Research and therapeutic approaches in Alzheimer’s.

With more than 6 million individuals in the U.S. who are diagnosed with Alzheimer's disease, there is an overwhelming urgency to identify treatments that can be of real help in slowing the progression of symptoms. But it’s equally important to understand that some therapies may not only be less than effective, they could have negative impacts as one evidence-based review revealed. 

Researchers set out to evaluate brain volume changes caused by different sub-classes of anti-amyloid beta (Aβ) drugs trialed in patients with Alzheimer's disease. This systematic review and meta-analysis included adults enrolled in randomized controlled trials of anti-Aβ drugs. Anti-amyloid treatments work by attaching to and removing beta-amyloid, a protein that accumulates into plaques, from the brain. Each works differently and targets beta-amyloid at a different stage of plaque formation.
 
The review team noted “these findings reveal the potential for anti-Aβ therapies to compromise long-term brain health by accelerating brain atrophy” and brain volume loss, as well as risk of intracranial bleeding. Additionally, they concluded that their review could provide new insight into the adverse effects of Amyloid-Related Imaging Abnormalities (ARIA).
 
It’s critical to understand too that while certain medications currently available, such as memantine and donepezil, may reflect some efficacy in reducing symptoms, they do not actually slow disease progression.   
 
What else we should know - and what we can do.
 
The expectation that medication alone can alter the course of any disorder is simply not realistic. Modifying our lifestyle habits, such as increasing regular activity levels and adopting healthy dietary plans, are equally important factors whether or not we have a neurological, cardiac, autoimmune, or other condition.
 
I have discussed at length and recommend The Bredesen Protocol, which has been shown to potentially reverse signs of dementia. In a 2022 published study, Drs. Dale Bredesen and Kat Toups led a team of esteemed researchers “to determine whether a precision medicine approach to Alzheimer's disease and mild cognitive impairment is effective enough in a proof-of-concept trial to warrant a larger, randomized, controlled clinical trial.”
 
Their results: All outcome measures revealed improvement: statistically significant improvement in MoCA scores, CNS Vital Signs Neurocognitive Index, and Alzheimer's Questionnaire Change score were documented. No serious adverse events were recorded. MRI volumetrics also improved. Based on the cognitive improvements observed in this study, the investigating team concluded that a larger, randomized, controlled trial of the precision medicine therapeutic approach described was definitely warranted.
 
Other clinicians, including those whose treatment practices follow a different approach, support the idea that positive dietary and lifestyle interventions should be part of a comprehensive approach, much like we have pursued in treating other disorders such as heart disease and diabetes.
  
You can download the Bredesen Protocol reference guide on our website, where you’ll also find a wealth of related reading about other neurological and autoimmune diseases, wellness, and much more.
 
As always, we encourage you to review concerns or questions with your physician regarding making any changes to current therapies. And please feel free to reach out to our offices if you would like to schedule a visit – we are here to help!
 
In hope and healing,
Dr. Suzanne Gazda
 
References:
 
Alzheimer's Association – Understanding Treatments and Research
https://www.alz.org/help-support/i-have-alz/treatments-research
 
Alves, F. et al. Accelerated Brain Volume Loss Caused by Anti–β-Amyloid Drugs: A Systematic Review and Meta-analysis. Neurology. 2023. DOI: 10.1212/WNL.0000000000207156.
 
Blanco-Silvente, L., Capellà, D., Garre-Olmo, J. et al. Predictors of discontinuation, efficacy, and safety of memantine treatment for Alzheimer's disease: meta-analysis and meta-regression of 18 randomized clinical trials involving 5004 patients. BMC Geriatr 18, 168 (2018). https://doi.org/10.1186/s12877-018-0857-5
 
Knowles J. Donepezil in Alzheimer's disease: an evidence-based review of its impact on clinical and economic outcomes. Core Evid. 2006;1(3):195-219.
 
Toups K, Hathaway A, Gordon D, et al. Precision Medicine Approach to Alzheimer's Disease: Successful Pilot Project. J Alzheimers Dis. 2022;88(4):1411-1421. doi:10.3233/JAD-21570
 
The Bredesen Protocol and Alzheimer's.
https://www.today.com/health/how-prevent-alzheimer-s-reduce-risk-foods-lifestyle-t189658
 
Additional reading:
 
Eat well today for a brighter cognitive future.
https://www.suzannegazdamd.com/blog/what-how-we-eat-now-could-determine-our-future-brain-health
 
Keto diet.
https://www.suzannegazdamd.com/blog/a-ketogenic-diet-can-it-be-beneficial-for-our-brains-and-our-bodies
 
Olive oil and brain health.
https://www.suzannegazdamd.com/blog/olive-oil-the-heart-of-the-mediterranean-diet-thats-good-for-your-brain-too
 
Vitamin D and neurodegenerative disease.
https://www.suzannegazdamd.com/blog/vitamin-d-deficiency-linked-to-neurodegenerative-disease