Alzheimer’s disease accounts for 60% to 80% of dementia. At present, there is no effective treatment for Alzheimer’s disease. Although the greatest known risk factor is increasing age – while the majority of people affected with Alzheimer’s disease are aged 65 years and older – Alzheimer’s is not merely an illness that comes with old age.

It is estimated that up to 5% of Americans with Alzheimer’s have an earlier onset, and are diagnosed when they are in their 40s or 50s. Alzheimer’s disease is also currently the third leading cause of death in the United States – after cardiovascular disease and cancer. All this entails that it will continue to be a significant threat to healthcare resources.

Current outlook of drugs used to treat Alzheimer’s disease

In a large clinical trial conducted in July last year, it was found that the new drug LMTZ reaped little benefit in patients. The drug appeared to only transiently address symptoms of Alzheimer’s and did not slow disease progression.

Following this, there was another hopeful drug designed to target the amyloid protein, which also failed in its clinical trial. In February this year, Merck announced the results of its trial of the drug, verubecestat. Designed to inhibit the formation of the amyloid protein in Alzheimer’s, Merck concluded that the drug did not reap any positive clinical effect among patients.

Unconventional protocol and results

Researchers from UCLA put together an unconventional protocol consisting of different lifestyle modifications aimed to optimise metabolic parameters associated with Alzheimer’s disease. Labelled as the Metabolic Enhancement for NeuroDegeneration (MEND) protocol, 10 memory-loss patients with brain-scan confirmed patterns of Alzheimer’s participated in the study.

The patients were counselled to change their lifestyle. They were to avoid simple carbohydrates, gluten and processed foods, include vegetable and fish intake in their diet, start exercising and learning yoga, develop techniques for stress management and get adequate sleep, among other things.

Such a method of intervention is not novel, as research has shown how comprehensive lifestyle adjustments do improve patients’ well-being in diseases; such as diabetes and hypertension. Essentially, it is difficult for such an intervention to gain traction because of the difficulty in executing the protocol.

Firstly, from the perspective of the patient, he needs to put in more effort to be involved. Not only is there a need for continuous support and counseling – but patients also need to be educated, so as to acquire the necessary knowledge to make the lifestyle adjustment.

Secondly, from the doctor’s perspective, there could be a differing expectation in delivery – since doctors are taught pharmacology, and have the expectation to share this knowledge with patients, rather than nutrition.

The results were rather stunning. Apart from the one patient who was already in the late stages of Alzheimer’s when the intervention started, who did not respond to the intervention, there was a noticeable improvement in memory for nine of them within six months of the protocol.

This led the researchers to suggest that it was highly probable that in the early onset of Alzheimer’s, a chance in the patient’s metabolic processes can further halt memory decline and the progress of the disease.

The results provide support that a comprehensive protocol – aimed at optimising the various metabolic processes in the body – may be effective in halting the progress of brain function decline in patients with early Alzheimer’s. It might be time to take these approaches more seriously – instead of relying solely on drugs, which very often have their limitations. MIMS

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