Lifestyle intervention improves cognition in Alzheimer’s patients A research review by Rebecca Smith, Editor. Originally published in True Natural Health, Spring 24
A randomised, controlled clinical trial study directed by Dr Dean Ornish looked at the effects of intensive lifestyle changes on patients with early dementia and Alzheimer’s disease. The research was published on June 7 in Alzheimer’s Research and Therapy.
Although the research group was small, the results of this trial are promising. After a 20 week study, the researchers concluded “Comprehensive lifestyle changes may significantly improve cognition and function…in many patients with mild cognitive impairment or early dementia due to Alzheimer’s disease”.
When interviewed about this research Dr Ornish said “A big obstacle that I struggle with… is people who hear ‘diet and lifestyle’ and think that is kind of boring; how powerful could that be.” … “They think it has to be high-tech and expensive to be powerful. Our unique contribution is to use … high-tech scientific measures to prove how powerful these simple lifestyle changes can often be.”
So let’s have a look at what the research demonstrated on just how powerful lifestyle changes can be.
What did the researchers look at?
The research team randomly assigned 51 men and women with a diagnosis of mild cognitive impairment or early dementia due to Alzheimer’s disease to two groups:
1. An intensive lifestyle intervention group with no drugs added or
2. A standard care control comparison group who were told not to make any lifestyle changes.
The intensive lifestyle intervention model
When Dr Dean Ornish and his team describe a lifestyle intervention as ‘intensive’, you know you can expect more than the current standard advice of “Do a bit more exercise and eat well”.
Below is a summary of the diet and lifestyle model, as well as the supplement protocol followed by the intervention group. Please note that the people following this protocol had the support of multiple health professionals. This protocol, particularly the supplementation, should be discussed with a trusted health professional before adopting it.
Diet
Wholefood vegan
Dr Ornish and his team provided meals and snacks to all participants so they could control their nutritional composition.
The provided diet was high in complex carbohydrates (mostly from fruits, vegetables, whole grains, legumes, soy products, seeds and nuts) and especially low in harmful fats, sweeteners and refined carbohydrates.
The macro-nutrient breakdown of the diet was:
14-18% of calories were from fats,
16-18% from protein and
63-68% from carbohydrates (most of these were complex carbohydrates).
Calories were unrestricted.
Exercise
Daily aerobic exercise, such as walking, for at least 30 minutes. As well as daily aerobic exercise, mild strength training exercises were completed at least three times per week. An exercise physiologist was available to guide these sessions.
Stress management
Those in the intervention arm engaged in stress management activities for one hour every day. These activities included meditation, gentle yoga poses, stretching, progressive relaxation, breathing exercises and imagery.
Flashing-light glasses at a theta frequency of 7.83 Hz plus soothing music as an aid to meditation and insomnia were provided as optional extras.
Everyone in the treatment arm was encouraged to get adequate sleep.
Group support
Participants and their spouses or study partners participated in a support group for one-hour sessions, three days a week. These group sessions were supervised by a mental health professional. Participants also received a book with memory exercises that were used periodically during group sessions.
Homework
To reinforce the lifestyle intervention, each patient and their study partner met once a week for a one-hour lecture on lifestyle.
Added extras
Additional optional exercise and stress management classes were provided.
Supplement protocol
Alzheimer’s disease is notoriously difficult to treat. This may be why Dr Ornish and his team choose to prescribe so many supplements in the intervention arm.
Supplement 1:
Omega-3 fatty acids with Curcumin
Dose: 1680 mg Omega-3 and 800 mg Curcumin (Nordic Naturals ProOmega CRP, 4 capsules/day).
Supplement rationale:
Omega-3 fatty acids: In those aged 65 or older, those consuming omega-3 fatty acids once a week or more have a 60% lower risk of developing Alzheimer’s disease (Morris, 2003).
Curcumin targets inflammatory and antioxidant pathways as well as amyloid aggregation, although there may be problems with bioavailability and crossing the blood-brain barrier (Voulgaropoulou, 2003).
Supplement 2:
Multivitamins and Minerals
Dose: 1 tablet/day (Solgar VM-75 without iron).
Supplement rationale: Combination formulations have been shown to improve cognitive performance and the behavioural difficulties that
accompany Alzheimer’s disease (Shea, 2015).
Supplement 3:
Coenzyme Q10
Dose: 200 mg (Nordic Naturals, 2 soft gels/day).
Supplement rationale: Coenzyme Q10 may reduce mitochondrial impairment in Alzheimer’s disease (Pradhan, 2021).
Supplement 4:
Vitamin C
Dose: 1 gram (Solgar, 1 tablet/day)
Supplement rationale: Maintaining healthy vitamin C levels may have a protective function against age-related cognitive decline and Alzheimer’s disease (Harrison, 2012).
Supplement 5:
Vitamin B12
Dose: 500 mcg (Solgar, 1 tablet/day)
Supplement rationale: B12 deficiency is linked to the development of Alzheimer’s disease pathology (Lauer, 2022).
Supplement 6:
Magnesium L-Threonate
Dose: 144 mg (Magtein, 2 tablets/day).
Supplement rationale: A meta-analysis found that magnesium deficiency may be a risk factor for Alzheimer’s disease and magnesium supplementation may be an adjunctive treatment for Alzheimer’s disease (Du, 2021).
Supplement 7:
Hericium erinaceus (Lion’s Mane)
Dose: 2 grams/day (Lion’s Mane, Stamets Host Defense)
Supplement rationale: Lion’s Mane may produce significant improvements in cognition and function in healthy people over 50 (Saistu, 2019)and in people with mild cognitive impairment compared to placebo (Mori, 2008).
Supplement 8:
Probiotics
Dose: Super Bifido Plus Probiotic Flora, 1 tablet/day.
Supplement rationale: A meta-analysis suggests that probiotics may benefit Alzheimer’s disease patients (Xiang, 2022).
The Results
After 20 weeks, 71% of the diet and lifestyle intervention group either maintained or improved their cognition. Meanwhile, 68% of the control group worsened across all measures and no one in the control group improved.
What did Dr Ornish say about the results?
“I’m cautiously optimistic and very encouraged by these findings, which may give many people new hope and new choices,” Dr Ornish said. “We do not yet have a cure for Alzheimer’s, but … we are now able to offer an improved quality of life to many people suffering from this terrible disease.”
What is so promising about this research?
It is well understood that dietary and lifestyle factors play a role in the development of Alzheimer’s disease. For example, the Chicago Health Study of around 7,000 people showed a 38% lower risk of developing Alzheimer’s disease in people who ate high amounts of vegetables, and a 60% lower risk in those who consumed omega-3 fatty acids at least once a week.
What Dr Ornish and his team were able to show was that some of these same protective diet and lifestyle habits can play a role in slowing the progression and even reversing some of the effects of Alzheimer’s disease. This is huge. For a long time, Alzheimer’s was viewed as a progressive
disease where improvements in cognition were not possible. Now this
research can join other papers published in recent years that show that this is not the case.
What is next?
With multiple components to the intervention, it is not possible to determine which parts were the most effective. Hopefully, future research will examine the dietary and lifestyle interventions separately to assess the potential results without the use of so much supplementation.
References
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Morris MC, Evans DA, Bienias JL, Tangney CC, Bennett DA, Wilson RS, et al. Consumption of fish and n-3 fatty acids and risk of incident Alzheimer’s disease. Arch Neurol. 2003;60(7):940–6. https://doi.org/10.1001/archneur.60.7.940. (Epub 2003/07/23. PubMed PMID: 12873849).
Voulgaropoulou SD, van Amelsvoort T, Prickaerts J, Vingerhoets C. The effect of curcumin on cognition in Alzheimer’s disease and healthy aging: A systematic review of pre-clinical and clinical studies. Brain Res. 2019;1725:146476. https://doi.org/10.1016/j.brainres.2019.146476. Epub 2019/09/29. PubMedPMID:31560864.
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