
Study suggests that memory loss in Alzheimer's patients may be reversed - pmiller2
http://neurosciencenews.com/alzheimers-memory-loss-reversal-1377/
======
drewvolpe
Here's the actual paper:

[http://www.impactaging.com/papers/v6/n9/full/100690.html](http://www.impactaging.com/papers/v6/n9/full/100690.html)

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.

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tokenadult
This is a press release about a primary research finding. We need to see
whether or not this study, which even the press release calls "small," will
replicate or not. I would be the first person here to cheer a genuine advance
in preventing or treating Alzheimer disease (I am older than most of you are),
but I have learned after 2145 days of participation on Hacker News that most
press releases about medical breakthroughs kindly submitted for discussion on
Hacker News never replicate and don't lead to any lasting productive paths in
research.

As for the lifestyle recommendations numbered in another comment here, I

(1) eat some simple carbohydrates, but have avoided obesity;

(2) eat some (but not a lot) of gluten and processed food, but especially eat
plenty of vegetables and fruits (and a little bit of fish);

(3) reduce stress through means other than yoga;

(4) do not meditate, having checked the evidence on this practice and found it
wanting;

(5) do not take melatonin;

(6) usually attempt to sleep 7-8 hours per night;

(7) take vitamin B12, but not usually in the form of methylcobalamin;

(8) take vitamin D3 each day;

(9) take fish oil each day;

(10) never take CoQ10;

(11) optimize my oral hygiene using an electric flosser and electric
toothbrush;

(12) don't take hormone replacement therapy (I'm not a woman, and I have
plenty of testosterone);

(13) fast for a minimum of 9 hours between dinner and breakfast, and for a
minimum of 1 hour between dinner and bedtime;

(14) and exercise for a minimum of 30 minutes three or four times a week.

I do the most of the things on the list that have the best evidence base. I
check the evidence all the time about what the latest treatment-control
studies say about healthy lifestyle.

Good luck to all of you desiring to keep healthy minds for a long life. That
begins with being skeptical about press releases about preliminary research
findings.

~~~
SEJeff
I was taking fish oil supplements daily until my Nephrologist suggested I
don't. He pointed to some recent proper clinical trials that showed it not
doing much of anything:

[http://www.berkeleywellness.com/supplements/other-
supplement...](http://www.berkeleywellness.com/supplements/other-
supplements/article/omega-3-supplements-question)

In addition to that, if you're taking liquid supplements (like gel caps, which
I was), my doc told me that there is risk that it has oxidized and can
actually cause cardiovascular damage. After that and a weekend of reading up
on the internet, I decided to stop taking any fish oil supplements.

Do the research yourself and make an educated guess.

~~~
omegaworks
> risk that it has oxidized

Always worth it to bite down on a couple pills every so often and check. Use
those rancid sensors built in by nature. It's oil after all. If it tastes bad,
it's gone bad.

------
jleader
This sounds interesting, but before anyone starts changing their lifestyle
based on this, you should be aware that not only isn't this a double-blind
trial, there's no control group, and the results lump together subjective and
objective improvement (in other words, 9 of the 10 either actually got better,
or just thought they got better, possibly through the placebo effect).

Also, the article mentions neuropsychological testing done on one of the
subjects, demonstrating his decline, but then there's no mention of whether he
was retested after the treatment to see if there was any measurable
improvement! And no mention of any objective testing of the other 9 subjects,
either before or after the treatment. This strikes me as odd, given that
neuropsychological testing is the most sensitive way of measuring cognitive
decline.

------
TomMasz
My elderly aunt, who is 88 now, has Alzheimer's and while she's declining in
cognitive ability now that her doctors have figured out her medications and
dealt with some psychological issues her rate of decline has improved. The
idea of somehow reversing her disease, or at least some of the major symptoms,
is intriguing but there's got to a point where the treatment, however well-
intentioned, isn't worth it.

But I can see the appeal for someone 30 years younger facing early-onset
Alzheimers.

------
clumsysmurf
Tumeric might also help with Alzheimers
[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665200/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3665200/)

and Herpes (HHV-6) might effect the progression of Alz
[http://www.ncbi.nlm.nih.gov/pubmed/23916950](http://www.ncbi.nlm.nih.gov/pubmed/23916950)

------
mrfusion
What is the argument against farm raised fish? Gluten?

~~~
Alex3917
The argument against farmed fish is that they're fed corn, so you're getting
high levels of omega-6, which causes inflammation and ultimately brain damage.

The argument against gluten is that it similarly causes inflammation, which
causes brain damage.

For what it's worth, Andrew Weil has an anti-inflammatory diet on his website:

[http://www.drweil.com/drw/u/ART02012/anti-inflammatory-
diet](http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet)

~~~
dsrguru
I've seen multiple studies that suggest a correlation between very high
Omega-6 to Omega-3 ratios and various cancers, but I've never seen anything
regarding brain damage.

Some casual googling just now suggests to me that this notion of generalized
"inflammation" and it causing brain damage isn't rooted in an understanding of
how pathology works and seems mostly talked about in rather quacky "woo"
circles.[1][2]

That being said, it does seem like over-expression of inflammatory mediators
like cyclooxygenase-2 (COX2) in the brain can cause brain inflammation[3], and
Wikipedia says high Omega-6 to Omega-3 ratio can result in over-expression of
COX2 in some parts of the body, so it's certainly possible that high Omega-6
levels _could_ result in over-expression of COX2 in the brain, but I haven't
yet seen anything supporting that.

Regarding Dr. Weil, he seems all over the lot with what he advocates.
Sometimes he advocates quackery based on "some religious group somewhere says
it works," but other times he points to a small body of positive evidence and
rightly points out that there's an unfortunate lack of further higher quality
research, and other times he espouses very logical or well-supported ideas.
And unfortunately, he often doesn't make clear which category the current
thing he's talking about falls under and often doesn't cite sources.

For what it's worth, his food pyramid doesn't ban gluten, and explicitly
allows for occasional pasta. According to your link, his main criticism of
glutenous foods has nothing to do with gluten but that such foods usually
contain wheat flour, which has a high glycemic index, even in the form of
whole wheat flour. In fact, he strongly recommends low-GI whole grains,
including bulgur wheat.

[1]
[http://boards.straightdope.com/sdmb/showthread.php?t=729545](http://boards.straightdope.com/sdmb/showthread.php?t=729545)

[2]
[http://scienceblogs.com/whitecoatunderground/2009/07/23/magi...](http://scienceblogs.com/whitecoatunderground/2009/07/23/magic/)

[3]
[http://tpx.sagepub.com/content/32/6/650](http://tpx.sagepub.com/content/32/6/650)

~~~
Alex3917
[http://www.ncbi.nlm.nih.gov/m/pubmed/10858586/](http://www.ncbi.nlm.nih.gov/m/pubmed/10858586/)

[http://www.biologicalpsychiatryjournal.com/article/S0006-322...](http://www.biologicalpsychiatryjournal.com/article/S0006-3223\(09\)01229-3/pdf)

------
sogen
Down for me.

Cached version:
[http://webcache.googleusercontent.com/search?q=cache:6h861Hp...](http://webcache.googleusercontent.com/search?q=cache:6h861HpvxcQJ:neurosciencenews.com/alzheimers-
memory-loss-reversal-1377/&hl=en&gl=mx&strip=1)

Meat of the article:

 _The model of multiple targets and an imbalance in signaling runs contrary to
the popular dogma that Alzheimer’s is a disease of toxicity, caused by the
accumulation of sticky plaques in the brain. Bredesen believes the amyloid
beta peptide, the source of the plaques, has a normal function in the brain –
as part of a larger set of molecules that promotes signals that cause nerve
connections to lapse. Thus the increase in the peptide that occurs in
Alzheimer’s disease shifts the memory-making vs. memory-breaking balance in
favor of memory loss.

Given all this, Bredesen thought that rather than a single targeted agent, the
solution might be a systems type approach, the kind that is in line with the
approach taken with other chronic illnesses—a multiple-component system._

...

 _(1) eliminating all simple carbohydrates, leading to a weight loss of 20
pounds;

(2) eliminating gluten and processed food from her diet, with increased
vegetables, fruits, and non-farmed fish;

(3) to reduce stress, she began yoga;

(4) as a second measure to reduce the stress of her job, she began to meditate
for 20 minutes twice per day;

(5) she took melatonin each night;

(6) she increased her sleep from 4-5 hours per night to 7-8 hours per night;
(7) she took methylcobalamin each day;

(8) she took vitamin D3 each day; (9) fish oil each day;

(10) CoQ10 each day;

(11) she optimized her oral hygiene using an electric flosser and electric
toothbrush;

(12) following discussion with her primary care provider, she reinstated
hormone replacement therapy that had been discontinued;

(13) she fasted for a minimum of 12 hours between dinner and breakfast, and
for a minimum of three hours between dinner and bedtime;

(14) she exercised for a minimum of 30 minutes, 4-6 days per week.

The results for nine of the 10 patients reported in the paper suggest that
memory loss may be reversed, and improvement sustained with this therapeutic
program, said Bredesen. “This is the first successful demonstration,” he
noted, but he cautioned that the results are anecdotal, and therefore a more
extensive, controlled clinical trial is needed._

~~~
bane
I'm curious about #11. Any ideas why that would be part of the program?

~~~
lvevjo
There is some evidence of a correlation between oral hygiene and Alzheimer's:

[http://www.medicalnewstoday.com/articles/264164.php](http://www.medicalnewstoday.com/articles/264164.php)

Basically, people with poor oral hygiene are more likely to develop
Alzheimer's than people with good teeth.

You might have heard about a similar study that found a link between oral
hygiene and heart disease. The theory, at least in that case, is that bad oral
hygiene causes chronic long-term inflammation throughout the body, not just in
your gums. This might increase risk of heart disease. Without looking at the
data, I would guess that the same theory applies to Alzheimer's and maybe
other diseases. The usual caveat about correlation != causation applies of
course.

~~~
eruditely
?? If Alzheimer's is related to memory & executive functioning(probably is)
then the people who are likely to develop Alzheimer's are likely to have poor
oral hygiene.

Oral hygiene is a good proxy for people who _know_ it's important, but somehow
still forget. A solid proxy for executive functioning decline, executive
functioning in general, working memory, and a cluster of other things.

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dang
We changed the title to a more neutral description taken from one of the image
captions.

