UNTANGLING THE MYSTERIES OF THE BRAIN


elderly people who walked about a mile a day over those who didn’t had bigger brain volumes and a lower risks of cognitive de- cline. Others have replicated the work. A subsequent analysis of 900 seniors with an average age of 78 doing various kinds of exercises that they enjoyed also found a positive relationship with brain volume. The brains of a group of seniors who ex- ercised and burned up to 3,400 calories a week had 5 percent more gray matter than those who simply stretched. That was true for even those who had been diagnosed with Alzheimer’s or mild cognitive impairment. The exercise didn’t reverse the symptoms, but it slowed down those individuals’ de- cline. Another scan and patient interview showed how, on an anecdotal basis, that that individual with Alzheimer’s actually man- aged to increase his brain volume by 5 per- cent with a diet high in Omega-3 fatty acids from fish, regular exercise, and challenging mental games like online chess. Researchers studying these biological


screening mechanisms say that they’re not ready to be rolled out to the mass market yet because they haven’t been thoroughly vetted. But Dr. Dale Bredesen, of UCLA and the Buck Institute, argued that the medical community should use genetic and other kinds of lab tests already at their disposal to help higher-risk individuals (such as APOE4 carriers and anyone over 45) lower the risk


high risk individuals should undertake to quantify their risks. They include testing vitamin levels, measuring brain volumes, getting genetically tested and measuring hormone levels, among other things. Indi- viduals can follow Bredesen’s protocol on their own as described in his book, and/ or use the results in consultation with their primary care physician. Or they can order the tests and a subsequent health report from Bredesen’s company AHNP Precision Health. The program also provides listings of “practitioners” who are familiar with the Bredesen protocol, which involves supple- ments, diet, sleep, and exercise recommen- dations, and brain training programs based on an individual’s lab results. The Alzheimer Association’s Fargo said


the Bredesen protocol hasn’t been vigorously vetted enough, although the organization supports generally healthy lifestyles and the recommendation that people should control their blood pressure. Bredesen, for his part, has published papers with data on 100 pa- tients using his protocol. There have been no randomized control trials, which is the gold standard for testing the efficacy of a protocol. The Alzheimer’s Association is testing the


idea of how best to preserve elderly brain health by setting up a study it calls the “U.S. Study to Protect Brain Health Through Life- style Intervention to Reduce Risk,” or The POINTER Study. The $35 million multi-site


“Just consider any other chronic disease, like heart failure, or hepatitis, or kidney failure, or HIV infection,” said Stan- ford’s Montine. “Just imagine trying to manage those dis- eases upon which you had no laboratory tests upon which to base your clinical management.”


factors that have been identified in academ- ic literature as contributors to Alzheimer’s. He details his thesis in The New York Times bestselling book: “The End of Alzheimer’s.” He argues that anybody can optimize


their brain health now, and even reverse disease symptoms, by screening for the fac- tors that he and other medical researchers have identified that contribute to unhealthy brains. He has outlined a package of tests and cognitive evaluations that he believes


study involving 2,500 volunteers between the ages of 60 to 79 will examine the impact of a Mediterranean diet and a four-times-a-week aerobic exercise regime on the participants’ cognitive abilities. The initial phase of the study will last for two years.


(Readers can


send an e-mail to POINTERinfo@alz.org to learn more and participate.) Theresa Braymer, a 59-year-old retired


naval officer in the Denver area, is a double APOE4 carrier. She took a genetic test from


20 SENIOR LIVING EXECUTIVE JANUARY/FEBRUARY 2019


23AndMe about four years ago along with her husband. That’s when she discovered her status. She said she doesn’t have time to wait for


the results of lifestyle studies or drug trials, or she’d end up developing the disease—or dead. She’s following her home-spun ver- sion of the Bredesen protocol. “I know that things can be done, and I


have implemented a number of those strate- gies,” Braymer said in a phone interview. “I have seen my biomarkers get better. Even if I get Alzheimer’s, I would have pushed that rock down the street quite a bit, and I’ve re- duced my chances of getting cardiovascular disease, I’ve reduced my chances of getting cancer, of all sorts of chronic diseases. It’s not that it won’t ever happen, but I’ve defi- nitely feel that I’ve reduced my chances, and that’s very empowering to me.” A 2017 survey of clinical drug trials led


by Dr. Jeffrey Cummings, the Cleveland Clinic’s Center for Neurodegeneration and Translational Neuroscience director, speaks to Braymer’s point. The survey at the time found that there


were 105 clinical drug trials underway. (A more recent roundup from the news site Alzforum noted that no new trials or break- throughs in existing trials occurred in 2018.) Cummings and his colleagues noted that it takes on average 13 years for a drug devel- oped in a lab to move to the FDA for review. It then takes another 10 years to clear the three-phase review process. Given the drug trials’ almost ubiquitous failure rate, the chances of finding a “cure” for Alzheimer’s disease by 2025, as set out by the White House’s National Plan to Address Alzheim- er’s Disease in 2011, look dim. The prospect for finding relief looks even


worse when one considers that many seniors suffer from multiple forms of dementia in the final decades of their lives, but the drug industry has only been focusing on develop- ing single drugs aimed at specific diseases. (Readers can find out more about commons kinds of dementia and their symptoms here: http://bit.ly/2VSkwET.) One National Institutes of Health-fund-


ed study published mid-2018 led by Penn’s Institute on Aging, for example, looked at 766 brain autopsies and found that a range of 27 percent to 81 percent of the elderly suffered from more than one disease. The study suggested that the nature of the main disease-causing protein and the way it spread


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