Precision medicine to treat Alzheimer’s: Results of a study using a whole-systems wellness approach
Standard pharmaceutical interventions for Alzheimer’s disease have thus far proven to be insufficient, with over 400 clinical trials to date being deemed unsuccessful and going unapproved1. Certain pharmaco-therapies like memantine or donanemab offered a delay in symptom progression but never offered any reversal of symptoms or treatment of pathology2. Apollo Health, led by Dr. Bredesen, a member of the Institute for functional medicine recently touted a “Precision medicine approach to Alzheimer’s Disease,” as a more beneficial treatment protocol than pharmacological interventions, with a clinical trial to boot3:
“Twenty-five patients with dementia or mild cognitive impairment, with Montreal Cognitive Assessment (MoCA) scores of 19 or higher, were evaluated for markers of inflammation, chronic infection, dysbiosis, insulin resistance, protein glycation, vascular disease, nocturnal hypoxemia, hormone insufficiency or dysregulation, nutrient deficiency, toxin or toxicant exposure, and other biochemical parameters associated with cognitive decline. Brain magnetic resonance imaging with volumetrics was performed at baseline and study conclusion. Patients were treated for nine months with a personalized, precision medicine protocol, and cognition was assessed at t = 0, 3, 6, and 9 months.”
All outcomes measured demonstrated improvement from baseline, with statistically significant improvements being noted in MoCA score, CNS Vital Signs Neurocognitive Index, and Alzheimer’s Questionnaire Change score. Treatment plans were tailored specifically to each individual patient and involved a health coach, nutritionist, physical trainer, and physician:
“Patients were treated for nine months with a personalized, precision medicine protocol that addressed each patient’s identified potentially contributory factors, and cognition was assessed at t = 0, 3, 6, and 9 months. The goal was to identify and address the factors associated theoretically and epidemiologically (though in some cases yet to be proven causally) with Alzheimer’s disease-related cognitive decline: restore insulin sensitivity, improve hyperlipidemia, resolve inflammation if present (and remove the cause(s) of the inflammation), treat pathogens, optimize energetic support (oxygenation, cerebral blood flow, ketone availability, and mitochondrial function), optimize trophic support (hormones, nutrients, and trophic factors), treat autoimmunity if identified, and detoxify if toxins were identified.”
Diet was controlled and rich in plants and ingredients with a low glycemic load, there was a fasting period of 12-16 hours each night. Exercise encouraged was 45 minutes daily aerobic exercise six times a week, with strength training twice per week and HIIT training twice a week as well. Sleep was 7-8 hours per night. In addition, “brain training was carried out using BrainHQ, a HIPAA and SOC-2-compliant platform with empirical validation , for a minimum of 15 minutes daily. Participants trained on 29 cognitive exercises that target the speed and accuracy of information processing3.” Additionally, treatments to regulate hormonal balance, gastrointestinal permeability, inflammation, toxicity, and infection, were carried out based on individual needs.
All patients showed marked improvement along with “a significant reduction in inflammation was observed (as reduction in serum high-sensitivity C-reactive protein), a significant reduction in glycation was observed (as reduction in hemoglobin A1c), a non-significant reduction in insulin resistance was observed (as HOMA-IR, homeostasis model assessment-estimated insulin resistance), a significant improvement in lipid profile was observed (as reduction in triglyceride-to-high-density-lipoprotein ratio), and a significant increase in serum vitamin D was observed (as serum 25-hydroxycholecalciferol)3.” 56% of patients demonstrated marked cognitive improvement based on AQ-C Informant-estimation. Overall, 84% of patients showed some improvement. These results indicate a precision medicine approach provides our best option for treating Alzheimer’s, specifically with a whole-systems optimization approach.
Written by Jeremiah Ockunzzi, courtesy of Dr. Bart Rademaker, MD.