Welcome to New Subscribers

For some reason, we have seen a recent increase in people subscribing to the blog.  Not that we have a huge number of subscribers, but his is still encouraging and rewarding.  So, to new folks, I say, "Welcome!"  And, if you are new, I encourage you to check out our YouTube channel.  Click here.  I don't turn out as much content as other YouTubers, but I try to put out what I think people will find interesting.

More Detail on Dr. Ornish's Sudy of Lifestyle Interventioins for Alzheimer's Disease

We have written often about the distinction between longitudinal studies and randomized controlled trials.  To date, the majority of the research on lifestyle and Alzheimer's has been longitudinal studies.  You look at a population and take surveys on what people eat, what exercise they get, etc.  You assume that they are telling you (and themselves) the truth about what they do (and don't) eat, and how much real exercise they get.  Then you see how many of them develop dementia.  Many longitudinal studies produce disappointing results, but my view is that the quality of their data is very poor.

In a randomized controlled trial, you change peoples' lifestyles and measure the results.  Rather than rely on self-reporting in surveys, you either control the actual food they eat or measure the chemicals in their blood to see what they've been eating.  With respect to exercise, you supervise the exercise and measure it.  You measure the results with intense cognitive tests, MRIs, PET scans, and blood tests.  Oh, and then there's the control group - a set of test subjects who don't change their lifestyles, but are subject to the same results measurements.

Obviously, the randomized controlled trials are MUCH more reliable.  However, they are much more difficult -- and costly -- to actually perform. 

Back in July of 2024, we reported that Dr. Dean Ornish was completing a randomized control trial of lifestyle interventions for Alzheimer's disease.  We were heartened that he not only found improvements in memory and cognition tests, but he also found improvements in biomarker evidence, specifically Alzheimer's biomarkers in cerebrospinal fluid.  That's now one of the two gold standard tests for diagnosing Alzheimer's.  Dr. Ornish's study involved 51 patients between the ages of 45 and 90, all of whom had been diagnosed with MCI or early dementia due to Alzheimer's.  But only about half of these received the interventions.  For the intervention group, Dr. Ornish found positive results after 20 weeks.

The other day I came across another article referencing this research ... except the article called it "new."  Thinking it was newer than what we discussed before, I started to develop a new post on the research ... before realizing I'd already posted about it.  Nevertheless, I think it's worth revisiting, since the research is so compelling.  And it's so consistent with my own experience.

What I think is worth revisiting are specifics about the interventions used in the study.  So here they are:

Diet: 

Whole foods, minimally-processed plant-based (vegan) diet, high in complex carbohydrates (predominantly fruits, vegetables, whole grains, legumes, soy products, seeds and nuts) and especially low in harmful fats, sweeteners and refined carbohydrates.  It was approximately 14-18% of calories as total fat, 16-18% protein, and 63-68% mostly complex carbohydrates. Calories were unrestricted. Those with higher caloric needs were given extra portions.  Twenty-one meals/week and snacks plus the daily supplements listed below were provided throughout the 40 weeks of this intervention to each study participant and his or her spouse or study partner.  Twice/week, three meals plus two snacks per day that met the nutritional guidelines as well as the prescribed nutritional supplements were shipped overnight to participants and partners.  Participants were asked to consume only the food and nutritional supplements sent to them and no other foods.

This is similar to the MIND diet, except the MIND diet restricts cheese, stick margarine, and butter.  It also allows some poultry and fish. 

Group Support:

Each patient and their spouse or study partner met three times/week, four hours/session via Zoom: 

- One hour of supervised exercise (aerobic + strength training) 

- One hour of stress management practices (stretching, breathing, meditation, imagery) 

- One hour of a support group lecture on lifestyle 

- Additional optional exercise and stress management classes were provided. 

Supplements 

- Omega-3 fatty acids with Curcumin (1680 mg omega-3 & 800 mg Curcumin, Nordic Naturals ProOmega CRP, 4 capsules/day). 

- Multivitamin and Minerals (Solgar VM-75 without iron, 1 tablet/day).

- Coenzyme Q10 (200 mg, Nordic Naturals, 2 soft gels/day). 

- Vitamin C (1 gram, Solgar, 1 tablet/day).

- Vitamin B12 (500 mcg, Solgar, 1 tablet/day). 

- Magnesium L-Threonate (Mg) (144 mg, Magtein, 2 tablets/day). 

- Hericium erinaceus (Lion’s Mane, Stamets Host Defense, 2 grams/day). 

- Super Bifido Plus Probiotic (Flora, 1 tablet/day).

Some Crazy Stuff about Shingles and Dementia

We've discussed before, both in this blog and in Beating the Dementia Monster, that there seems to be a correlation between people getting their shingle shot and a reduced incidence of developing Alzheimer's disease.  The case for this continues to strengthen, as illustrated in some recent studies in Wales and Australia.  I believe it's likely that my disease stems from my history of three episodes of shingles.

In our book, we noted that some researchers believe that the amyloid plaques we're trying to get rid of are actually part of the body's defense against a variety of microbial pathogens.  The plaques may be trying to encapsulate the pathogens and stop their propagation in the brain.  In our discussion of pathogenic causes of Alzheimer's, we noted researchers have also correlated another pathogen, the bacteria causing gum disease (p. gingivalis), with the advent of Alzheimer's symptoms.  At autopsy, evidence of the presence of the herpes virus and p. gingivalis are usually found in the brains of Alzheimer's victims.

So here's a question.  How does the role of pathogens in the brain correlate with the positive effects of applying The Dementia Toolkit, notably with respect to exercise and diet?  Well, according to one paper, perhaps "environmental factors like stress, diet, sleep, and exercise may influence Alzheimer's risk in part by modulating the innate and adaptive immune responses to [pathogens]."  In other words, the time you spend on the treadmill is regulating the ability of the pathogen to cause damage in your brain.  The paper appeared in the journal, Molecular Psychiatry.  It was entitled, "The viral hypothesis: how herpesviruses may contribute to Alzheimer’s disease."

What's prompting me on this topic is a new study in Australia about a relatively small but consistent correlation between the shingles shot and the advent of dementia.  The study replicated the results of a similar study in Wales.  The Australian study was published in the JAMA Network.  It's a little complicated, but by studying the medical records of more than 101,000 patients with a mean age of about 62 years, there was a 1.8% decrease in the probability of receiving a dementia diagnosis during a 7.4-year period.  That's not a lot, but hopefully most of us will have several more 7.4 year periods after we turn 62.  And the rate of development of the disease increases with age.  So what would that mean for a 7.4-year period beginning at the age of 75?  It might be a lot more than 1.8%

But what may be more important here is the insight this research gives us on the causes and mechanisms of the disease.  As time as gone on, most researchers have migrated away from a simplistic understanding that the disease is fundamentally about the development of amyloid plaques and microtubule tangles.  As a minimum, the amyloid hypothesis has been maturing, and some have abandoned it.

I apologize for being a bit of a slug about posting here.  My wife and I took a trip to a resort area in the Cascades for a few days, and then I was in Seattle for an overnight stay in the hospital while they wired me up to study my sleeping brain.  I'm hoping this will yield a positive outcome for my chronic insomnia.  And, I'll admit it, I have a harder time these days finding the energy to research and write on these topics.  And the YouTube channel is a lot of work.  So I do what I can.