Alice Park in Time: Lately, the biggest news in Alzheimer’s has been around a new drug treatment that can slow cognitive decline by nearly 30% among people in the early stages of the disease. In coming months, the U.S. Food and Drug Administration is expected to make a decision about another such promising therapy. But in addition to pharmaceutical interventions, which are expensive and require repeated infusions, making sustained lifestyle changes can also slow the progression of the disease, and possibly even prevent further decline, 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. The study was conducted by Dr. Dean Ornish, founder and president of the nonprofit Preventive Medicine Research Institute and professor of medicine at the University of California, San Francisco, and a team of scientists. It appeared in the journal Alzheimer’s Research and Therapy.
Previous studies have shown that moderate changes in lifestyle can lead to some slowing in cognitive decline, so Ornish and his team decided to test whether a more in-depth, formal program of behavior changes could slow brain changes even further. Ornish had previously developed the program to address heart disease risk and showed that the combination of improved diet, exercise, stress reduction, and social engagement could significantly lower the risk of atherosclerosis and heart disease.
“I have a unifying theory that many different chronic diseases share the same underlying biological mechanisms,” he says. “Those include inflammation, overstimulation of the sympathetic nervous system, changes in the microbiome…gene expressions, and immune system changes. That’s why what is 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 made the lifestyle changes in Ornish’s program for 20 weeks, and the other half kept their normal habits (although the latter group was offered the opportunity to join the program after the study ended). Everyone provided blood samples so that the researchers could track changes in markers for Alzheimer’s and fecal samples to provide insight into their microbiome, or gut bacteria.
The program was easier to stick to in the study than it would be in real life. Twice a week, the researchers shipped 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 a day (mostly walking) and strength training at least three times a week. A stress-management specialist guided them in meditation, yoga, stretching, and relaxation exercises 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 were experiencing. They also took several vitamins and supplements, including omega-3 supplements, a multivitamin, and Lion’s mane mushrooms and probiotics for cognition.
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 worsening scores on all four tests.
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