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Boston Globe
3 days ago
- Health
- Boston Globe
An expensive Alzheimer's lifestyle plan offers false hope, experts say
Kerry Briggs was taking them all because a doctor had told her that with enough supplements and lifestyle modifications, her Alzheimer's symptoms could not only be slowed, but reversed. It is an idea that has become the focus of television specials, popular podcasts, and conferences; the sell behind mushroom supplements and self-help books. Advertisement But the suggestion that Alzheimer's can be reversed through lifestyle adjustments has outraged doctors and scientists in the medical establishment, who have repeatedly said that there is little to no proof for such a claim and expressed concern that the idea could harm a large group of vulnerable Americans. Get Starting Point A guide through the most important stories of the morning, delivered Monday through Friday. Enter Email Sign Up John Briggs had come across the idea after learning about Dale Bredesen, who had been performing a series of small and unconventional studies through which he claimed to have designed a set of guidelines to reverse Alzheimer's symptoms. 'Very, very few people should ever get this,' Bredesen told an audience in July, referring to cognitive decline. His company has made bracelets with the phrase 'Alzheimer's Is Now Optional' on them. His pitch has gained a following. Bredesen's 2017 book, 'The End of Alzheimer's,' has sold around 300,000 copies in the United States and became a New York Times bestseller. Advertisement A day's worth of supplements for Kerry Briggs, diagnosed with early-onset Alzheimer's. JAMIE KELTER DAVIS/NYT Many doctors encourage Alzheimer's patients to modify their diets and exercise regimens in hopes of slowing the disease's progress, said Dr. Bruce Miller, director of the Memory and Aging Center at the University of California San Francisco. 'The question, though, of reversal is very different.' 'It's one thing to say that you're reversing an illness because someone says they feel better and another to prove it,' Miller said. 'We don't have the proof.' Bredesen, 72, was once also a top neurologist at the University of California San Francisco, but he has not had an active medical license for much of the past three decades and doesn't see patients anymore. He became skeptical of the medical and pharmaceutical industries' approach to treating Alzheimer's and dedicated himself to an alternative method focused on food, supplements, lifestyle tweaks, and detoxification treatments. The central idea was that there was no 'silver bullet' -- no one pill or intervention -- that could cure Alzheimer's. Instead, Bredesen believed in firing a 'silver buckshot' (a reference to the sprayed pellets that come out of shotgun shells) by modifying 36 factors simultaneously. His strict protocol could be personalized after extensive lab testing but generally involved a low-carbohydrate diet, intermittent fasting, supplements and, at times, interventions such as hormone treatments and home mold remediation. For the Briggses, who live in North Barrington, Ill., the adjustments did not come cheap: $1,000 a month for supplements, $450 per hour for a specialty doctor and other costs, which altogether added up to $25,000 over eight months. Advertisement But Kerry Briggs wanted to do something to help find a treatment for the disease, and John Briggs wanted to help his wife. More than 7 million people in the United States -- roughly 11 percent of those 65 and older -- have Alzheimer's, the world's leading cause of dementia. Despite decades of research and the development of a few medications with modest benefits, a cure for the disease has remained elusive. The Alzheimer's Association, which helped fund Bredesen's earlier and more conventional research, sees his recent approach as insufficiently rigorous. His trials have suggested his protocol can improve cognition, but Maria Carrillo, the organization's chief science officer, said they 'fall short of what the research community' would consider convincing enough to suggest to patients, since they lack control groups and are small, with the number of participants ranging from 10 to 25. Others have expressed similar unease. In 2020, Dr. Joanna Hellmuth, then a neurologist at the University of California San Francisco, published an article in The Lancet Neurology pointing to a number of 'red flags' within Bredesen's studies, including 'the substantial potential for a placebo effect.' Dr. Jason Karlawish, co-director of Penn Memory Center at the University of Pennsylvania, said Bredesen's research and recommendations don't adhere to the standards of medicine. The Alzheimer Society of Canada has gone so far as to say Bredesen is offering 'false hope.' Bredesen maintains that the results of his program can be remarkable, though he acknowledges it's less successful for people with more noticeable symptoms: 'It amazes me how people fight back against something that's actually helping,' Bredesen said. Advertisement He connected The New York Times with patients who said they had benefited from his recommendations. Sally Weinrich, 77, in South Carolina, said she used to forget her pocketbook or miss the school pickup window for her grandchildren, but now thinks more clearly. Darrin Kasteler, 55, in Utah, who had struggled to tie a necktie and to drive, said both had become easier. To Bredesen's supporters, the testimonials are evidence of promise. But what divides Bredesen from the medical establishment isn't his emphasis on lifestyle adjustments; it is the boldness of his claims, his unconventional and strict treatment plan, and the business he is building around both. It was one of Kerry Briggs' sisters, Jennifer Scheurer, who first noticed that something was off. In 2021, while visiting Scheurer in Oregon, Briggs repeated the same story a few times in one day, and had trouble finding words and playing board games. Scheurer also found Briggs standing in her kitchen, seemingly lost. This was particularly odd; Briggs was an architect, and she had designed the kitchen herself. Briggs underwent a series of tests, ending in a spinal tap, which showed evidence of Alzheimer's. She was 61. The news was devastating, but Briggs told her husband that she wanted to enroll in a clinical trial to help others. But none of the trials admitted her. She weighed too little, and her disease was already too advanced. Then a friend recommended 'The End of Alzheimer's.' John Briggs read that book and a follow-up, 'The First Survivors of Alzheimer's.' Excited, he reached out to Bredesen's company, Apollo Health, to see what could be done for his wife. Bredesen had developed a paid plan called 'Recode,' a portmanteau of the phrase 'reversal of cognitive decline,' and a training program for health practitioners like medical doctors, chiropractors and naturopaths to learn to implement it. On the Apollo Health website, Bredesen's program is advertised as the 'only clinically proven program to reverse cognitive decline in early stage Alzheimer's disease.' Advertisement In January 2024, John Briggs paid an $810 fee to join Apollo Health, which gave Kerry Briggs access to a personalized plan and matched her with Dr. Daniel LaPerriere, a doctor in Louisville, Colo. On LaPerriere's recommendation, the Briggses began to eat a modified keto diet that was low in sugar and rich in plants, lean protein, and healthy fats. The Briggses were not allowed most fruit -- no apples, bananas, peaches or grapes ('all these things that we love,' John Briggs said), though the couple made an exception for blueberries. To see if Kerry Briggs was in a metabolic state of ketosis, where fat is used for energy instead of carbohydrates, John Briggs experimented with pricking her finger twice each day to test her blood. In keeping with Bredesen's general guidelines, Kerry Briggs began working with a therapist to manage stress and tried the brain-training games the protocol recommended, though she struggled to play them. LaPerriere gave John Briggs the unconventional instruction to collect dust samples at home in order to determine whether 'toxic mold' was present (only trace amounts were) and ordered lab tests to see if Kerry Briggs was suffering from an inability to flush it from her organs (she wasn't). He also prescribed Briggs hormone-replacement therapy, in the hope of improving her cognition. Advertisement Briggs' primary-care physician raised concerns about the risks, John Briggs said, but she took the hormones anyway. Briggs understood that the protocol would be unlikely to restore Kerry Briggs to her former self. But he was determined to see it through for at least six months. By last September, though, John Briggs was struggling to notice many benefits. Kerry Briggs could no longer keep track of conversations with her therapist, who suggested they stop the sessions. The next month, John Briggs began touring memory-care facilities for his wife. In February, after about eight months, they quit the protocol altogether. Bredesen said that he rarely tells people not to try his program, even if the chance of helping is small, because of the possibility of improvement. But he considered Kerry Briggs' experience 'not representative' of the results he has achieved in trials and said in retrospect that 'you could kind of tell ahead of time' that she would not fare well. Bredesen has urged prospective patients to start his program preventively or early in the disease's progression. Helping patients already experiencing significant decline, like Briggs, is difficult, he and LaPerriere said. 'People are more incentivized to come in when they're farther along,' Bredesen said. 'And that's a real dilemma, which is why we're telling people, 'Please do not wait because we can do so much more.'' This article originally appeared in
Telegraph
30-04-2025
- Health
- Telegraph
The controversial neurologist who believes you can dementia-proof your brain
Dr Dale Bredesen, a neurologist who has worked in many of California's major universities, is known for boldly claiming that Alzheimer's disease can be reversed – even in the case of severe degeneration after several years living with the condition. In 2014, Dr Bredesen was touted as the first doctor to have successfully reversed memory loss in people diagnosed with the disease, after a small study he led at UCLA. He has since written two books about the power of a dementia treatment regimen he has designed, called ReCODE. He has now written a third, called The Ageless Brain. It is no less defiant of the current medical consensus. Research has shown that 'there is no reason why anyone should get dementia in the first place,' Dr Breseden claims, 'and the idea that there's nothing that can be done for people who already have the disease is just outdated at this point'. With dementia cases set to triple worldwide by 2050, this is exactly the news that many of us are desperate to hear. But could such a thing really be true? That our lifestyles go a long way in determining our dementia risk is solid scientific fact. 'There is some evidence that certain diets, such as the MIND diet which is based on the traditional Mediterranean diet, can help to prevent dementia or slow cognitive decline,' says Barbara Sahakian, a professor of clinical neuropsychology at the University of Cambridge. 'I am yet to see any method that can reverse Alzheimer's symptoms, however.' 'There is currently no cure for any type of dementia,' agrees Dr Richard Oakley, an associate director of research and innovation at the Alzheimer's Society, though 'around 45 percent of dementia cases could be prevented or delayed with lifestyle and societal-level changes'. Engaging in just 35 minutes of physical exercise per week, for example, has been associated with a 41 per cent lower risk of developing dementia compared with a completely sedentary lifestyle. The earlier in life we adopt a regimen of clean eating and frequent exercise, the better, for the health of our brains. But there is much we can do in midlife, says Dr Bredesen, who is far more optimistic than most of his colleagues in the field. In fact, 'your forties and fifties are really the sweet spot when it comes to dementia prevention,' Dr Bredesen says. Though we are living for longer, 'our brain spans aren't yet matching our lifespans,' he explains, and our 40s and 50s are the right time to make sure that you stay sharp into your eighties and beyond. 'People find that they're pretty healthy throughout their 30s, but that things start to feel different when they hit 40, and then andropause and menopause comes in from around 50 and makes everything different again,' says Dr Bredesen. 'This is when the first signs of cognitive decline might set in, like slower mental processing and worsened memory, and at this point, there really is a tremendous amount that you can do to reverse them and make sure you never get dementia.' That said, it won't be easy. 'Reversing or preventing dementia is extremely difficult, because it involves wholesale change in the way a person is living their life, what they're eating, how they're exercising, socialising and sleeping,' explains Dr Bredesen. The good news is that 'getting even a few of these right is enough to massively reduce your risk of developing Alzheimer's'. Here is Dr Bredesen's prescription for a lifestyle that could successfully ward off dementia. Make sure you eat the right diet (and it isn't the one you think) What we eat affects the health of our brains – and most of us know that now. But the best diet for your brain goes a step beyond the Mediterranean diet and the advice to eat lots of vegetables and oily fish, according to Dr Bredesen. His ReCODE protocol includes a ketogenic (high fat, low carbohydrate) diet, with a small amount of fasting, both 'to reset the body's sensitivity to insulin' and avoid insulin resistance in the future. Insulin resistance is thought to affect up to 40 per cent of people aged over 40. Those who are overweight and inactive are most at risk, but this issue is typically identified through a blood test. Insulin resistance is problematic when it comes to dementia risk because it can lead to a build-up of amyloid and tau, two proteins that are thought to damage brain cells. Ketones meanwhile, a type of chemical produced by the liver in the process of breaking down fat, may be helpful in delaying or preventing the onset of Alzheimer's disease, according to some research. 'The purpose of this diet is to restore insulin sensitivity and to restore your body's ability to make ketones when needed,' Dr Bredesen explains. For this, the doctor prescribes a diet that's heavy in cruciferous vegetables like Brussels sprouts and cabbage, as well as fermented foods such as sauerkraut, though produce sprayed with insecticides and herbicides is to be avoided (as these can contribute to toxic exposure, another risk factor for dementia). Low-mercury fish, pastured chicken and eggs as well as grass-fed beef are in, while grains, dairy products and simple carbs like white bread and pasta are out. Fibre and healthy omega-3 fats from sources such as avocados, nuts and seeds are given a starring role: like sauerkraut, both 'help your gut microbiome, which we know now is crucial in protecting your brain,' Dr Bredesen says. It's also best for your brain, he believes, to fast for 12 hours overnight, and for at least three hours before bed – meaning that if you eat dinner at 7pm, you should have breakfast at 7am the next day, no earlier and no later. A small amount of fasting before bed and in the morning helps to regulate your glucose levels, Dr Bredesen explains, a key factor in insulin sensitivity. He doesn't advise however that people who want to ward off dementia try intermittent fasting or fast for much longer than 12 hours at a time, as 'you don't want to starve your body of the energy it needs'. Exercise a lot, in different ways When it comes to dementia, any amount of movement is far superior to none at all – as shown by a recent study from the Johns Hopkins Bloomberg School of Public Health, which found that just five minutes of 'moderate to vigorous' exercise a day can cut dementia risk by over 40 per cent (if stuck to every day of the week, for four years). The reason for this seems to be that exercise increases flood flow, stimulating the growth of new brain cells and reducing inflammation, the chronic sort of which is linked to increased risk of cognitive decline. But most of us struggle to find the time to exercise, and it only becomes less appealing as you age. So how can you get the most bang for your buck? Dr Bredesen, who is as evangelical about the benefits of regular exercise as any other expert in the brain, advises people to aim for at least 30 to 40 minutes of exercise a day, five times a week, to include three to four strength training sessions, for no more than 20 minutes at a time and regular cardio. 'The two kinds of exercise are very complementary in what they do for the brain,' says Dr Bredesen. 'Running is especially great because it improves your coordination. Any kind of aerobic exercise improves blood flow and promotes better sleep, while strength training improves insulin sensitivity. Anyone who's physically able to do so should be trying to build or at least maintain muscle and strength.' Those in midlife should consider incorporating some high-intensity interval training (HIIT) into their weeks, Dr Bredesen adds. The practice combines the most useful aspects of aerobic and strength training, he explains in his book, and the combination of short bursts of exercise and short breaks 'does seem to do something special in the brain', though HIIT shouldn't be treated as a full replacement for longer aerobic or strength training sessions. Dr Bredesen also recommends exercise with oxygen therapy to anyone with vascular problems, a predictor for dementia, as this can improve the oxygenation of a person's bloodstream and lower blood pressure. 'But that can be pretty expensive, and it's still important that people just get out if this is outside of their budget.' At the end of the day, 'you just want to aim to get your heart rate up at least five times a week, every week,' Dr Bredesen says. 'A very gentle walk won't cut it, but going slightly uphill or more quickly than is comfortable is enough.' So goes the adage, that the best kind of exercise is the one that you'll stick to. 'Figure out what works well for you, and then add to that if you can. I like to play pickleball or some tennis with my wife.' Get enough sleep (but not too much) Most people in midlife could do with getting a bit more sleep – women especially. Perimenopausal women get less sleep than both postmenopausal and premenopausal women, according to some research, with more than half getting less than seven hours' sleep per night, deemed the minimum for good brain health. The sweet spot for sleep is in fact seven hours, 'with at least an hour of deep sleep and an hour and a half of REM (rapid eye movement) sleep,' Dr Bredesen advises. But too much sleep is bad for the brain; regularly sleeping for nine hours or more 'is associated with risk for dementia'. All this is because sleep helps to 'cleanse and restore' the brain, ridding it of unhelpful influences and preparing it for the next day ahead. REM sleep, when dreaming occurs, seems especially important. Research suggests that for every percentage decrease in the REM sleep we get, dementia risk rises by 9 per cent. Deep sleep meanwhile seems to be the crucial period in which the brain rids itself of waste products. To know whether you're actually getting enough sleep each night – and enough deep sleep and REM sleep at that – it isn't enough to simply count the hours between your bedtime and your morning alarm. Though we might not remember it, the average person wakes between two and five times in the night, cutting the time actually spent sleeping. 'It is well worth investing in a fitness tracker that has a sleep function,' says Dr Bredesen. There are many commercially available options. While it may not come cheap, 'buying one is certainly cheaper than spending the last decades of your life in a nursing home'. Train your brain with big and small challenges Fitness is a matter for your brain as well as your body, Dr Bredesen says, and to protect yourself from dementia, you must challenge it over the course of your life. Research now shows that 'cognitive reserve' isn't enough, says the doctor. Instead you must constantly present your brain with new tasks and dilemmas. That doesn't always have to mean putting your brain through a structured boot camp. Dr Bredesen recommends that people in midlife 'take on a small cognitive challenge each day, a medium cognitive challenge each month, and a big cognitive challenge each year'. It needn't be complicated, 'but some degree of intentional brain training has been shown time and time again to help prevent dementia'. The point is that each challenge encourages you to go about your life slightly differently, making your brain work harder and remain 'plastic', in a more flexible state of growth. Examples of a small challenge include trying a new kind of puzzle (making the switch to sudoku if you're a regular crossword-er), visiting a new coffee shop or simply 'setting up your desk in a new part of the house if you're someone who works from home,' says Dr Bredesen. A medium challenge meanwhile might entail cooking recipes from a cuisine you haven't yet tried your hand at, or listening to a new kind of music. 'But the key is that the nature of the challenge has to change each month – you can't have Italian food one month and sushi the next, and think you're sorted,' Dr Bredesen says. A hard challenge, your year-long project, should involve 'true mastery' of a subject, says the doctor. Learn a language, become a chess expert or finally learn how to do algebra, 'so long as it has nothing to do with your day job, as you won't find the benefits of a more plastic brain here'.
