Have Doctors Discovered A Cure For Alzheimer’s?
No. At least, it’s very unlikely.
But that’s not the impression you’d get from reading the news about the MEND or Bredesen protocols. And it’s not the impression you’d get from reading their published research either. For the full scoop, you’d have to ask other experts in the field and look at the background research that got us here.
(Editor’s note: When we say AD, we’re talking about Alzheimer’s-type dementia in this article. Alzheimer’s disease itself can’t be proven without an autopsy.)
With the publishing of both MEND case reports in 2014 and 2016, Dr. Bredesen and his colleagues claimed to show a “reversal of cognitive decline in Alzheimer’s patients”. They go as far as to claim that a few of their patients are asymptomatic — essentially cured of Alzheimer’s disease (AD). But that was just ten patients. Now, according to this month’s abstract in AAIC 2016, they claim that 40% of 76 patients treated for at least 6 months have improved their memory function, based on “standard neuropsych tests”.
We have some caveats.
The MEND researchers are claiming levels of improvement that have never been seen in Alzheimer’s patients before. These are bold claims in a research industry that’s been scrambling for any footing with the disease.
Some have questioned whether the protocol is an attempt to make money off the ignorance of desperate, elderly people. Participation fees range up to $20,000 per year for the service. Critics of the research point out that these case reports are not equal to randomized trials; case reports show anecdotally that something might work, but only randomized trials can prove whether a treatment is effective or not. Bredesen and his colleagues claim that a randomized trial will be conducted in the future, but they continue to expand globally and bring in new patients for the time being.
The efficacy measurements used in MEND can’t be trusted without a control population. The MEND researchers used cognitive tests, exams much like you’d see in school, to measure changes in memory and mental function. Critics have noted that participants naturally get better at cognitive tests each time they take them. Essentially, practice makes perfect. Without a control group of untreated AD patients to compare with, the MEND researchers couldn’t tell whether the improvements they saw were due to practice or the treatment itself.
So what is the MEND protocol? It’s personalized medicine — the treatment regimen varies from patient to patient, based on their personal characteristics. That’s a point of concern for one critic who claimed we don’t have enough data (as we’ll explain below) to power the proper use of individualized medicine for AD.
The full MEND protocol is trademarked and proprietary, but from comparing the case reports we can extrapolate the treatments that have been shared among reported patients: Eat fewer carbs and don’t snack, take melatonin and increase sleep, exercise daily, and take vitamin D3, CoQ10, and fish oil.
The shared MEND protocol among reported cases:
- Exercise at least 4 times/week
- Take 0.5 mg melatonin each night
- Attempt to increase sleep to 7–8 hours/night
- Eliminate simple carbs.
- Increased fruit and veggies, no farmed fish, limited meat.
- Fast 12 hours between dinner & breakfast; eat dinner 3 hours before bed.
- Take vitamin B12 1 mg/day
- Take vitamin D3 2000 IU/day
- Take CoQ10 200 mg/day
- Take Fish oil with at least DHA 320 mg and EPA 180 mg/day
In addition some patients were advised to add the following: Yoga, meditation, increased oral hygiene, probiotics, vitamins C and E, zinc, turmeric, a variety of other supplements, and hormone therapy for women.
The evidence remains to be seen. Ultimately, we haven’t seen the patients and we don’t have the experience or training of Dr. Bredesen or his colleagues, so we can’t say that the MEND protocol definitively does or doesn’t work. What we can do is look at each treatment individually and analyze their merits.
The actual Alzheimer’s research behind each of the MEND protocol treatments
Of all the treatments, the evidence is strongest for exercise. Observational and longitudinal research shows pretty conclusively that people who exercise are much less likely to develop AD later in life, and the more intense and regular the exercise, the less likely AD will develop (source 1, 2, 3, 4, 5). Studies are now examining whether regular exercise can be used to treat AD. So far, the results have been promising but not conclusive (source 6, 7, 8, 9, 10).
We know that sleepless nights are a common problem for AD patients, and that they have emotional issues in the day after a bad night’s sleep. Unfortunately, melatonin may not be helpful for this group of patients (source 1, 2), but physical activity has been shown to improve sleep. There also hasn’t been any research conducted to see if increasing sleep duration can improve the symptoms of AD.
The MEND protocol asks patients to eliminate all added sugars and simple carbs from their diet, to reduce meat consumption, and eat a lot more fruits and vegetables. While this is generally a good diet recommendation for any of us, there’s limited research to show its efficacy for AD patients. Researchers have been investigating the link between insulin resistance (such as diabetes patients experience) and AD development. The results right now are inconclusive (source 1, 2). So far, AD biomarkers have been shown to improve in rodents fed a high protein, low carb (ketogenic) diet, but that’s very different from showing that a low-carb diet can treat AD symptoms in humans.
Research has confirmed that AD patients are low in B12 (source 1, 2), but there’s conflicting evidence about whether B12 deficiency is related to AD development (source 3, 4). Either way, B12 supplements don’t appear to treat AD symptoms.
Vitamin D might be an important player in AD. Research shows that Alzheimer’s patients are often vitamin D deficient, and that healthy people who are vitamin D deficient are more likely to develop AD later in life. One study also showed a combination of memantine and vitamin D supplements improved cognition in elderly AD patients.
Coenzyme Q10 is an antioxidant in our bodies that helps to convert food into energy. We know that natural Q10 levels aren’t any different for AD patients compared with the average person, but there’s some speculation that supplementation might help. Q10 supplements improved AD biomarkers and signs of cognitive function in mouse studies, but no tests have been published for humans with AD, so we still don’t know if it would be effective.
While fish oil was shown to improve mild cognitive impairment in the general elderly population, it’s shown mixed-to-possible minor benefits in AD patients (source 1, 2, 3). Fish oil supplements will often be recommended to AD patients for their cardiovascular effects, but they’re not typically used to treat the mental symptoms of AD.
Of the shared treatments in these case studies, only exercise and memantine+vitamin D have been shown conclusively to have any cognitive benefit for AD patients in controlled studies. Other components of the MEND protocol, such as reducing carbs, increasing sleep, and supplementation with CoQ10 and fish oil might have some merits but are still unproven. So even if someone with AD were to follow all of this advice, it’s unlikely they’d experience more than a mild improvement in their symptoms. Without more information on the specifics of the MEND protocol, we think it’s unlikely that it could dramatically improve symptoms in the average Alzheimer’s patient from the methods presented.
Alzheimer’s is a complex disease without a clear solution, and many of us are looking for whatever help we can find. We’re trying to consider the MEND protocol in the full scope of Alzheimer’s research, most of which is still being conducted. Ultimately, lifestyle changes like exercise, diet, and vitamins show some promise, but probably won’t cause great improvements. However, with reasonable expectations set, this research shows lifestyle modification is still a good option.