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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
Yahoo
16-05-2025
- Health
- Yahoo
San Francisco leaders inspired by European city to end fentanyl crisis
SAN FRANCISCO - A city in Switzerland is the latest inspiration for San Francisco leaders working towards tackling the drug crisis. The backstory In the 1980s and 1990s, Zurich was a hotspot for the HIV/AIDS crisis and rampant public drug use. The city created the Four Pillars approach, a strategy aimed at tackling the issues, and was largely successful. San Francisco leaders think the Four Pillars strategy could pave the way for a safer future for the city. Overdose deaths in San Francisco climbed between January and March 2025, increasing by 50%. A report by the Coroner's Office found nearly 200 drug-related deaths, with fentanyl being the most-used drug. In a report initiated by former Supervisor Dean Preston, the four pillars are identified as prevention, harm reduction, treatment, and law enforcement. "All of these pillars are integral to their strategy of reducing public drug use, reducing overdose rates, getting people connected to the help that they need," said Supervisor Jackie Fielder. She said there are already steps being made towards the goal, but there are areas to improve. San Francisco police officers are part of the outreach teams on the streets. Narcan is used to save drug users from overdosing, and there are some shelter beds, but it's not enough. "There is not enough capacity with our limited resources either in our public safety system, criminal justice system, or treatment system, so we need to figure out what to do with those people in the meantime," she said. Fielder said the hearing brought to light the fact that drug users are often arrested, cited, and released instead of being brought to shelters or treatment. Along with stricter enforcement, an addiction expert at the University of California San Francisco, Dr. Daniel Ciccarone, said the city should provide supervised consumption spaces, a method tried and abandoned in the past. "There are 200 around the world. No one has ever died in one, and people can consume drugs there safely under medical supervision," he said. "Overdoses go down, hospitalization utilization goes down, arrests go down, public nuisance goes down, and health goes up." The approach also calls for sobering centers and access to safe supplies and syringes. However, there is one pillar Fielder said San Francisco is missing: prevention, which includes identifying risk factors and education. "What can we do about childhood trauma? What can we do about adverse childhood experiences?" Ciccarone asked. Homelessness advocate and business owner Christin Evans, who is also part of the Homeless Oversight Commission, said to address the drug crisis, the city needs to provide more affordable housing and mental health services. "When they go into a shelter placement, a lot of times what happens is they are exited to the street because of behavioral issue," she said. What's next Dr. Ciccarone said it could take a few years to coordinate existing programs and implement the approach. "It took the Zurich folks months, perhaps even a couple years, to come together across the different philosophies so that public safety really worked with the doctors and public health," he said. Fielder said this is just the start of an ongoing conversation to coordinate city efforts. Earlier this week, Mayor Daniel Lurie announced that more than $27 million will go towards mental health and addiction treatment. KTVU reached out to his office for a comment about the Four Pillars strategy, but did not immediately hear back.
Yahoo
15-05-2025
- Health
- Yahoo
Georgia Is Using a Brain-Dead Woman as an Incubator
Georgia's LIFE Act is killing at least one family, as it keeps a brain-dead woman on life support against the wishes of her family—all because she was nine weeks pregnant at the time of her death. Atlanta mother Adriana Smith has been transformed into a human incubator due to Georgia's heartbeat law, which bans abortions once a heartbeat is detected in the fetus. That can happen as early as six weeks into pregnancy, making it one of the most restrictive abortion bans in the nation. One in three people discover they're pregnant at the sixth week of pregnancy or later, according to the University of California San Francisco's Bixby Center for Global Reproductive Health. Smith, a 30-year-old registered nurse for Emory University Hospital, was declared brain-dead more than 90 days ago. In early February, she began experiencing intense headaches and sought treatment at Northside Hospital, where she was given medication and released. 'They gave her some medication, but they didn't do any tests. No CT scan,' Smith's mother, April Newkirk, told 11AliveNews. 'If they had done that or kept her overnight, they would have caught it. It could have been prevented.' Smith woke up the following morning gasping for air. Two hospital trips later, CT scans at Emory University Hospital revealed multiple blot clots in her brain. 'They asked me if I would agree to a procedure to relieve the pressure, and I said yes,' Newkirk said. 'Then they called me back and said they couldn't do it.' Smith had been declared brain-dead, but the state is the one not letting her go—and her family is having to foot the mounting hospital bills. Smith's medical team is legally required to keep her alive until they believe the fetus can survive outside of the womb, at approximately 32 weeks' gestation. Doctors advised Smith's family that they are not legally allowed to consider alternatives, reported 11Alive. Newkirk said Smith is currently 21 weeks pregnant. 'I think every woman should have the right to make their own decision,' said Newkirk, who described seeing her daughter's still-breathing body as 'torture.' 'And if not, then their partner or their parents.' Georgia's LIFE Act bestows legal personhood on unborn fetuses. It was passed in 2019 and went into effect after Roe v. Wade was overturned by the Supreme Court in 2022. Pro-abortion activists have long warned that fetal personhood, an ideology that calls for providing equal human rights to a fetus (even if it's just a cluster of cells), will effectively strip pregnant people of their own rights. The legal language behind fetal personhood also effectively categorizes any person receiving an abortion at any stage as a murderer. 'How many different ways can they prove to us that they do not see us as human beings?' asked abortion columnist Jessica Valenti in a video reacting to the news of Smith's situation. 'You are a vessel, you are an incubator, but you are most certainly not a human being.' 'Corpses have more rights than a pregnant person in these states with abortion bans,' Valenti continued. 'How many families are they going to devastate?' The language of 'fetal personhood' has already reached the national stage by way of sneakily drafted executive orders. One of dozens of executive orders signed by Donald Trump the evening of his inauguration cemented language at the executive level to delegitimize transgender identities. But within the fold of that order, titled 'Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government,' the Trump administration also decided to legally brand a person's gender identity as beginning 'at conception.' ''Female' means a person belonging, at conception, to the sex that produces the large reproductive cell,' the order read in part. ''Male' means a person belonging, at conception, to the sex that produces the small reproductive cell.'
Medscape
15-05-2025
- Health
- Medscape
The New Playbook for Ditching Dangerous Senior Meds
A new tool presented at the American Geriatrics Society (AGS) 2025 Annual Scientific Meeting may give clinicians practical and safer alternatives to risky medications for patients. Developed as a companion to the widely cited AGS Beers Criteria, the new Alternatives List was unveiled by a panel of clinicians and researchers who spent months identifying and reviewing safer options for high-risk medications. The list has pharmacologic and nonpharmacologic approaches and is tailored to the realities of treating geriatric patients. Originally updated in 2023, the AGS Beers Criteria outlines medications that may be inappropriate for use in older adults who are not receiving end-of-life care. 'The real goal is to help older adults feel better and function better while reducing the risk of medication harms,' said Michael Steinman, MD, geriatrician and professor of medicine at the University of California San Francisco, who led the development of the list. Eight workgroups covered 21 conditions commonly linked to potentially inappropriate medications, such as insomnia, anxiety, and allergic rhinitis. Clinicians from a range of disciplines — pharmacy, nursing, psychology, physical therapy, and medicine — collaborated to ensure the recommendations were practical, evidence-informed, and clinically relevant. Yet even assembling the list came with challenges. 'Treatments for common conditions are often not well-studied in older adults, and practice guidelines often give little information on how approaches to treating these conditions should be modified to meet the unique needs of older adults,' Steinman told Medscape Medical News . Each entry on the list includes commonly used medications flagged in the Beers Criteria, safer nonpharmacologic and pharmacologic alternatives, and resources for clinicians and patients. 'We focused on what clinicians actually see and treat every day,' Steinman said. 'If someone's taking diphenhydramine for sleep or allergies, what should we be recommending instead? That's what this tool answers.' During the panel, members of the AGS-convened work group shared insights from the development process. Judith Beizer, PharmD , clinical professor of pharmacology at St. John's University College of Pharmacy and Health Sciences in New York City, highlighted treatment considerations for gastroesophageal reflux disease, a condition often treated with medications deemed high-risk for older adults. 'We know that proton pump inhibitors (PPI) are often continued far longer than necessary,' Beizer said. Beizer presented a range of safer alternatives for long-term PPI use to treat gastroesophageal reflux disease, emphasizing first-line nonpharmacologic strategies such as avoiding trigger foods, elevating the head of the bed, and modifying meal timing. When pharmacologic intervention is necessary, Beizer recommended transitioning to H2 blockers like famotidine or using antacids with alginic acid while tapering patients off PPIs. 'It's not just about stopping the medication,' she said. 'It's about doing so thoughtfully and supporting the patient through the transition.' The panel also addressed nocturia, another condition in older adults that is often treated with desmopressin, a drug the Beers Criteria advises avoiding due to the risk for hyponatremia. Instead of using this drug, clinicians should conduct a comprehensive review of underlying causes of nocturia using the SCREeN approach, which examines sleep disorders, cardiovascular health, renal function, endocrine issues, neurologic conditions, and medication side effects, Beizer said. 'Nocturia is a symptom, not a diagnosis,' she said. 'We have to explore the root cause before prescribing.' Alternative approaches to treating nocturia include bladder retraining, fluid management, and, in certain cases, pharmacologic agents such as beta-3 agonists or, for men with benign prostatic hyperplasia, alpha blockers and 5-alpha reductase inhibitors. For women, Beizer noted that vaginal estrogen could be beneficial. Steinman said that the tool is not just about safer prescribing but about creating a more individualized approach to care. 'Deprescribing is not just about stopping a medication — it's about communication and trust,' he said. 'Sometimes a potentially inappropriate medication is still the right choice, but that decision should come after weighing risks, exploring safer alternatives, and engaging in shared decision-making.' But implementing alternatives — especially nondrug strategies — can be difficult in time-constrained primary care settings. Steinman acknowledged this reality but offered solutions. 'The list is designed to be easy to use in busy practice settings,' he said. In some cases, nonpharmacologic strategies can take longer to explain than simply writing a prescription, he said. But clinicians can hand patients off to nurses or other staff to offer more detailed explanations. 'Building buy-in takes time, but that time can be shared across multiple visits and supported by handouts or other team members,' he said. Clinicians will soon be able to access the Alternatives List in an upcoming issue of the Journal of the American Geriatrics Society , and The AGS Beers Criteria Alternatives List is still evolving, with plans to be updated as evidence grows, panelists said. Steinman reported no relevant disclosures. Beizer reported serving as an editor for Wolters Kluwer.
Medscape
14-05-2025
- Health
- Medscape
Neighborhood May Affect HS Risk, Study Finds
A retrospective study found that individuals living in socioeconomically disadvantaged neighborhoods had a higher risk of developing hidradenitis suppurativa (HS), an association that persisted across racial and ethnic groups. METHODOLOGY: This cross-sectional analysis included 65,766 individuals (mean age, 50.4 years; 41.8% women; 56.5% White; 15.7% Asian, Native Hawaiian, or other Pacific Islander; 7.5% Hispanic; and 3.8% Black individuals) from dermatology clinics at the University of California San Francisco health system between August 2019 and May 2024. Neighborhood-level socioeconomic status (nSES) was assessed at the census tract level using a validated index derived from seven socioeconomic indicators. Patients were categorized into five nSES quintiles, with Q1 representing the lowest SES neighborhoods and Q5 the highest. The study outcome was HS diagnoses. TAKEAWAY: A total of 485 participants (0.7%) received a new HS diagnosis. The proportion of patients with HS was highest in Q1 (24.3%). After adjusting for age, sex, and race/ethnicity, the odds of an HS diagnosis decreased with each successive increase in nSES compared with the highest quintile (odds ratio, 3.32 for Q1, 2.25 for Q2, 1.97 for Q3, and 1.44 for Q4; P < .001 for linear trend). < .001 for linear trend). Race-stratified analyses showed consistently higher odds of HS diagnosis in lower SES neighborhoods among Black, Hispanic, and White individuals. Obesity partially mediated the association between nSES and HS diagnosis (adjusted proportion mediated, 0.17-0.35 across all quintiles). IN PRACTICE: 'This cross-sectional study found that nSES was independently associated with a new diagnosis of HS in dermatology patients,' the study authors wrote. This finding, they added, 'supports the hypothesis that neighborhood-level factors may influence the development of HS.' SOURCE: The study was led by Aileen Y. Chang, MD, University of California San Francisco School of Medicine, and was published online on May 14 in JAMA Dermatology . LIMITATIONS: The generalizability of the effect size could be limited outside of the San Francisco Bay Area. Other limitations were selection bias, missing data, underpowered subgroup analyses, cross-sectional design. Also, nSES was assessed only at the index visit. DISCLOSURES: The study received support from the University of California San Francisco Academic Research Systems and the National Center for Advancing Translational Sciences of the National Institutes of Health. Chang and another author disclosed receiving support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases for this study. Two authors declared receiving personal fees from Abbvie, Medscape, Novartis, UCB, and Sonoma Biotherapeutics, Aurinia, UCB, and AstraZeneca and serving as vice president of the Hidradenitis Suppurativa Foundation.
