Professor Dale Bredesen's Alzheimer's treatment now on offer in New Zealandby Catherine Woulfe
A dietary and lifestyle regime that claims dramatic success in treating Alzheimer’s disease is on offer here.
New Zealanders can now receive an intensive lifestyle intervention designed to heal failing brains – even those in the early stages of Alzheimer’s.
The man behind the programme is University of California neuroscientist Professor Dale Bredesen. As reported in the Listener, Bredesen puts patients through a battery of metabolic and genetic tests and uses the results to prescribe changes to their diets, sleep, exercise and stress levels. There’s no wonder drug involved, but patients take supplements containing such things as fish oil, curcumin and probiotics based on their biomarkers.
Bredesen is overseeing 112 patients who have been diagnosed with early Alzheimer’s or its precursors, mild cognitive impairment (MCI) or subjective cognitive impairment. He is reporting a 90% success rate.
He has published 19 case studies in the journal Aging. Most of these patients report a reversal of major symptoms, such as not recognising friends, being disorientated at home or driving on the wrong side of the road. Many had to leave their jobs but after several months on the programme were able to return to work. Further, these changes are reflected in cognitive tests and brain scans: some patients who had been formally diagnosed with Alzheimer’s or MCI no longer meet diagnostic criteria.
Bredesen’s star patient is a 66-year-old doctor with MCI. Independent MRIs taken before treatment and 10 months in showed his hippocampus increased in volume from the 17th percentile for his age to the 75th. In other words his brain grew back.
Clinical trials are due to start in the US and UK next year. Getting such research off the ground has long been a frustration for Bredesen and his team. The problem is that his regime relies on roughly 36 variables working in sync, making it a nightmare to test under traditional medical trial conditions that are geared around just one variable (usually a drug). With such astonishing, high-stakes claims being made in the absence of gold-standard data, many in the medical community are yet to be convinced. Scienceblog.com published a scathing post calling Bredesen’s first paper “thin gruel”.
Alzheimers New Zealand has said although it is “too early” to recommend the treatment, “several key components of the professor’s intervention are already being trialled separately … most notably dietary changes, exercise and mindfulness-based meditation, also with promising but early results”.
Professors Richard Faull and Cliff Abraham, co-directors of Brain Research New Zealand, say the disappointing results of previous research trials of promising treatments mean it’s crucial that clinical-trial participants are randomly allocated to an intervention and “blinded” as to what intervention they’re receiving. They say the effectiveness of programmes of lifestyle changes at delaying the development of dementia in individuals is the focus of a number of international trials and part of the activities in the Dementia Prevention Research Clinics that are being established as part of Brain Research NZ’s national centre of research excellence.
Meanwhile, Bredesen has partnered with US company MPI Cognition to develop software to crunch patients’ test result data. The company is training medical practitioners to use the software and deliver the programme. An app is planned to “gamify” behaviour change for patients and cut back on the need for personal coaching.
The programme will be delivered in New Zealand by Dave Jenkins, a Kiwi doctor who set up a large-scale public health initiative in Indonesia. He will work with his partner, Miki Okuno, a nutritionist and clinical hypnotherapist, who is starting formal training this month.
Jenkins studied medicine at the University of Otago, practised as a rural GP in Edgecumbe for five years and later spent five years as a senior lecturer at the University of Auckland, working to improve the training of rural doctors.
By 1999, Jenkins was living in Singapore and working as the director of education for a corporate health insurance company. On a surfing trip to Indonesia’s Mentawai Islands, he saw a cemetery full of child-sized graves, and rampant, preventable disease such as malaria and pneumonia. One month later, Jenkins had chucked the job, sold his house and set up SurfAid. It’s now a successful “hand up, not hand out” non-profit that provides basics such as mosquito nets and fresh water, trains hundreds of local “health volunteers” and helps remote villages recover from – and prepare for – storms and tsunamis.
Now 57 and based in Indonesia, Jenkins has cut back to part-time with SurfAid and is throwing himself into what a few years ago would have sounded an impossible dream: “to end Alzheimer’s in Australia and New Zealand”.
It’s an ambitious plan. There’s no big-pharma backing for research or marketing, and although many elements of the programme align with findings in epidemiological studies, Jenkins knows it will be tough to change the attitudes of doctors, as well as patients and families.
Many are warned at the point of diagnosis that there’s nothing that will halt – let alone reverse – the spiral of the disease. Both Jenkins’ parents are in the early stages of Alzheimer’s, so he has heard the “abandon all hope” mantra twice. “I have no doubt that in five or 10 years’ time, that attitude will be starting to soften. But it’s going to be challenging,” he says.
The treatment itself can be tough to stick to, mostly because of the diet: minimal sugar, carbohydrates, processed foods and alcohol.
Those who let the regime slip for a time have seen a return of symptoms.
Jenkins, pragmatically, will take on only motivated, mobile patients who have family support. The programme does not seem to work as well for people who are over 75 or in mid to late stages of dementia.
Patients bear the cost
And for now, patients will have to pay. Jenkins is offering two programmes: “reversal”, for those with symptoms, and “prevention”, for those worried by family history or genes. The cost will range from $4000-$20,000 a year, plus supplements and testing.
Is this all a cynical cash-in? “I stand by my track record,” he says, referring to his years of earning nothing, then a tiny salary, at SurfAid. He says the intense amount of attention he will give each patient means he expects to earn no more than a busy GP.
On the one hand, “It’s completely unjust that someone with Alzheimer’s who is well motivated can’t reverse their Alzheimer’s because they can’t afford it.” On the other hand, he aims to scale up by training a network of doctors, and knows that to attract them “it has to make sense financially.”
“We are committed to finding ways to provide the service much more cheaply for those who can prove they’re on the poverty line … to make sure everyone benefits from this.” The hope is that eventually, given the billion-dollar burden of dementia in New Zealand, treatment will be government-subsidised.
He envisages collaborating with universities on research, and with Alzheimers New Zealand. He wants a public health campaign and a future in which cognitive screening at age 55 is routine.
Meanwhile, Jenkins’ first client is three months into the “reversal” programme. He is 75, lives in Australia and has MCI. According to the man’s son, over the past decade he became forgetful, anxious and frustrated. Activities were jettisoned; he slept in the afternoons; his days dwindled to “convenient, localised and safe routine”.
Giving up toast has been a pain, as has cutting back from three wines a night to one. But now, says the son, “he’s happily participating, debating current events and joking along. A streak of negativity and anxiety has been replaced by a positive openness and engagement that we have not experienced in decades.
“With an increase in confidence, he’s also able to make mistakes without reacting by getting angry, finding fault or withdrawing. Everyone is amazed and asks, ‘Wow, what’s the old man on?’”
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