You may be doubtful that reversing cognitive decline and dementia is even possible.
I used to be too.
But I want to point you to an amazing study published in the Aging Journal.
It’s called “Reversal of cognitive decline: A novel therapeutic program” by Dr. Dale Bredesen, MD, professor at the Easton Laboratories for Neurodegenerative Disease Research at UCLA, and author of the book The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline.
I recently stumbled upon it, and the results show that reversing cognitive impairment and Alzheimer's disease is definitely possible, despite what most doctors and experts may tell you.
Based on the underlying pathogenesis of Alzheimer's disease, Dr. Bredesen used a comprehensive therapeutic program to reverse cognitive decline in nine patients.
The program involves multiple modalities, which I will be exploring in this post.
The study included 10 participants with Alzheimer's disease, amnestic mild cognitive impairment, or subjective cognitive impairment.
Within 3 to 6 months, nine of the 10 patients showed a significant improvement in memory and cognition.
Only one patient with very advanced Alzheimer's disease did not improve.
Before the study, six of the patients had to discontinue work or were struggling with their jobs.
After the study, all six of them returned to work or continued working successfully.
The improvements also continued long after the study ended.
Why This Research Is So Important
Cognitive decline is obviously a major concern today.
Alzheimer's disease is the major cause of age-related cognitive decline, with over 5 million Americans and 30 million people globally struggling with the disorder. I pulled these numbers from the study and they are probably even higher now.
Dementia is the third leading cause of death in the United States behind cardiovascular disease and cancer, and by 2050, it’s estimated that 13 million Americans and 160 million people globally will be affected by the disease (82).
So we clearly need an effective prevention and treatment strategy, and conventional medicine is failing to deliver.
As Dr. Bredesen points out:
Instead, we need a multi-faceted approach to combat the illness.
There is no magic bullet to regaining your cognitive function.
And Dr. Bredesen recognized this, and tried something new with his patients.
And the results speak for themselves.
Here is one of the cases from the study. I think this really demonstrates how conventional medicine fails so many people today:
This woman then began Dr. Bredesen’s therapeutic protocol that I lay out below.
She followed some of the protocol components, but not all of them.
Regardless, after three months, all her symptoms had decreased. She could:
- Navigate without problems;
- Remember telephone numbers without difficulty;
- Prepare reports and do her work without difficulty; and
- Read and retain information.
Overall, her symptoms disappeared and she said her memory was better than it had been in many years.
Two and one-half years later, now age 70, she still doesn’t have symptoms and continues to work full-time.
Without further ado, let’s jump into the therapeutic program that helped this woman and many others get remarkably better.
1. Optimize Your Diet
The participants in Dr. Bredesen’s study followed a low-glycemic, low-inflammatory, low-grain diet.
They eliminated all gluten and processed food from their diet, and increased their intake of vegetables, fruits, wild fish, grass-fed beef and organic chicken.
Simple carbohydrates were also limited to minimize inflammation and reduce insulin resistance.
This type of diet was followed because chronically elevated blood glucose leads to insulin resistance and diabetes, which have been linked to memory loss and Alzheimer’s disease (1, 7-9).
In fact, a lot of brain health researchers and experts suggest that Alzheimer's disease should actually be called “Type 3 diabetes.”
So if you want to prevent and reverse cognitive decline, the first thing you should do is avoid processed food that contains refined carbohydrates (particularly flour and sugar) because they increase inflammation and cause blood sugar fluctuations.
Breakfast cereals, fruit juice and sport drinks containing high-fructose corn syrup are your brain’s worst enemies.
My Free Grocery Shopping Guide for Optimal Brain Health contains a bunch of healthy brain-boosting foods that you can eat on a regular basis.
2. Try Intermittent Fasting and Ketosis
Besides eating a healthy diet, Dr. Bredesen’s patients fasted for 12 hours every night, starting 3 hours before bedtime.
When your body and brain are running on ketones rather than glucose, you’re in a state of “ketosis.”
And ketosis and MCT oil have been shown to significantly improve cognition and memory in people with mild to moderate Alzheimer's disease (6, 10-12).
Researchers have also found that ketosis and fasting can enhance “autophagy”, which is a process in which your body cleans itself and removes debris (4-5).
And this autophagy process can reduce amyloid beta, the main component of amyloid plaques found in the brains of patients with Alzheimer's disease (2-3).
So if you’re trying to prevent dementia or reverse cognitive decline, intermittent fasting and ketogenic dieting should definitely be considered.
I personally fast for about 12 hours most days, and follow a ketogenic diet every now and then.
3. Reduce Your Stress
Alzheimer's disease is linked to high levels of cortisol, our body’s main stress hormone (13, 14).
That’s why I highly recommend you try to do something every day to manage your stress.
My favourite ways to reduce stress include neurofeedback, meditation (using the Muse headband), massage, acupuncture, eye movement desensitization and reprocessing (EMDR), emotional freedom techniques (EFT), heart-rate variability (HRV) training, and this acupressure mat.
This anti-anxiety supplement also includes a number of natural compounds that have personally helped me manage my stress over the years (Use the the coupon code FIVE$45496275 for a 5% discount).
4. Optimize Your Sleep
Recent evidence demonstrates that sleep and circadian disruption often occur early in the course of Alzheimer’s disease (80).
So getting enough high-quality sleep was another key aspect of Dr. Bredesen’s therapeutic protocol.
Participants in his study increased their sleep so that they got 7 to 8 hours every night.
They also supplemented with 0.5 mg of melatonin at bedtime.
Melatonin is a hormone released by your pineal gland, a small gland in your brain. It helps control your sleep and wake cycles (circadian rhythm), and adequate levels of melatonin are necessary to fall asleep quickly and sleep deeply throughout the night.
And a considerable amount evidence suggests that melatonin can help prevent and treat major neurodegenerative disorders, including Alzheimer disease, Parkinson disease, Huntington's disease and Amyotrophic Lateral Sclerosis (15).
In fact, one study found that patients with mild to moderate Alzheimer’s disease who supplemented with melatonin had significantly better cognitive performance and sleep quality compared to placebo (16).
Besides supplementing with melatonin, here are some other steps you can take to maximize the quality of your sleep:
- Expose your eyes to sun in the morning
- Supplement with magnesium and collagen before bed. This pre-made bone broth is a really good source of collagen.
- Lie on this acupressure mat for 10 minutes before bed
- Turn off household lights, install f.lux on your computer and wear blue blocking glasses for 3 hours before bed. These glasses block out blue light from your environment. Blue light suppresses your body’s production of melatonin. You can learn more about blue light here.
- Go to bed at the same time every night
- Don’t eat for 3 hours before bed
- Completely black out room with curtains and wear sleep mask.
And consider taking this sleep supplement, which contains magnesium and a number of other natural compounds that I’ve used over the years to promote the production of melatonin. You can use the coupon code FIVE$45496275 for a 5% discount.
Not surprisingly, exercise was an important aspect of Dr. Bredesen’s program.
Participants exercised for 30-60 minutes, 4-6 days each week.
The types of exercise included swimming, cycling and running.
Lots of human and animal research demonstrates that exercise supports the brain, improves learning and memory, protects from neurodegeneration, and alleviates depression, particularly in elderly populations (18).
Other studies have shown that physical activity can help preserve brain volume in individuals at increased genetic risk for Alzheimer’s disease (19, 20).
Many brain health experts recommend exercise as their number one piece of advice for optimal brain health.
You should choose a sport or exercise routine that you enjoy, so that you’ll stick with it consistently.
I plan on discussing my exercise routine in more depth soon, but for now, this is the general gist of it:
- Lift heavy weights 1-4 times per week
- High-intensity interval sprinting 1-2 times per week
- Walk as much as I can (ideally 30-60 minutes every day)
6. Reduce Homocysteine
Homocysteine is an inflammatory compound at high levels, and can contribute to the development of mild cognitive impairment and Alzheimer’s disease. However, certain B vitamins have been shown to normalize homocysteine levels and reduce the rate of cognitive decline (21-24).
As a result, the participants in Dr. Bredesen’s study supplemented with methy-B12, methyl-folate, and P-5-P (bioactive B6).
Here is a complete article all about how to lower homocysteine.
7. Increase Your Vitamin B12 Levels
But in and of itself, Vitamin B12 deficiency can contribute to cognitive decline, and higher levels of vitamin B12 are associated with slower rates of cognitive decline (25).
B12 is part of this supplement.
8. Reduce Your Inflammation
Reducing inflammation was another main goal of Dr. Bredesen’s program.
This is because cutting-edge research suggests that inflammation plays a critical role in the development of Alzheimer’s disease (26, 27).
Long-term use of anti-inflammatory drugs has also been shown to reduce the risk of developing the disease, and blocking brain inflammation halts the progression of the disorder (28, 29).
Omega-3 fatty acids are found primarily in fish and are necessary for optimal functioning of your brain and nervous system.
That’s why I personally eat salmon regularly and supplement with this krill oil.
9. Balance Your Hormones
Balancing hormones is another important aspect of optimal brain health and cognition, and Dr. Bredesen didn’t ignore this fact.
He points to studies showing that estrogen use is associated with less cognitive decline among women (30, 31).
Some of the patients in his study undertook hormone replacement therapy.
I've also discussed 13 different ways to support your thyroid and its hormones.
I plan on writing more about hormones soon.
10. Improve Your Gut Health
Improving gut health is another way to prevent cognitive decline and dementia.
This is because many studies show that probiotics and prebiotics can reduce inflammation (32-36).
That’s why I eat prebiotic-rich foods regularly, including sweet potatoes, carrots, onions, asparagus and squash. These foods promote the growth of many different strains of good bacteria in your lower bowel and are included in my free grocery shopping guide for optimal brain health.
Resistant starch is one of the most potent ways to boost your prebiotic intake. A convenient way to incorporate more of it into your diet is by using Bob’s Red Mill Unmodified Potato Starch. Other high-quality resistant starches include banana flour, plantain flour and waxy maize. Cooked and cooled white rice and potatoes also contain some resistant starch.
For probiotics supplementation, I created and take the Optimal Biotics supplement.
If you want to learn more, check out this post where I share five ways to improve your gut health.
11. Reduce Amyloid Beta
Another of objective of Dr. Bredesen’s therapeutic program was to reduce amyloid beta, the main component of amyloid plaques found in the brains of patients with Alzheimer's disease.
A couple of supplements have been shown to do that, and participants in Dr. Bredesen’s study supplemented with them.
The first one was curcumin. Not only is curcumin anti-inflammatory, but it’s also been shown to reduce neurodegeneration because it can reduce amyloid plaque and prevent the build up of amyloid beta (37, 38).
The other supplement is ashwagandha, an adaptogenic herb with anti-anxiety and neuroprotective effects.
Studies show that ashwagandha can reverse behavioural deficits, plaque pathology and the accumulation of amyloid beta peptides in the brains of mice with Alzheimer's disease (39).
12. Enhance Your Cognition
Enhancing the cognition of the participants was another goal of Dr. Bredesen’s protocol.
Dr. Bredesen’s did this by giving participants two different compounds.
The first was 250 mg of bacopa monniera, an adaptogenic herb with cognitive-enhancing effects.
Both healthy and elderly people who take the herb experience improved attention, learning and memory (40-43).
It’s important to note that it takes about 4 to 6 weeks for bacopa to take effect and start working.
Bacopa is included in this supplement.
The other substance used in the study was magnesium threonate, a recently-developed form of magnesium that can promote learning and memory by increasing magnesium in the brain. It’s been shown to reduce amyloid beta plaque and prevent further memory decline in mice with Alzheimer’s disease (44-46).
I previously wrote about the many brain and mental health benefits of magnesium here.
13. Optimize Your Vitamin D Levels
Vitamin D is a fat-soluble vitamin that our skin synthesizes when exposed to the sun.
Every tissue in your body has vitamin D receptors, including the brain, heart, muscles, and immune system. This means your entire body needs it to function properly and a deficiency can lead to costly physiological and psychological consequences, including dementia and cognitive decline.
Research shows that vitamin D deficiency is associated with a substantially increased risk dementia and Alzheimer disease (47).
If you decide to supplement, Vitamin D3 is included in this supplement.
14. Increase Nerve Growth Factor (NGF)
Nerve growth factor (NGF) is a neuropeptide involved in the growth, maintenance, and survival of neurons.
Studies show that NGF is reduced in mild cognitive impairment and Alzheimer's disease, and animal studies suggest that increasing NGF can reverse, halt and slow the progression of dementia (48-51).
Acetyl-L-carnitine is an acetylated form of the amino acid carnitine. It has neuroprotective and cognitive-enhancing effects, and has been shown to increase NGF in the central nervous system (52).
The other supplement that can increase NGF is lion’s mane mushroom (also known as Hericium erinaceus).
Research shows that it contains active compounds that stimulate the synthesis of NGF (53).
I recently started taking this lion’s mane mushroom. It’s one of the highest-quality lion’s mane mushroom supplements that I could find from a reputable brand. I spent a lot of time researching and looking into different sources and settled on this one. You can get it here or here.
15. Build New Brain Synapses
As a result, he recommended oral administration of Citicoline and omega-3 fatty acids, which are the structural components of synapses, and have been shown to support the brains of people with neurodegenerative diseases who have experienced synaptic loss (54).
Citicoline is the most bioavailable form of choline, an essential B vitamin that most people don’t consume enough of, because very few foods in the Western diet contain it.
Not only does it promote the synthesis of new brain synapses, it also has anti-inflammatory and neuroprotective effects, and enhances the synthesis and release of acetylcholine and dopamine – two neurotransmitters that are critical for optimal brain function and mental health (55-60).
Unfortunately, many prescription drugs are anticholinergic, meaning they reduce acetylcholine in the brain.
The commonly-prescribed antidepressant Wellbutrin is anticholinergic, meaning it inhibits the physiological action of acetylcholine. I took Wellbutrin for multiple years and experienced gradual cognitive decline during that time.
In fact, one of the participants in Dr. Bredesen’s study worked with her doctor to reduce her daily dose of Welbutrin because of its known anticholinergic effects.
And as I mentioned earlier, I eat salmon regularly and take this krill oil supplement for my omega-3 fatty acids.
In addition to choline and omega-3 fatty acids, supplementing with uridine is also a good idea if you’re struggling with cognitive decline. Research shows that these three nutrients are “synergistic” and work together to boost dopamine and increase the formation of synapses in the brain (61, 62).
Check out this article for 12 other ways to form new synapses in the brain.
16. Optimize Your Intake of Antioxidants
Another key aspect of preventing and overcoming dementia is optimizing your intake of antioxidants.
Dr. Bredesen included a number of antioxidants as part of his protocol:
- Vitamin E (Mixed tocopherols and tocotrienols)
- Selenium - I take this as part of this multimineral
- N-Acetyl-Cysteine (NAC) – previously discussed here
- Vitamin C
- R-Lipoic Acid (RLA)
Several other studies have found that a combination of nutrients and antioxidants – including NAC, RLA, Vitamin C and Vitamin E – can improve cognitive functioning and decrease symptoms of dementia (63-68).
This is likely because oxidative stress plays a major role in the development of cognitive decline, and these antioxidant nutrients and plant compounds can counteract this (69-71).
17. Balance Zinc and Copper
As I’ve discussed before, consuming too much copper and not enough zinc can be a huge problem and contribute to anxiety and stress.
But it can also contribute to various other brain and mental health problems, including cognitive decline and dementia.
Researchers believe ingestion of copper from tap water is one of the root causes of Alzheimer’s disease, as they routinely find high levels of copper in Alzheimer's patients.
Elevated levels of copper are also linked to cognitive impairment (72).
Furthermore, zinc plays a critical role in the protection of brain cells, and studies show that Alzheimer's patients are deficient in zinc (72).
One study found that zinc supplementation protected against cognitive decline by restoring zinc levels and reducing copper levels (72).
So not surprisingly, the patients in the main study supplemented with zinc if they were deficient.
I also supplement with zinc. I created and take the Optimal Zinc supplement.
Check out my previous post about zinc and copper if you’re interested in discovering more steps you can take to increase zinc and lower copper levels.
18. Optimize Your Mitochondria
It’s becoming increasingly clear that chronic dysfunction of mitochondria is another underlying factor that contributes to cognitive decline and Alzheimer’s disease.
Mitochondria are considered the “powerhouses of the cell,” generating most of the energy in your body.
So not surprisingly, numerous studies show that there is a correlation between impaired mitochondrial functioning in the brain and many psychiatric and neurodegenerative diseases.
But luckily, there are ways to halt and reverse mitochondrial decay, like Dr. Terry Wahls has.
To support the mitochondria of the participants, Dr. Bredesen’s therapeutic protocol included the following nutrients:
- Coenzyme Q10
- R-Lipoic Acid
- Pyrroloquinoline quinone (PQQ)
- N-Acetyl-Cysteine – previously discussed here
- Acetyl-L-carnitine (ALCAR)
- Selenium - I take it as part of this multimineral
- Vitamin C
- Thiamine (Vitamin B1) - I take it as part of this B complex
I recommend checking out my previous post about mitochondria and brain health. It includes several other steps you can take to support your mitochondria. You can read it here.
19. Pantethine and Resveratrol
Pantethine, the bioactive form of Vitamin B5, is one of my favourite nutrients for mood, energy, focus and motivation.
It was included in Dr. Bredesen's protocol to improve the focus and concentration of the participants.
Pantethine also plays a key role in the synthesis of acetylcholine, a neurotransmitter that is important for memory and learning (81).
This is because it increases SirT1 function, and SirT1 has neuroprotective effects (73-79).
I take this resveratrol every so often, but not all the time.
Overall, it appears that memory loss in patients with subjective cognitive impairment, mild cognitive impairment, and at least the early phase of Alzheimer's disease, can be reversed with the therapeutic program.
- Follow a low-glycemic, low-inflammatory, low-grain diet
- Fast for 12 hours every day
- Try a ketogenic diet with coconut oil and/or MCT oil
- Reduce stress and lower cortisol with yoga, meditation, neurofeedback, acupressure, heart-rate variability training
- Optimize your sleep with melatonin, magnesium, collagen, bone broth, blue blocking glasses, curtains and/or sleep mask
- Exercise for 30-60 minutes, 4-6 days weekly
- Reduce homocysteine with B vitamins, TMG and/or Sam-E
- Supplement with Vitamin B12
- Reduce inflammation with curcumin and krill oil
- Balance your hormones, including your thyroid hormones
- Improve your gut health with probiotics, prebiotics and resistant starch
- Reduce amyloid beta with curcumin and ashwagandha
- Enhance your cognition with bacopa and magnesium threonate
- Optimize your Vitamin D levels with sunlight and a Vitamin D lamp
- Increase nerve growth factor with ALCAR and lion’s mane mushroom
- Build new brain synapses with Citicoline and krill oil
- Optimize your intake of antioxidants, including Vitamin E, Selenium, Blueberries, NAC, Vitamin C, and RLA
- Avoid copper and supplement with zinc
- Optimize your mitochondria
- Supplement with pantethine and resveratrol
Optimizing one of these areas can help somewhat, but the combination of all of them is very powerful and can have a significant effect.
This is the first study I’ve seen that combines a lot of the advice I give through my website into one study, and I’m very happy it exists.
What’s amazing about it is that six of the 10 patients had to discontinue working or were struggling with their jobs, but after the study, they all could return to work or their performance at work improved significantly.
I hope this gives a lot of people hope that they can get better and improve the quality of their life.
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Reviewed by Dr. Richard Nahas, MD CCFP DCAPM ABIM