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 [19], 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.
1)
https://www.apollohealthco.com/clinical-trial-results-2021/
2)
https://medlineplus.gov/druginfo/meds/a604006.html
3)
https://content.iospress.com/articles/journal-of-alzheimers-disease/jad215707
