Published on August 15, 2018
Alzheimer’s Disease & modifiable risk factors: A new model of healthcare using health coaches for the treatment & prevention of Alzheimer’s Disease & cognitive decline: Alzheimer’s Disease & modifiable risk factors: A new model of healthcare using health coaches for the treatment & prevention of Alzheimer’s D isease & cognitive decline Sara Mushel , MS in Holistic Nutrition (C) Trained in Bredesen Protocol American College of Heathcare Sciences Master’s Capstone Project About me: About me Slide 3: Today most Americans are now affected by Alzheimer’s disease, either because they have been diagnosed themselves or know someone who has. Slide 4: In fact, 1 in 3 people will be diagnosed with AD or dementia, and it’s the 6 th leading cause of death. Slide 5: To date, no treatments have been developed, and interventions targeting amyloid plaques have been ineffective. Slide 6: However, new research strongly suggests that prevention can start years in advance by addressing modifiable risk factors related to lifestyle, and randomized control trials and pilot studies examining multimodal interventions that address modifiable risk factors have shown promise ( Bredesen , 2016; Mistridis et. al, 2017). Slide 7: One in particular is the Bredesen Protocol, which will be discussed in detail in this presentation. Slide 8: A study conducted by Barnes and Yaffe (2011) identified seven modifiable risk factors for AD contributed to nearly half of AD cases around the world, including: diabetes , mid-life hypertension, mid-life obesity, smoking, depression, low educational attainment, and physical inactivity. The study determined that a global reduction of 10-25% of all seven risk factors could prevent 1.1 – 3 million cases of AD worldwide and 184,000 – 492,000 cases in the U.S. Several complementary and alternative medicine therapies have also been credited for their ability to reduce AD risk, such as: mind-body exercise, physical activity, supplements, stress reduction techniques, sleep improvement, and dietary interventions (Eyre et. al, 2015). Barnes and Yaffe Eyre et al Slide 9: Following the study by Barnes & Yaffe (2011), the World Dementia Council (WDC) requested a report from the Alzheimer’s Association in 2014 to examine the evidence of modifiable risk factors associated with cognitive decline and dementia ( Baumgart et. al, 2014). The report concluded that there are several modifiable risk factors associated with reduced risk for cognitive decline and dementia, including: R egular physical activity R educing cardiovascular risk factors, such as diabetes, obesity, smoking, and hypertension M aintaining a healthy diet E ngaging in life long learning and cognitive activity The Functional Medicine Approach: The Functional Medicine Approach Slide 11: “Multimodal therapy approaches that combine interventions aimed at different aspects of disease are emerging as potential – and perhaps essential – ways to enhance clinical outcomes for patients with psychiatric and neurological disorders… Indeed, for most chronic diseases, multiple pathways are involved simultaneously, making it unlikely that single treatment will prove sufficiently effective.” -Robert M. Califf , MD, MACC, Commissioner of Food and Drugs, Food and Drug Administration (FDA) Slide 12: “Functional Medicine is an evolution in the practice of medicine that better addresses the healthcare needs of the 21st century. By shifting the traditional disease-centered focus of medical practice to a more patient-centered approach, functional medicine addresses the whole person, not just an isolated set of symptoms. Functional Medicine practitioners spend time with their patients, listening to their histories and looking at the interactions among genetic, environmental, and lifestyle factors that can influence long-term health and complex, chronic disease. In this way, Functional Medicine supports the unique expression of health and vitality for each individual.” -Institute for Functional Medicine, 2018 Slide 13: The Bredesen Protocol (the “Protocol”) is based on the work of Dr. Dale Bredesen , President and CEO of the Buck Institute, internationally recognized expert on neurodegenerative disease, and founder of the program. An important component of the Protocol is to identify and address modifiable risk factors in patients at risk or living with cognitive decline, dementia, or early Alzheimer’s disease with the goal to prevent or delay symptoms of cognitive decline. This is done in part using a valuable tool developed by the Institute for Functional Medicine (IFM) called the Functional Medicine Matrix, which helps the practitioner identify "Modifiable Personal Lifestyle Factors", including sleep and relaxation, exercise and movement, nutrition, stress, and relationships. Patients who have followed this protocol show remarkable results: in a small study, 9 out of 10 patients following the program had improved cognition within in 3-6 months, with one failure in a patient with progressive late stage Alzheimer’s disease ( Bredesen , 2014). Patients also reported being able to return to work or improve their performance, and sustained and marked improvement was reported in a two-and-a-half year follow up ( Bredesen , 2014). The Bredesen Protocol: The Bredesen Protocol Comprehensive, multimodal, programmatic, personalized MPI Cognition & ReCODE Report Institute for Functional Medicine Advanced Clinical Training Bredesen Protocol Practitioners: MDs, NDs , nutritionists, etc.