by Lin particular, the biggest news in Alzheimer’s was a new drug treatment that could 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 promising therapy.
But in addition to pharmaceutical interventions, which are expensive and require repeated infusions, ongoing lifestyle changes may slow the progression of the disease, and possibly even prevent further deterioration, 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 on standard tests for dementia, and even improved some people’s symptoms. Dr. Dean Ornish, founder and president of the non-profit Preventive Medicine Research Institute and professor of medicine at the University of California, San Francisco, and a team of scientists conducted the study. It was featured in the magazine Alzheimer’s Research and Therapy.
Previous studies have shown that modest lifestyle changes can lead to cognitive decline, so Ornish and his team decided to test whether a more in-depth, formal program of behavioral changes could further slow brain changes. Ornish had previously developed the program to address heart disease risk and showed that the combination of improved diet, exercise, stress reduction and social participation could significantly reduce the risk of atherosclerosis and heart disease.
“I have a unified 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 expression, and changes in the immune system. That’s 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 of them made the lifestyle changes in the Ornish program for 20 weeks, while the other half maintained their normal habits (although the latter group was offered the opportunity to join the program after the study ended). Each person provided blood samples so the researchers could track changes in Alzheimer’s markers and fecal samples to provide insight into their microbiome, 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 daily vegan meals and two snacks to people in the lifestyle change group and their partners. Those participants also did 30 minutes of aerobic exercise per day (mostly walking) and strength training at least three times a week. A stress management specialist guided them in meditation, yoga, stretching and relaxation 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 mental health and emotional issues they had. They also took several vitamins and supplements, including omega-3 supplements, a multivitamin, and Lion’s mane mushrooms and probiotics for cognition.
Read more: Multivitamins Are Linked to Slower Brain Aging
By the end of the 20-week study, those who made the lifestyle changes showed statistically significant improvements in three of four standard cognitive tests and borderline statistically significant changes in the fourth test – compared to people in the control group, who showed scores going up bad on. the four tests.
Although the improvements were small, Ornish says 20 weeks is a relatively short period of time, and other metrics support the encouraging changes recorded on those tests. In one case, the more closely people adhered to the lifestyle changes, the better their improvements; another was that blood markers for amyloid protein, which increases in the brains of Alzheimer’s patients, showed positive changes similar to those recorded in people taking the new Alzheimer’s medication, 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 drastic lifestyle changes can improve cognition and functioning in Alzheimer’s patients.”
Ornish hopes these results will encourage insurers to cover the program; Medicare already does for heart disease. He also hopes that the results will give more people access to a way to slow or even prevent their disease from progressing. “This was designed as an intervention so anyone can do it,” he says. “We didn’t want concierge medicine. And we have data on 15,000 people who did the cardiac program, which is exactly the same. Greater lifestyle changes may lead to better clinical outcomes, cost savings and better adherence.”
Read more: Doctors are taking on the Early Diagnosis of Cognitive Decline
For those who question whether people can stick to a vegan diet, exercise regimen, stress management, and support group schedule, Ornish points to the power of positive versus negative messages when it comes to making behavior changes. “When people feel better and see changes, that reframes the motivation from the fear of death to the joy of living, which is more sustainable,” he says. Anecdotally, some program participants have reported being able to pick up reading again, something they had to give up when Alzheimer’s made it impossible to follow storylines and remember characters, she says Ornish.
“When you make changes that make people feel a lot better quickly, it gives them hope again that they can do things they’ve been told they wouldn’t do again,” says Ornish.
His team hopes to continue following this group of patients, as well as include more people from different backgrounds to strengthen the data. He is also keen to see how the program might work alongside lecanemab and any other drugs that may be approved for Alzheimer’s.
