition and Reverse Decline at Any Age, Dr. Dale Bredesen offers a new approach to preventing and reversing Alzheimer's disease. Dr. Bredesen is a neurologist and neuroscientist who has been studying Alzheimer's disease for over 20 years. Using evidence-based research and anecdotal data from the patients he works with, he has developed a comprehensive yet individualized program that addresses the underlying causes of Alzheimer's disease, rather than just the symptoms. The program identifies 36 metabolic factors (micronutrients, diet, exercise, hormones, sleep, stress management, supplements, etc.) that help to prevent and reverse Alzheimer’s.
What I like about this approach is that it’s functional, that is it addresses the root causes without using the bandaid approach. Since Alzheimer’s is progressive, a diagnosis tends to come well the disease has already made the brain its home and the onset of those early stages are often preceded by years and decades of poor, but preventable, health habits. The approach used in this book, therefore is a way to not only to treat and reverse Alzheimer’s but as a way to minimize the risk of cognitive decline and other health concerns as we age.
How To Prevent & Reverse Alzheimer’s Disease
1. Address Insulin Resistance
Insulin resistance occurs when the muscle, fat, and liver cells lose their ability to effectively respond to insulin, a crucial hormone responsible for sugar absorption. As a result, these cells fail to transport sugar to the essential parts of the body, leading to elevated blood sugar levels. This condition has significant implications, especially in relation to Alzheimer's disease, as virtually all individuals with this neurodegenerative disorder experience insulin resistance. In fact, Alzheimer's is often colloquially referred to as "type 3 diabetes," although it should be noted that the relationship between the two is more complex than a simple categorization would suggest.
It should go without saying then, that insulin resistance should be addressed immediately. Signs of insulin resistance include:
Abdominal fat
The inability to fast
Hypoglycemic episodes
A BMI greater than 25 (calculate yours here)
Fasting glucose greater than 114
Fasting insulin greater than 5.5
HbA1c (hemoglobin A1C) greater than 5.7
You can also have insulin resistance without being overweight which he refers to as TOFI--thin outside, fat inside. While the risk of insulin resistance increases with age, it's seen more and more often in younger people.
Here's how Bredesen suggests addressing it:
Exercise regularly
Reduce stress
Treat sleep apnea (more on that here)
Consider supplements (he suggests considering the following as needed but consult with your doctor):
Monitor glucose with a device such as a CGM (continuous glucose monitor). These are more frequently covered by insurance so ask your doctor about it.
Adopt a KetoFLEX 12/3 diet.
"Keto" refers to ketosis which uses your body's stored and dietary fat as fuel instead of carbohydrates.
"Flex" refers to both a flexitarian diet (meat optional) and metabolic flexibility, or using fat and glucose as fuel.
The "12" is the number of hours you should fast overnight and the "3" is the number of hours that you should stop eating before bed.
KetoFLEX 12/3 also includes limiting sugars, processed foods, simple carbohydrates, dairy, and grains, The 3 components of the KetoFLEX 12/3 diet are fasting, diet, and exercise on the foundation of quality sleep.
2. Improve Sleep and Avoid Sleep Meds
Sleep is essential for brain health. Bredesen provides a variety of sleep hygiene tips that I've written about in previous posts such as going to bed at a consistent time, stopping or limiting caffeine in the afternoon, fasting for 3 hours before bed, using blue light blockers, and respecting the 3-hour sleep window before bed (see links below).
He also highlights the importance of avoiding sleep medication:
"Benzodiazepines taken for 3 to 6 months increases risk of Alzheimer's by 32% and taking them for more than 6 months boost the risk by 84%. Using benzodiazepines for more than a year can cause cognitive impairments that continue beyond cessation of the medication for up to 3.5 years."
I knew the use of sleep meds had a negative impact on memory and cognitive health but I was blown away by these stats when I read them. Examples of benzodiazepines are Xanax, Librium, Tranxene, Valium, Paxipam, Ativan, Serax, Centrax, and Doral. Even non-benzodiazepines (a.k.a. "Z" drugs) are becoming more of a concern for cognition because they down-regulate acetylcholine. Some common non-benzodiazepines are zolpidem, zopiclone, zaleplon, and eszopiclone.
Instead of using these sleep aids, Bredesen suggests some supplements I've written about like magnesium, ashwagandha, and L-theanine (read about those here) as well as others like CBD oil, chamomile, lemon balm, melatonin, and tryptophan.
Related:
3. Oral Health And The Brain
What does your mouth have to do with Alzheimer's? Surprisingly, a lot. Bredesen writes that "The mouth is one of the most important sources for the insults of cognitive decline."
He points to 6 main subcomponents of oral health that are correlated with cognitive decline:
Mercury amalgams
Herpes simplex
Periodontitis
Gingivitis
Root canals
The oral microbiome
Mercury amalgams, also known as dental amalgam fillings or silver fillings, are a type of dental material used to repair cavities in teeth. For mercury amalgams, he suggests having them removed by a biological dentist (find one here). He also suggests having no more than one or two of them removed at a time and a few months between each sitting to allow your body to detox. I had my metal amalgams removed about 5 years ago when I first learned about the potential cognitive risks of having metal in the mouth (and not just mercury). While I can't say I notice a difference, I have no regrets about doing it.
Cold sores (a.k.a. herpes simplex virus type 1 or HSV-1) are viruses that live in the trigeminal ganglion which are nerves of the face. These ganglion cells stretch from the lips and face to the brain which means that this virus can also travel that route, directly into the brain. Bredesen recommends the antiviral acyclovir or valacyclovir to both treat cold sores as they occur and to prevent outbreaks. He notes that "These drugs have minimal toxicity and are generally well tolerated" and people take them for extended periods, up to years. Talk to your doctor before beginning any supplement or medication.
Some other recommendations he has for taking care of your mouth are to use an electric toothbrush and a water pic, do oil pulling, and stop mouth breathing.
Does This Program Actually Reverse and Prevent Alzheimer’s?
Does this program actually work? It’s important to note that there’s no cure for Alzheimer’s. This program is said to “prevent and reverse” Alzheimer’s and Bredesen’s research helps to back this claim up although this research is refuted.
Despite decades (and arguably centuries) of attempts to manage Alzheimer’s, we haven’t gotten very far. This is a testament to how complex the human brain is and how unique each person’s brain and body is despite the billions that have been put up against it. Additionally, there are recent allegations over the amyloid hypothesis and the research surrounding it which is a major issue in itself.
To determine if a program works to mitigate dementia, it requires more than case series of reports. Replicable randomized control trials with strict protocols are needed, but they are costly, time-consuming, and difficult to conduct given that dementia is a multi-faceted disease. Each measure taken impact dementia (e.g. cinnamon, exercise, cortisol levels) requires its own study put up against a control group with many participants over many years to help determine if it even plays a role in cognitive decline. Even then, the methods, type of exercise, type of cinnamon, and the accuracy of self-reports and blood tests will be up for debate. This is a complicated game that the field of nutrition has been playing and arguably losing for years (great article on that here).
Where does that leave us? In my humble opinion, this program is a great way to address your overall health and well-being which in itself can support the prevention and reversal of Alzheimer’s and general cognitive decline.
The old “results” will vary applies to any approach that addresses humans and the brain and this is no exception, however, if I, or a loved one, was diagnosed with Alzheimer’s or any form of dementia then I would adopt this program.
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