ICurrently, the biggest news in Alzheimer’s disease revolves around a new drug treatment that can slow cognitive decline by nearly 30% among 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 therapy.
But beyond pharmaceutical interventions, which are expensive and require repeated infusions, making sustained lifestyle changes can also slow disease progression and possibly even prevent further decline, 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, as measured in standard tests for dementia, and even improved symptoms for some people. The study was led by Dr. Dean Ornish, founder and president of the nonprofit Preventive Medicine Research Institute and professor of medicine at the University of California, San Francisco, and a team of scientists. Appeared in the newspaper Alzheimer’s Research and Therapy.
Previous studies have shown that moderate lifestyle changes can lead to some slowing in cognitive decline, so Ornish and his team decided to test whether a more in-depth, formal program of behavioral changes could slow brain changes even further. Ornish had previously developed the program to address the risk of heart disease and showed that the combination of an improved diet, exercise, stress reduction and social engagement could significantly reduce the risk of atherosclerosis and heart disease.
“I have a unifying theory that many different chronic diseases share the same underlying biological mechanisms,” he says. “These include inflammation, overstimulation of the sympathetic nervous system, changes in the microbiome… gene expressions and changes in the immune system. This is why what’s good for the heart is good for the brain – these same mechanisms affect different conditions, and lifestyle choices can make them better or worse.”
In the study, 49 people with mild cognitive impairment or early Alzheimer’s dementia agreed to participate. Half made the lifestyle changes in Ornish’s program for 20 weeks, and the other half maintained their normal habits (although the latter group was given the opportunity to join the program after the study ended). All provided blood samples so researchers could track changes in Alzheimer’s disease markers and fecal samples to provide information about their microbiome, or gut bacteria.
The program was easier to follow in study than in real life. Twice a week, researchers sent three daily vegan meals and two snacks to people in the lifestyle change group and their partners. These participants also did 30 minutes of aerobic exercise a day (mostly walking) and strength training at least three times a 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 joined a support group three times a week to discuss any emotional and mental health issues they were facing. They also took several vitamins and supplements, including omega-3 supplements, a multivitamin, and lion’s mane mushrooms and probiotics for cognition.
see more information: Multivitamins are linked to slower brain aging
At the end of the 20-week study, those who made lifestyle changes showed statistically significant improvements on three of four standard cognitive tests and statistically significant borderline changes on the fourth test – compared to people in the control group, who showed worsening scores on all four tests.
Although the improvements were small, Ornish says that 20 weeks is a relatively short period of time and that other metrics further support the encouraging changes recorded in these tests. On the one hand, the more people adhere to lifestyle changes, the better their improvements will be; another was that blood markers of the amyloid protein, which accumulates in the brains of Alzheimer’s patients, showed positive changes similar to those seen in people taking the new Alzheimer’s disease drug, lecanemab.
“This is the first step,” says Ornish. “This is not the 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 insurers 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 the disease or even stop it from progressing. “This is designed as an intervention so anyone can do it,” he says. “We didn’t want concierge medicine. And we have data from 15 thousand people who did the cardiac program, which is exactly the same thing. Major lifestyle changes can lead to better clinical outcomes, cost savings and improved adherence.”
see more information: Doctors are dramatically underdiagnosing early cognitive decline
For those who question whether people can follow a vegan diet, exercise regimen, stress management and support group schedules, Ornish points to the power of positive versus negative messages when it comes to making behavior changes. “When people feel better and see changes, it shifts motivation from the fear of dying to the joy of living, which is more sustainable,” he says. Interestingly, some people who participated in the program reported being able to resume reading, which they had to abandon when Alzheimer’s disease made it impossible to follow the stories and remember the characters, says Ornish.
“When you make changes that make people feel much better quickly, it gives them hope again that they can do things they were told they would never do again,” says Ornish.
Next, his team hopes to continue tracking this group of patients, as well as include more people from diverse backgrounds to bolster the data. He is also eager to see how the program could work in conjunction with lecanemab and any other drugs that may be approved for treating Alzheimer’s disease.
This story originally appeared on Time.com read the full story
