New research findings look set to empower many people with renewed hope in the face of early dementia. For the first time, a randomised controlled clinical trial has demonstrated that an intensive lifestyle intervention, without drugs, can improve cognitive impairment.
Those involved in the study experienced significantly improved cognition and function after 20 weeks in many patients with mild cognitive impairment or early dementia due to Alzheimer’s disease.
This peer-reviewed study was directed by lifestyle medicine pioneer Dean Ornish, MD, founder and president of the nonprofit Preventive Medicine Research Institute and clinical professor of medicine at the University of California, San Francisco. It was conducted in collaboration with other renowned scientists and neurologists from leading academic medical centres.
“I’m cautiously optimistic and very encouraged by these findings, which may empower many people with new hope and new choices,” Dr Ornish said.
“We do not yet have a cure for Alzheimer’s, but as the scientific community continues to pursue all avenues to identify potential treatments, we are now able to offer an improved quality of life to many people suffering from this terrible disease.”
Mild cognitive impairment
The research team recruited 51 participants with a diagnosis of mild cognitive impairment or early dementia due to Alzheimer’s disease and randomly assigned them to either an intensive lifestyle intervention group (no drugs added) or a usual-care control (comparison) group. Members of the control group were instructed not to make any lifestyle changes during the 20-week trial.
The intervention group participated in an intensive lifestyle program with four components:
- Awhole-foods, minimally processed plant-based diet low in harmful fats, refined carbohydrates, alcohol and sweeteners — predominantly fruits, vegetables, whole grains and legumes, plus selected supplements — with all meals sent to each patient’s home to maximize adherence;
- Moderate aerobic exercise and strength training for at least 30 minutes per day;
- Stress management, including meditation, stretching, breathing and imagery, for one hour per day; and
- Support groups for patients and their spouses or study partners for one hour three times per week.
Not all patients in the intervention group improved; in the CGIC test, 71% improved or were unchanged. In contrast, none of the patients in the control group improved, eight were unchanged and 17 (68%) worsened.
Many patients who experienced improvement reported regaining lost cognition and function—Dr Michael Greger covers the personal impact in his video below. Keep the tissue box handy; this video contains a powerful piece of personal testimony.
In addition to improvements in cognition and function, the intervention group also demonstrated significant improvements in several key blood-based biomarkers. One of the most clinically relevant biomarkers is called the Aβ42/40 ratio, which is a measure of amyloid, thought to be an important mechanism in Alzheimer’s disease.
This measure improved in the lifestyle intervention group (with the presumption that this improvement reflected amyloid moving out of the brain and into the blood), but it worsened in the randomized control group, and these differences were statistically significant (p = 0.003).
A dose-response correlation
There was also a statistically significant dose-response correlation between the degree of lifestyle change and the degree of improvement in this amyloid ratio (p = 0.035). This direction of change in amyloid was also a major finding with lecanemab, a drug approved for treating Alzheimer’s disease, last year.
Interestingly, the gut microbiome in the intervention group showed a significant decrease in organisms that raise the risk of Alzheimer’s disease and an increase in organisms that are protective against Alzheimer’s disease. These biomarker and gut microbiome results also add to the biological plausibility of the overall findings.
According to renowned Alzheimer’s scientist Miia Kivipelto, M.D., Ph.D., “These findings add to the growing body of evidence that moderate multimodal lifestyle changes may help prevent Alzheimer’s disease or slow its progression, and also suggest that more intensive multimodal lifestyle changes may have additional benefits for improving cognition in patients with early Alzheimer’s disease.”
In the following video, Dr Ornish discusses his research on Alzheimer’s with Dr Neal Barnard at last year’s ICNM Conference. He will be one of the key speakers at this year’s conference, which takes place August 15-17 in Washington, D.C.
See earlier article: Study links inflammation …
