The End of Alzheimer’s
The First Program to Prevent and Reverse Cognitive Decline
Alzheimer’s. Even just thinking about that dreaded disease freaks you out a bit, eh? Over 5 million people in the US alone have Alzheimer’s. 1 in 9 people over 65. We’re told that there’s little we can do to prevent it and even less (make that: nothing) we can do to reverse it. Well... What if we could put an End to Alzheimer’s? Dale Bredeson, MD tells us we can via, as per the sub-title: “The First Program to Prevent and Reverse Cognitive Decline.” Bredeson wants us to know this: “Alzheimer’s disease can be prevented, and in many cases its associated decline can be reversed.” This is a potentially life-changing book. Big Ideas we explore include the ReCODE protocol (playing chess vs. checkers), the three threats that lead to three different types of Alzheimer’s (inflammation, deficient nutrients, toxins), how to give yourself Alzheimer’s (just live like most people!), genetic risk (ApoE2 + ApoE3 + AppE4), and heroes behind progress (it isn’t easy!).
Big Ideas
- ReCode: Checkers vs. chessCheckers vs. chess.
- The three threatsInflammation, nutrients (and friends) and toxins.
- How to give yourself Alzheimer’s: A PrimerAlzheimer’s: A primer.
- Genetic Risk: ApoE2 + E3 + E4ApoE2 + ApoE3 + ApoE4.
- The Heroes behind progressBehind progress.
“Let me say this as clearly as I can: Alzheimer’s disease can be prevented, and in many cases its associated decline can be reversed. For that is precisely what my colleagues and I have shown in peer-reviewed studies in leading medical journals—studies that, for the first time, describe exactly this remarkable result in patients. Yes, I know it flouts decades of conventional wisdom to claim that cognitive decline can be reversed, that there are hundreds of patients who have done just that, and that there are steps we can all take now to prevent the cognitive decline that experts have long believed to be unavoidable and irreversible. These are bold claims deserving of healthy skepticism. I expect you to exercise that skepticism as you read about the three decades of research in my lab, which culminated in the first reversals of cognitive decline in early Alzheimer’s disease and its precursors MCI (mild cognitive impairment) and SCI (subjective cognitive impairment). I expect you to exercise that skepticism as you read about the personalized therapeutic programs we developed to enable everyone to prevent cognitive impairment and, if they are already showing signs of it, to stop mental decline in its tracks and restore their ability to remember, to think, and to once again live a cognitively healthy life.
But if the results I describe overcome your skepticism, then please open your mind and consider changing your life—not only if you have already begun the slide into cognitive decline, but even if you haven’t. Needless to say, the people who will find this book most immediately and directly life-changing are those whose memory and cognition are already suffering (and their family members and caretakers). By following the protocol I describe, those with cognitive impairment that is not yet Alzheimer’s disease, as well as those who are already in the grip of Alzheimer’s, can not only halt but often actually reverse the cognitive decline they have already suffered. For those so stricken, progression to severe dementia has until now been inevitable, with nothing but bad news from every expert. The anti-Alzheimer’s protocol my colleagues and I developed consigns that bleak dogma to the dustbin of history.”
~ Dale Bredesen, MD from The End of Alzheimer’s
Alzheimer’s.
Even just thinking about that dreaded disease freaks you out a bit, eh?
Over 5 million people in the US alone have Alzheimer’s. 1 in 9 people over 65. We’re told that there’s little we can do to prevent it and even less (make that: nothing) we can do to reverse it.
Well… Let me repeat the central theme of this book as clearly as I can: “Alzheimer’s disease can be prevented, and in many cases its associated decline can be reversed.”
That, of course, is a powerful statement. Worthy, of course, of the healthy skepticism Dr. Dale Bredesen tells us we should have as we read his book and review his peer-reviewed protocol.
Bredesen has dedicated his life to studying neurodegenerative diseases and to understanding the root causes of Alzheimer’s. He studied at Caltech as an undergrad then at Duke for med school followed by a postdoc at UCSF before establishing his own lab at UCLA (go Bruins!) in 1989.
This book walks us through the fruits of his and his colleagues’ labor, giving us the details of, as per the sub-title of the book: “The First Program to Prevent and Reverse Cognitive Decline.”
I highly recommend the book. (Get a copy here.)
Although we’ll be skipping the nuts and bolts of the scientific underpinnings of the disease, I’m excited to share a few of my favorite Big Ideas we can apply to our lives TODAY so let’s jump in.
Download MP3
Download PDFYou never change things by fighting the existing reality. To change something, build a new model that makes the existing model obsolete.
Cognitive decline is largely a matter of three fundamental threats to our brain: inflammation; a shortage of brain-boosting nutrients, hormones, and other cognition-supporting molecules; and toxic exposure. What we call Alzheimer’s disease is a protective response to these three brain threats.
Get the BookReCode: Checkers vs. chess
“This book is not a scientific tome—though I include the scientific evidence that supports my conclusions—but instead a practical, easy-to-use, step-by-step manual for preventing and reversing the cognitive decline of early Alzheimer’s disease or its precursors, mild cognitive impairment and subjective cognitive impairment, and for sustaining that improvement. It is also a guidebook by which the 75 million Americans who carry the ApoE4 gene can escape the fate written in their DNA. The protocol for achieving this led to the first-ever scientific publication of a study, in 2014, reporting the reversal of cognitive decline in patients—nine out of ten of them—with Alzheimer’s disease or its precursors, thanks to a sophisticated personalized protocol based on our decades of research on the neurobiology of Alzheimer’s disease. Called ReCODE, for reversal of cognitive decline, the protocol not only achieved the reversal of cognitive decline in Alzheimer’s disease and pre-Alzheimer’s that no one thought possible; it also allowed patients to sustain that improvement. The very first patient treated with what is now the ReCODE protocol is, as I write this, five years into the treatment, and at 73 remains cognitively healthy, traveling the world and working full-time. Our extensive subsequent work, with hundreds of patients, proves that she is far from unique.”
That’s from the first chapter called “Disrupting Dementia” in which we get introduced to the failures of the current approaches to treating Alzheimer’s along with the protocol Bredesen and his team have been working on for decades.
They call it ReCODE. Short for “reversal of cognitive decline.”
In a moment we’ll take a look at the three different types of threats that lead to three different types of Alzheimer’s then we’ll look at what to do about it.
But… First, let’s look at a passage from the end of the book: “For centuries, we humans typically died from acute infections such as bacterial pneumonia, and the great biomedical success of the twentieth century was to develop antibiotics that treat them and public health policies that prevent them. As a result, most of us now die from chronic, complex illnesses such as cancer, cardiovascular disease, and neurodegenerative disorders. Unfortunately, we tried to solve the problem of chronic illness in the same way we solved the problem of acute illness: with a single pill, monotherapy. This is like using your checkers strategy in a chess match.”
Two different types of illnesses: Acute vs. Chronic. Require two very different strategies. Let’s put away the checkers strategy and play some wise chess.
You have a remarkably powerful computer inside your skull. It contains an estimated 100 billion neurons, each with an average of almost 10,000 connections, for nearly one quadrillion—that’s 1,000,000,000,000,000 —total connections, or synapses, in your wonderful brain.
The three threats
“Alzheimer’s disease is what happens when the brain tries to protect itself from three metabolic and toxic threats:
Inflammation (from infection, diet, or other causes)
Decline and shortage of supportive nutrients, hormones, and other brain-supporting molecules
Toxic substances such as metals or biotoxins (poisons produced by microbes such as molds)
In chapter 6 I will explain in detail how we discovered that these three types of threats—which have dozens of contributors—trigger this protective response in the brain—including what the three kinds of threats do and why the amyloid response that they incite is so toxic to the brain’s synapses. But for now let me simply say that once we recognize that Alzheimer’s disease is what happens when the brain struggles to defend itself against inflammation, to function despite a shortage of beneficial compounds, or to fight an influx of toxic substances, the optimal way to prevent and treat the disease becomes clear: identify which of the many potential contributors to these three classes of threats a particular patients’ brain is responding to defensively, remove the specific contributors, and help it fend off the remaining attackers.”
That’s from Chapter 2 called “Patient Zero” in which we get introduced to the very first patient to successfully go through the ReCODE protocol.
We also get introduced to what Bredesen believes are the three different types of threats that lead to cognitive decline and three different types of Alzheimer’s.
Here’s another way Bredesen puts the same wisdom: “Cognitive decline is largely a matter of three fundamental threats to our brain: inflammation; a shortage of brain-boosting nutrients, hormones, and other cognition-supporting molecules; and toxic exposure. What we call Alzheimer’s disease is a protective response to these three brain threats.”
In Part Three of the book, he walks us through “Evaluation and Personalized Therapeutics.” That section starts with giving ourselves a “Cognoscopy.”
We’re supposed to get a colonoscopy at age 50, so why don’t we get a cognoscopy? (Seriously.)
Bredesen gives us a SUPER comprehensive set of diagnostic tools we can use to give ourselves a good ol’ cognoscopy—which help us determine what type of, if any, cognitive decline we may be experiencing.
Key tests include knowing your ApoE genetic vulnerability (more on that in a moment) and blood tests measuring everything from your inflammation (via hs-CRP) and vitamin D to your fasting insulin, glucose and hemoglobin A1c levels. Then there are toxin-related tests (stuff like mercury, mold, etc.) plus cognitive performance tests, imaging and sleep studies.
With deeper clarity on all that, we can get to work with a personalized ReCODE protocol for which Bredesen provides a super-thorough overview along with case studies.
It makes no more sense to try to treat Alzheimer’s disease with a single agent than it does to treat a roof with thirty-six holes with a single patch of roofing compound.
The Greek god of sleep is Hypnos, son of Nyx (the night) and Erebus (the darkness), and the father to the gods of dream. Sleep is one of the most powerful weapons in the large anti-Alzheimer’s armamentarium
How to give yourself Alzheimer’s: A Primer
“Okay, how shall we start? Well, if you’re like me, you often work late and find yourself craving a late-night snack, preferably something sugary, making your insulin level skyrocket right before bed, keeping it high while you’re sleeping. Maybe you get to bed well after midnight and sleep poorly because of sleep apnea (often the result of weight gain). Nonetheless, you rise bright and early, getting just a few hours of sleep. Your feet have barely hit the bedroom floor when you start feeling stress as you contemplate the day ahead. You grab a typical American breakfast—a sweet roll or doughnut, a large glass of orange juice, a big slug of low-fat milk in your coffee—and thereby get a hefty dose of inflammatory-triggering dairy, take another step toward insulin resistance with the sugar, and poke holes in your gastrointestinal lining with the gluten. You pop your proton pump inhibitor to prevent gastric reflux, even though by reducing stomach acid you’ll impair your ability to absorb key nutrients such as zinc and magnesium and vitamin B12; then you’ll take your statin, a great way to lower your cholesterol below 150 and thereby increase your risk for brain atrophy. Oh, and we’ll do all this less than twelve hours after our late-night snack, which means the body never gets to induce autophagy and remove the accumulating amyloid and various damaged proteins.”
Welcome to chapter 4: How to Give Yourself Alzheimer’s: A Primer.
Bredesen continues that little portrait of the typical American life for another couple pages. Highlights include: lots of stress, more unhealthy (processed and sugar-laden) meals and little exercise. Repeat year after year. For decades. And… Congrats. You’ve given yourself Alzheimer’s.
In Part Two of the book, we get a high-level look at the underlying science that’s driving the destruction of our brains.
The (very) short story?If you’re doing what most people are doing (rarely a good idea), you’re doing a great job of making yourself vulnerable to destroying your brain. (One more time: It’s no measure of health to be well-adjusted to a profoundly sick society.)
Check out the book for more (of course; as always) but know that all our lifestyle choices are, to use the metaphor Bredesen employs throughout the book, basically poking holes in our roof. Imagine a roof. It has holes. Bredesen and his team have identified 36 different potential holes. (All of which are measured by that cognoscopy, btw.)
One of the reasons why current approaches aren’t working is that any given drug will, at best plug ONE hole. There’s no drug that will ever be produced that will simultaneously take care of ALL of the holes we’re creating via our onslaught of poor lifestyle choices.
That’s the bad news. It’s also the GOOD news. Why? If all those poor lifestyle choices are punching holes in our roofs, we can STOP doing the damage. And, start doing the repair work.
On that front… What’s ONE thing you KNOW you can do for your brain TODAY? :)
Man still bears in his bodily frame the indelible stamp of his lowly origin.
Success is how high you bounce when you hit bottom.
The secret of getting ahead is getting started.
Genetic Risk: ApoE2 + E3 + E4
“Today, most people carry two copies of ApoE3. This gives them a genetic risk of Alzheimer’s of about 9 percent. But 25 percent of Americans, about 75 million, carry a single copy of ApoE4; they have a risk of Alzheimer’s disease of about 30 percent. And 7 million carry two copies of ApoE4, pushing their risk well above 50 percent. That is, it is more likely than not that people who inherit an ApoE4 from both parents will develop Alzheimer’s, and this is often, though not always, the inflammatory subtype.
This subtype typically begins with a loss of the ability to store new information, even as long-held memories and the ability to speak, calculate, spell, and write are retained. In people who carry two copies of ApoE4, symptoms often begin in the late forties or fifties. For people who carry one copy of ApoE4, symptoms typically begin in the late fifties or sixties. For those with no copies of ApoE4, symptom onset is typically in the sixties or seventies.”
What about genes? Well, bad news and good news again.
First, the bad news. If you carry two copies of ApoE4, statistically speaking, you have a greater than 50% chance of getting Alzheimer’s. Eek.
The good news? Although our genes certainly contribute to the likelihood that we’ll suffer from Alzheimer’s, they are NOT determinative. As Bredesen says:“Genetics affect your risk for Alzheimer’s disease, but your Alzheimer’s fate is by no means written in your DNA. Instead, much more than you might expect, you are in control of your own fate.”
Fact is, the more vulnerable we are, the MORE committed we need to be to rocking the protocol. And, the irony is that our apparent weakness can actually be turned into a strength when we do the work. By addressing the underlying metabolic drivers of Alzheimer’s we’re SIMULTANEOUSLY addressing the same basic drivers behind everything else we want to avoid. (“Hi, cancer, diabetes, heart disease, etc.!”)
P.S. 23andMe data will give you ApoE info. (You may need to request the raw data and run it through something like Promethease.) Note: If you DO have the two ApoE4 genes, check out this online community that’s thriving following Bredesen’s protocol: apoe4.info.
Genetics affect your risk for Alzheimer’s disease, but your Alzheimer’s fate is by no means written in your DNA. Instead, much more than you might expect, you are in control of your own fate.
The Heroes behind progress
“After this triple rejection—from the IRBs [institutional review boards], the foundation, and the philanthropist—I was dejected. When your research takes you in a direction that goes against multibillion-dollar corporations, governmental juggernauts, indignant academic experts, solipsistic foundations, officious bureaucrats, overworked practitioners, and a global mind-set, I realized, the proverbial snowball in hell is laughing at your chances. But I kept in mind something the brilliant physicist Richard Feynman once said: ‘For a successful technology, reality must take precedence over public relations, for Nature cannot be fooled.’ It is the underlying mechanisms of a disease that dictate what treatment will ultimately prove to be efficacious—not the drug companies, not the government, not the reviewers, not the NIH, not the foundations, not the billionaires. Those are the groups that dictate which treatments will be tested, but not which will prove effective.
Shortly after these setbacks, I received a call, asking if I would speak with someone who was having problems. It was Patient Zero.”
That’s from an early chapter in which we get a look behind the scenes at just how hard it’s been for Bredesen to make progress creating an alternative protocol to treat Alzheimer’s.
It’s funny because the book I read immediately after this one is called Longitude. That book is all about the true story of a lone genius (John Harrison) who solved that era’s greatest challenge: figuring out longitude while navigating the open seas.
Quick context: As we discuss in that Note, in order to figure out longitude with any precision, a navigator must know the time at the home port (or another location with a known longitude) so that he can run some quick calculations to figure out their location. (Given 24 hours in a day and 360 degrees in the circumference of the Earth, each hour of time difference meant 15 degrees longitude—approximately 1,000 miles at the equator.)
Harrison was a “village carpenter” who happened to be a self-taught master clockmaker who dedicated his life to solving this “longitude problem.” While the scientific establishment of his era literally looked to the heavens for guidance (go astronomers!), he built an extraordinarily simple, elegant and effective pocket watch.
In Longitude, Dava Sobel tells us: “In comparison, John Harrison offered the world a little ticking thing in a box. Preposterous! Worse, this device of Harrison’s had all the complexity of the longitude problem already hardwired into its works. The user didn’t have to master math or astronomy to gain experience to make it go. Something unseemly attended the sea clock, in the eyes of scientists and celestial navigators. Something facile. Something flukish. In an earlier era, Harrison might have been accused of witchcraft for proposing such a magic-box solution. As it was, Harrison stood alone against the vested navigational interests of the scientific establishment. He became entrenched in this position by virtue of his own high standards and the high degree of skepticism expressed by his opponents. Instead of the accolades he might have expected for his achievements, he was to be subjected to many unpleasant trials that began after the completion of his masterpiece, the fourth timekeeper, H-4, in 1759.”
I read that and thought the parallels between the two books was remarkable.
The modern scientific establishment? They’re looking for wonder drugs to magically treat the symptoms of not only Alzheimer’s but the other pernicious chronic diseases like cancer, heart disease, and diabetes.
A protocol like Bredesen’s that addresses underlying metabolic dysfunction via stuff like nutrition, exercise, and sleep? HAH! Facile.
To be fair, Bredesen himself concedes the fact that even HE would have laughed at what he now proposes: “If someone had told me a few decades ago that, as a research neurologist, I would be recommending protocols that involve meditation, yoga, laughter, music, joy, fasting, exercise, herbs, nutrition, and sleep, I would have laughed. But I cannot argue with results, or with the conclusions of years of research. Indeed, my wife, an excellent family practice and integrative physician, told me twenty-five years ago, during my laboratory’s early research into neurodegeneration, that whatever we found would end up having something to do with basic processes such as nutrition, stress, and toxicity. Of course, since I took a reductionist approach, I argued that we would ultimately identify one specific molecule that would be the key to Alzheimer’s disease. Needless to say, I should have listened to her.”
On that note… Want to make your doctor laugh? (I laughed as I typed that.)
Just tell them you read a book that’s all about preventing and reversing Alzheimer’s via nutrition, sleeping, exercise and all that jazz. :)
Unless you have a VERY open-minded, progressive mainstream doctor, they’ll probably dismiss the idea of out of hand. Of course, if you work with an integrative/functional medicine doctor, they probably know about this book (and all the research) and ALREADY have you doing most of the things Bredesen recommends.
Here’s to taking good care of our roofs as we age wisely and put an end to Alzheimer’s!
It must be remembered that there is nothing more difficult to plan, more doubtful of success nor more dangerous to manage than the creation of a new system. For the initiator has the enmity of all who profit by the preservation of the old institution and merely the lukewarm defenders in those who could gain in the new one.
Sometimes it takes a good fall to know where you stand.
Everyone knows a cancer survivor, but no one knows an Alzheimer’s survivor.’ As I hope I have succeeded in showing you in this book, this is yesterday’s news. The world has changed.
About the author
