Cup o’Joe-Hope for Alzheimer’s Disease? [Video]

When Dr. Alois Alzheimer asked 51-year-old Auguste Deter to write her name, she tried but could not. “I have lost myself,” she said. The year was 1901 and Deter had just been admitted to a mental hospital suffering from delusions about her husband being adulterous and paranoia about her neighbours trying to kill her. Before being institutionalized, for a decade she had shown increasing memory loss and symptoms of dementia. When August D. as she was known in medical records, died in 1906, her brain was examined by Dr. Alzheimer who found “senile” plaques and “neurofibrillary tangles” that would become the hallmark of “Alzheimer’s disease.” Later those plaques were identified as deposits of a protein called beta-amyloid while the tangles were composed of another type of protein now known as “tau.”
Alzheimer’s is an age-related disease with victims often ending up in a tragic vegetative state. Numbers are expected to increase significantly with an aging population. There is no cure for the disease and the medications available have minimal impact. But now there is a slight, very slight, glimmer at the end of the long dark tunnel with a study showing that modification of lifestyle factors may be able to slow the progression of the disease. The principal investigator is Dr. Dean Ornish who has long worked on reversing heart disease through a vegetarian diet, exercise, yoga and meditation with some success. Now he has turned his attention to Alzheimer’s disease.
Fifty-one patients with early Alzheimer’s disease were randomized into experimental and control groups. The experimental group had vegan meals delivered to them as well as supplements of omega-3 fatty acids, curcumin, coenzyme Q10, Lion’s mane mushroom and various minerals and vitamins, with some of the latter in higher doses than found in common daily multi-vitamin tablets. The experimental group was also given a program of exercise and were guided to learn relaxation techniques. After twenty weeks, all the patients underwent standard tests for cognition and the conclusion was that the patients in the control group continued to decline, while in the experimental group some actually showed an improvement. The findings generated lots of headlines about a vegan diet, exercise and meditation possibly halting Alzheimer’s disease.
The results were actually less than spectacular. First, you can hardly hang a hat on an experimental group comprised of only twenty-four subjects. Of these, 10 showed improvement, 7 were unchanged and 7 worsened. None in the control group improved, 8 were unchanged and 17 worsened. And the “improvement” was not impressive. For example, in the test that showed the best result, with a lower score indicating better cognition, the experimental group dropped from 21.5 to 20.5 while the control group increased 21.3 to 22.2. The other tests resulted in an even smaller difference. These numbers are hardly something to crow about. Another measurement involved a blood test for two types of amyloid proteins, termed beta-amyloid 40 and beta-amyloid 42. Both are found in the bloodstream, but the 42 version is the one found in senile plaques. An elevated level of 42 in the blood is indicative of more also occurring in senile plaques so that a decreased ratio of beta amyloid 42/40 is a strong marker of Alzheimer’s disease and can be detected early in the disease progression, even before clinical dementia occurs. In this study there was a slight increase in the ratio meaning that the amount of beta amyloid in the brain decreased. But again, the change was small.
There is yet another issue. Even if we assume that there is a benefit, there remains the question of which component of the program is responsible. Generally, in a randomized trial you want just one variable. In this case there were many. Is the result due to the diet? The exercise? The meditation? One of the many supplements? We don’t know. The authors’ own conclusion is that “in persons with mild cognitive impairment or early dementia due to Alzheimer’s disease, comprehensive lifestyle changes may improve cognition and function.” There is that troublesome word, “may.” Why troublesome? Because “may not” could also be a fitting conclusion. Still, there is a tinge of hope for someone who can follow Ornish’s strict regimen.