HEALTH ARTICLE, 25-POINT CHECKLIST:
MEND is UCLA’s 25-step personalized program to reverse memory loss. Nine of 10 participants displayed significant memory improvements. Learn how. Includes a chart summing-up the 25 steps.
MEND is a novel, personalized and comprehensive program to reverse memory loss. In a recent MEND study, nine of 10 participants displayed subjective or objective improvement in their memories, beginning within three to six months after the program’s start. Of the six patients who had to discontinue working or were struggling with their jobs at the time they joined the study, all were able to return to work or continue working with improved performance.
Improvements have been sustained, and as of this writing, the longest patient follow-up is two and one-half years from initial treatment. These first ten included patients with memory loss associated with Alzheimer’s disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI; when a patient reports cognitive problems). One patient, diagnosed with late stage Alzheimer’s, did not improve.
MEND: 25-Step Memory Program
|Optimize diet: minimize simple carbohydrates, minimize inflammation.||Patients given choice of several low glycemic, low inflammatory, low grain diets.||Minimize inflammation, minimize insulin resistance.|
|Enhance autophagy, ketogenesis||Fast 12 hr each night, including 3 hr prior to bedtime.||Reduce insulin levels, reduce Aβ.|
|Reduce stress||Personalized—yoga or meditation or music, etc.||Reduction of cortisol, CRF, stress axis.|
|Optimize sleep||8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea.|
|Exercise||30-60′ per day, 4-6 days/wk|
|Brain stimulation||Posit or related|
|Homocysteine <7||Me-B12, MTHF, P5P; TMG if necessary|
|Serum B12 >500||Me-B12|
|CRP <1.0; A/G >1.5||Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygiene||Critical role of inflammation in AD|
|Fasting insulin <7; HgbA1c <5.5||Diet as above||Type II diabetes-AD relationship|
|Hormone balance||Optimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol|
|GI health||Repair if needed; prebiotics and probiotics||Avoid inflammation, autoimmunity|
|Reduction of Aβ||Curcumin, Ashwagandha|
|Cognitive enhancement||Bacopa monniera, MgT|
|25OH-D3 = 50-100ng/ml||Vitamins D3, K2|
|Increase NGF||H. erinaceus or ALCAR|
|Provide synaptic structural components||Citicoline, DHA|
|Optimize antioxidants||Mixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid|
|Optimize Zn:fCu ratio||Depends on values obtained|
|Ensure nocturnal oxygenation||Exclude or treat sleep apnea|
|Optimize mitochondrial function||CoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine|
|Increase focus||Pantothenic acid||Acetylcholine synthesis requirement|
|Increase SirT1 function||Resveratrol|
|Exclude heavy metal toxicity||Evaluate Hg, Pb, Cd; chelate if indicated||CNS effects of heavy metals|
|MCT effects||Coconut oil or Axona|
Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan
The study, which comes jointly from the UCLA Mary S. Easton Center for Alzheimer’s Disease Research and the Buck Institute for Research on Aging, is the first to suggest that memory loss in patients may be reversed, and improvement sustained, using a complex therapeutic program that involves comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.
The findings, published in the current online edition of the journal Aging, “are very encouraging. However, at the current time the results are anecdotal, and therefore a more extensive, controlled clinical trial is warranted,” said Dale Bredesen, the Augustus Rose Professor of Neurology and Director of the Easton Center at UCLA, a professor at the Buck Institute, and the author of the paper.
In the case of Alzheimer’s disease, Bredesen notes, there is not one drug that has been developed that stops or even slows the disease’s progression, and drugs have only had modest effects on symptoms. “In the past decade alone, hundreds of clinical trials have been conducted for Alzheimer’s at an aggregate cost of over a billion dollars, without success,” he said.
Other chronic illnesses such as cardiovascular disease, cancer, and HIV, have been improved through the use of combination therapies, he noted. Yet in the case of Alzheimer’s and other memory disorders, comprehensive combination therapies have not been explored. Yet over the past few decades, genetic and biochemical research has revealed an extensive network of molecular interactions involved in AD pathogenesis. “That suggested that a broader-based therapeutics approach, rather than a single drug that aims at a single target, may be feasible and potentially more effective for the treatment of cognitive decline due to Alzheimer’s,” said Bredesen.
While extensive preclinical studies from numerous laboratories have identified single pathogenetic targets for potential intervention, in human studies, such single target therapeutic approaches have not borne out. But, said Bredesen, it’s possible addressing multiple targets within the network underlying Alzheimer’s may be successful even when each target is affected in a relatively modest way. “In other words,” he said, “the effects of the various targets may be additive, or even synergistic.”
Given this, Bredesen thought that rather than a single targeted agent, the solution might be a systems type approach, the kind that is in line with the approach taken with other chronic illnesses — a multiple-component system.
“The existing Alzheimer’s drugs affect a single target, but Alzheimer’s disease is more complex. Imagine having a roof with 36 holes in it, and your drug patched one hole very well — the drug may have worked, a single “hole” may have been fixed, but you still have 35 other leaks, and so the underlying process may not be affected much.”
“The shift to applying a broad combination therapy to Alzheimer’s is a crucial turning point towards effectively treating Alzheimer’s disease,” says Dr. Marwan N. Sabbagh, Research Professor of Neurology at the University of Arizona College of Medicine in Phoenix
Bredesen’s approach is personalized to the patient, based on extensive testing to determine what is affecting the plasticity signaling network of the brain. As one example, in the case of the patient with a demanding job who was forgetting her way home, her therapeutic program consisted of some, but not all of the components involved with Bredesen’s therapeutic program, and included:
- (1) eliminating all simple carbohydrates, leading to a weight loss of 20 pounds;
- (2) eliminating gluten and processed food from her diet, with increased vegetables, fruits, and non-farmed fish;
- (3) to reduce stress, she began yoga;
- (4) as a second measure to reduce the stress of her job, she began to meditate for 20 minutes twice per day;
- (5) she took melatonin each night;
- (6) she increased her sleep from 4-5 hours per night to 7-8 hours per night;
- (7) she took methylcobalamin each day;
- (8) she took vitamin D3 each day;
- (9) fish oil each day;
- (10) CoQ10 each day;
- (11) she optimized her oral hygiene using an electric flosser and electric toothbrush;
- (12) following discussion with her primary care provider, she reinstated hormone replacement therapy that had been discontinued;
- (13) she fasted for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime;
- (14) she exercised for a minimum of 30 minutes, 4-6 days per week.
Pluses & Minuses
The results for nine of the 10 patients reported in the paper suggest that memory loss may be reversed, and improvement sustained with this therapeutic program, said Bredesen. “This is the first successful demonstration,” he noted, but he cautioned that the results are anecdotal, and therefore a more extensive, controlled clinical trial is needed. “The current, anecdotal results require a larger trial, not only to confirm or refute the results reported here, but also to address key questions raised, such as the degree of improvement that can be achieved routinely, how late in the course of cognitive decline reversal can be effected, whether such an approach may be effective in patients with familial Alzheimer’s disease, and last, how long improvement can be sustained,” he said.
The downside to this program is its complexity. It is not easy to follow, with the burden falling on the patients and caregivers, and none of the patients were able to stick to the entire protocol.
On the other hand, the fact that there was such great memory improvement in so many patients shows that this is not an all-or-nothing program. Even doing some of the program’s steps was enough to improve memory.
Even better, said Bredesen, are the program’s side effects: “It is noteworthy that the major side effect of this therapeutic system is improved health and an optimal body mass index, a stark contrast to the side effects of many drugs.”
Big Trial, Rapid Results
Muses Labs will soon launch a two-year observational study to conduct a large-scale trial of the MEND program. The trial will include 200+ participants with Alzheimer’s disease, at selected medical facilities across the country.
Says Muses Labs’ CEO Vik Chandra, “Muses Labs intends to utilize the Internet and recent technology innovations to make personalized combination therapy practical and accessible to every individual with Alzheimer’s disease around the world.”
As the therapy does not rely upon new drugs, but rather an innovative combination of existing pharma and broader-based therapeutics, wider availability is only a couple of years away.
- Dale E. Bredesen. Reversal of cognitive decline: A novel therapeutic program.Aging, September 2014
Anything is worth a try but the thing that jumps out at me from this study is to reduce inflammation first and foremost. Practising meditation would be good if the agitation is low enough to allow for it and fasting plus reduction of simple carbs can only be good for everybody.
What if the daily exercise is responsible for all the improvement? That is the one thing missing from the huge percentage of older adults who just take pills. There should be a non-exercising control group.
This is a regimen that makes sense. There are numerous components, but they make sense. It is not an overpriced medication, but changes in lifestyle that are attainable with planning. My grandmother and two aunts have Alzheimer's disease. I am taking these steps to heart and going to make some life style changes that can only help in the long run. I would volunteer to be a part of the study!!!!!
If only it was that simple. My Mom and my sister both had Alzheimers. Both exercised and walked daily. Both ate healthy diets. Neither of them smoked or drank; except for an occasional glass of red wine.
This is tantamount to blaming the sufferes of this awful disease.
The ideas presented are a means to potentially improve memory and not at all to blame victims of the disease. Put another way, if I had a heart attack and then read an article discussing how diet and exercise and nutrition might improve the health of my heart, I would not interpret the article as placing blame on me. I'm caring for my Mom with Alzheimer's and, while science is unable to explain why she has this malady I still want to know how I can improve her life. No, there is no blame intended here, only potentially helpful information.
I know how you feel, Linda. My father has advanced Alzheimer's and he did almost everything right– exercised, learned new things, ate lots of fish and vegetables, and so on. When I read articles by vegans and such saying that their diet will stave off dementia, I think "Yeah, right– whatever helps you sleep at night." I'm heartened by this study, though, and have gone on the low-inflammation diet. My dad would approve, I believe. The researchers themselves admit that there is still no cure, and that their findings represent only a small bit of hopeful information.
No because hormonal imbalance, vitamins, lack of sleep, etc stress many many factors 37 point program complicated protocol it is not simple. You need a doctors help
Sometimes I can't name or mention something, but I can drive properly and I always remember malls or the ways to them and comeback safely. Do I suffer from dementia?
Where is the IRB review?
I'm not an Alzheimer's specialist, but I am a physician. My father has moderate/severe Alzheimer's — still recognizes family members, but cannot remember my deceased mother. Can converse, but generally cannot remember something you said or that happened a few minutes ago. We've started him on this UCLA approach, in addition to his taking standard Alzheimer's meds. His status has been unchanged for several years, which is an accomplishment because we expected progressive mental decline. Considering myself at-risk, I've begun following the UCLA approach – the vitamins, the fasting, etc — and my own mental performance and quality of life have noticeably improved — I used to take methylphenidate for adult inattentive ADD — I barely need that medicine, currently. This is all anecdotal, but I do encourage others to give it a try as it is wholly safe (assuming you do not overdose the vitamins — follow prescribed dose guidelines). Best to all.
One item rarely mentioned on websites related to this. 25% of all humans have the genetic predisposition for this and it's in nearly every building in the country.
I would be interested if they use coconut and flax seed oil. I think key is the fact that doctor's do not distinguish between plant and animal fats re cholesterol stats. When folks with memory loss are deficient in healthy cholesterol. Acetylcholine can be helped with Sage, but an excess of Calcium is something doctor's overlook. It is involved with B12, cholesterol and Acetylcholine production. For men with low Testosterone I have discovered that Zinc is the answer, not testosterone supplements. Men store Zinc in sperm, prostate and testes, which women do not have of course. Zinc is also involved in insulin production. This is why more women than men get Alzheimer's. If they offered individuals prize money for research it would certainly help me. I gave up my business to become a ft carer for my mom. I discovered the info on nutritional deficits, but came to the conclusion my mom's was caused by a toxic thyroid and boy, was I right. Only this year was she diagnosed with Hyperparathyroidism. Her GP ignored the excess Calcium and low Sodium for years. Told her to take more salt. Why are doctor's so ignorant on the importance of the sodium pump and largely clueless about nutrition. I also see clear signs of "cause" and "effect". Finland leads the world statistically in dementia and it took me 5 mins to find out why. A doctor started a low cholesterol drive in the early 70's to cut heart attack statistic's. It worked, but they replaced one epidemic with another because they do not distinguish between plant and animal fats. Decades now we are told that yellow oils and spreads and low cholesterol is healthy for us. Utter bullshit! Anyhow, it is interesting research, but I do not have enough time, or energy these days.
My mom is 94 with Alzheimer's. I am heartened to read this article. I have four sisters and lead a very healthy diet, but could tweak my regimen and draw closer to perfection. Dad and grandpa died with type 2 diabetes..this healthy way of living could benefit all of us!