"Our data actually shows cognitive improvement," says neurologist Dr. Richard Isaacson, founder of the Alzheimer's Clinic at New York Presbyterian and Will Cornell Medical Center.
"This is the first study in a clinic in a real-world setting setting up individualized clinical management can improve cognitive function and also reduce the risk of Alzheimer's and cardiovascular disease," Isaacson said.
"We need more than just this type of clinical trial, "says Harvard neuroscience professor Dr. Rudy Tansey, who heads the Henry and Alison McCans Brain Health Center at Massachusetts Hospital in Boston.
" We spent so much time waiting for drug tests a, but there are really a lot of things we can do to maintain brain health with our lifestyle, "says Tanzi, who did not participate in the study.
" But it's hard to convince society to do it in the absence of clinical trials to tell us that sleep and diet, exercise and meditation are important, "he said. "The way this study was designed and conducted is a great guide to the future."
Risk reduction is key
Some may experience subtle signs of cognitive loss; others are still blind to the growth of devastating plaques and entanglements designed to steal their memories.
But does one size fits all? Or do we all need a unique action plan tailored to our specific risk factors?
Isaacson bet on the latter. Since 2013, clients at his Alzheimer's Prevention Clinic have been undergoing a battery of physical and mental tests. NMR scanning was performed to check for early signs of amyloid plaque buildup. Current and past medical problems, genetics, family history, eating patterns, exercise habits, stress levels and sleep patterns have been documented.
They are also asked if they would like to participate in the study.
"Our study was designed to look at the effects of lifestyle intervention on cognitive function," Isaacson said. "Does the cognitive function decrease? Is it the same or could it be improved? ”
Isaacson and his team were able to enroll 154 patients between 25 and 86 years old, all with a history of Alzheimer's disease in their families. Most of them have not yet experienced memory loss, but have shown troubling results in cognitive tests.
A small group of 35 were diagnosed with mild cognitive impairment (MCI). The Alzheimer's Association defines MCI as "cognitive changes that are severe enough to be noticed by the person concerned and by family and friends but do not affect the individual's ability to perform daily activities."
Based on these results each person has received a personalized recipe plan. Of the nearly 50 evidence-based interventions, an average of 21 lifestyle behaviors were provided to each person.
"Physical activity and nutrition were by far the two most important things on the list, but they were also personalized for each individual," Isaacson said.
In physical activity, for example, the program may recommend aerobic interval training for one person, while the use of a balanced ball or desk weight training may be recommended for another.
"Within the diet, you might say, consume caffeinated coffee just before 2pm to protect your sleep. Without carbohydrates for 12 hours or more per day – this is the fasting protocol, "said Isaacson.
The program covered alcohol intake, dairy intake, minerals and vitamins, sleep hygiene tips, education to learn something new, listening to music, meditation, mindfulness and more.
The results were encouraging
Isaacson found people diagnosed with mild cognitive impairment who followed 60% or more arithmetically more than 12 of 21 behavioral changes had better memory and thinking skills 18 months later.
Those with MCI who made less than 60% of the personalized behavior showed no improvement. In fact, they continue to decline.
The second group of patients at genetic risk, but without present clinical signs of dementia, called the prevention group, were able to receive an equally impressive cognitive boost. It seems irrelevant whether they comply with less than 60% of the recommendations.
Isaacson is wary of overstating these results. The study was not designed to prevent Alzheimer's disease, but only to see if lifestyle changes affect cognitive function.
"We need more research, we need more clinics and more doctors to do it," he said. "But I think this model is a roadmap for doctors and patients to work together to improve their brain health.
" We envision a day where people can go to their doctor and hear nothing you can't do it, the doctor will say, "Well, we may not have the perfect answers, but here are 21 different things you can do based on your individual risk to protect your brain health."