L.The biggest news about Alzheimer’s right now is about a new drug treatment that can slow cognitive decline by about 30% in people in the early stages of the disease. In the coming months, the US Food and Drug Administration is expected to make a decision on another such promising treatment.
But in addition to pharmaceutical interventions that are expensive and require repeated infusions, making persistent lifestyle changes can also slow the progression of the disease and possibly even prevent it from getting worse, according to a new study.
In the trial, an intensive program of diet, exercise, stress reduction and social interaction slowed the progression of cognitive decline measured on standard tests for dementia and even improved some people’s symptoms. The study was led by Dr. D., founder and president of the nonprofit Preventive Medicine Research Institute and professor of medicine at the University of California, San Francisco. It was conducted by Dean Ornish and a team of scientists. Featured in the magazine Alzheimer’s Research and Therapy.
Previous studies have shown that modest changes in lifestyle may lead to some slowing of cognitive decline; So Ornish and his team decided to test whether a more in-depth, formal behavioral changes program could slow the brain changes even further. Ornish previously developed the program to address heart disease risk and showed that a combination of improved nutrition, exercise, stress reduction and social participation can significantly reduce the risk of atherosclerosis and heart disease.
“I have a unifying theory that many different chronic diseases share the same basic biological mechanisms,” he says. “These include inflammation, overstimulation of the sympathetic nervous system, changes in the microbiome… gene expressions and immune system changes. So what’s good for the heart is good for the brain; the same mechanisms affect different conditions, and lifestyle choices make them better or worse.” It can make it worse.”
Forty-nine people with mild cognitive impairment or early-stage Alzheimer’s dementia agreed to participate in the study. Half made the lifestyle changes in Ornish’s program for 20 weeks, and the other half continued their normal habits (though the second group was offered the opportunity to participate in the program after the study ended). Everyone gave blood samples so researchers could track changes in markers for Alzheimer’s and stool samples to provide information about their microbiomes, or gut bacteria.
It was easier to stick to the program in the study than in real life. Twice a week, the researchers sent three vegan meals and two snacks per day to people in the lifestyle change group and their partners. These participants also did 30 minutes of aerobic exercise (mostly walking) per day and strength training at least three times per week. A stress management expert guided them through meditation, yoga, stretching and relaxation exercises for an hour a day to improve their concentration and relaxation. Finally, these participants and their partners attended a support group three times a week to discuss the mental health and emotional issues they were experiencing. They also took a variety of vitamins and supplements, including omega-3 supplements, a multivitamin, lion’s mane mushrooms, and probiotics for cognition.
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At the end of the 20-week study, those who made the lifestyle changes showed statistically significant improvements on three of four standard cognitive tests and borderline statistically significant changes on the fourth test; Compared with people in the control group, test results showed worsening. all four tests.
Although the improvements were small, Ornish says 20 weeks is a relatively short period of time and other measurements further support the encouraging changes noted in these tests. First, the more closely people adhere to lifestyle changes, the better their recovery will be; Another was that blood markers for the amyloid protein that accumulates in the brains of Alzheimer’s patients showed positive changes similar to those noted in people taking the new Alzheimer’s drug lecanemab.
“This is the first step,” Ornish says. “This is not a study to end all studies. “But it shows for the first time that intensive lifestyle changes can improve cognition and function in Alzheimer’s patients.”
Ornish hopes these results will encourage insurance companies to cover the program; Medicare already does this for heart disease. He also hopes the findings will give more people access to a way to slow their disease or even prevent its progression. “This is designed to be an intervention that anyone can do,” she says. “We didn’t want the doorman medicine. And we have data on 15,000 people who did the heart program, which is exactly the same. Greater lifestyle changes may lead to better clinical outcomes, cost savings, and better adherence to treatment.”
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To those who question whether people can stick to a vegan diet, exercise regimen, stress management, and support group program, Ornish points out the power of positive and negative messages when it comes to behavioral changes. “When people feel better and see changes, it reshapes motivation from the fear of dying to the joy of living, which is more sustainable,” he says. Anecdotally, some people who participated in the program reported being able to resume reading, Ornish said; But they had to give it up when Alzheimer’s disease made it impossible to follow the story and remember the characters, Ornish says.
“When you make changes quickly that make people feel a lot better, it gives them new hope that they can do things they were told they would never do again,” Ornish says.
Going forward, his team hopes to continue following this group of patients and include more people with different backgrounds to supplement the data. He’s also looking forward to seeing how the program might work with lecanemab and other drugs that may be approved for Alzheimer’s.