The Bredesen Protocol
There are some striking realities currently with Alzheimer’s disease. The population affected by it is growing rapidly, it progresses fairly quickly causing large amounts of disability and even at huge expense, the available treatments up to this point have done little to lessen symptoms and nothing to slow or stop the process.
The last point above is discussed succinctly by one of the most innovative researchers in this area, Dale Bredesen, M.D. He states that of the 244 drugs that have been developed and stuied, 243 have failed to produce any benefit. The one that has shown some positive result only lessens symptoms temporarily and does not alter the progressive decline seen with this disease.
This disappointment was a factor in a number of researchers looking at a different approach to the disease. One of them has been Dr. Bredesen who has developed a comprehensive treatment program that has produced strikingly different results. The program was driven by several factors:
While a portion of the risk of developing the disease is genetically mediated, an equally large portion of the risk is related to lifestyle factors. This is the classic “nurture versus nature” discussion about how chronic disease develops. Extensive research relating to almost all chronic diseases has shown that it is both nature/genetics and nurture/lifestyle.
An immense body of research has established relationships between lifestyle such as eating and exercising habits. There is also strong correlation between other lifestyle related diseases such as type II diabetes and Alzheimer’s risk. Those with type II diabetes have a doubling of their risk of developing Alzheimer’s. The associated risk is so supported by data that several prominent researchers have dubbed Alzheimer’s as “type III diabetes,” or diabetes of the brain.
With the extensive association of Alzheimer’s risk with modifiable lifestyle related factors it was a natural step to transition to exploring the modification of these factors in the prevention and treatment of Alzheimer’s disease. These factors may include omega-3 fatty acid intake, diet, intake of specific vitamins and minerals and many others. Most have shown a moderate relationship with positive prevention and treatment effects.
The key point that was understood and explored in developing the Bredesen Protocol was that the disease does not stem from any one factor but from the co-existence of multiple factors in the same person. Similarly, an effective treatment protocol must examine a broad group of related factors in each patient and target treatment on all of them as the “sum is more than the pieces”. Dr. Bredesen describes the process as a barn roof with 36 holes (the number of observed possible risk factors to date). The current drug approach to treatment is asking which one hole do you want to plug when it is raining to try to stay dry. His answer is all of them. The typical patient may have a collection of 20 factors and the exact collection is unique to each patient. Treatment is similarly targeted specifically to each patient.
The protocol involves extensive testing to identify which factors may be involved in a given patient. Once that is done, specific interventions with diet, nutritional supplements, exercise, sleep modification and indicated medical interventions such as hormone therapy are used concurrently. Practitioners using the protocol have access to a comprehensive software analysis of the collected data developed by Dr. Bredensen and his research team called “ReCode” which will guide a precise treatment process.
The real question is, however, what have been the results with the Bredesen Protocol? In a published small study of his early results 90% success has been obtained in not only stopping the progression of the disorder but reversing the effects of it in properly selected patients. A second study details more completely the degree of recovery seen with the protocol.
The success has been primarily with all phases through mild and early/moderate Alzheimer’s. Once the disease is at moderate to severe, high levels of success diminish greatly. This phase corresponds to extensive loss of brain volume or size and more severe interference in the ability to perform normal daily activities. Specific brain performance tests are used in diagnosis which helps to isolate the degree of functional loss that has occurred helping with the treatment prognosis.
The Bredesen Protocol is in the earlier stages of development and clinical use. The results, however, have been striking in a disease with an otherwise dim outlook. Larger trials are continuing with other institutions including at the Cleveland Clinic. While the larger clinical trials will be helpful in expanding the use of this protocol over the next decade, as it is now, it remains perhaps the brightest hope for current patients.