The Paradigm Shift in Alzheimer's - Excerpt from The First Survivors of Alzheimer's by Dr. Dale Bredesen
Imagine being told that you have Alzheimer’s disease. Because this is such a common disease, there is a very good chance that this will happen to someone you love or someone I love. Now imagine that, instead of being told there is no hope, you are told that this is readily treatable, and that you can expect to get your normal cognition back; what’s more, your children may be assured that they, their children, and your family’s subsequent generations can avoid Alzheimer’s disease. This reversal of fortune is
life-changing, with reverberations through the generations ad infinitum. This was the goal in translating the research that my colleagues and I performed over thirty years into a therapeutic approach.
Do you remember the first time you heard that an untreatable illness had finally become treatable? Down through history, we humans have conquered one disease after another, often through biochemical research, sometimes through anecdotes from tribal medicine, and other times through sheer dumb luck. Regardless of the method, though, the result with each vanquished disease initially feels miraculous: suddenly the death sentences are lifted from thousands or even millions of people, restoring hope and a future for each. These events represent one of the most rewarding aspects of what it means to be human, and they never cease to inspire me:
Najiv was a teenage boy in the 1940s, living in a village in India, when he developed fever and a headache and lapsed into unconsciousness. He was taken by bullock cart from his village to the city, where the doctor diagnosed bacterial meningitis. At the time, this was typically a rapidly fatal illness. On this occasion, however, the doctor told Najiv’s parents, “Until last week there would have been nothing I could do to save your son, but a new drug has just arrived from England. It is called penicillin.” Instead of dying, then, Najiv made a full recovery, and this is of more than passing interest to all of us: Najiv’s son is one of the most gifted biomedical researchers I have ever met, and his research may offer the best hope for an effective antiviral treatment not just for the COVID‑19 of the current pandemic but also for any subsequent coronavirus pandemics—a brilliant advance with global lifesaving ramifications.
Whether it is Edward Jenner’s development of the first vaccine—it has been pointed out that Jenner is responsible for saving more lives than any other human in history—or Frederick Banting and Charles Best’s discovery of insulin, thus saving millions with diabetes, or David Ho’s development of triple therapy to treat HIV effectively, each of these pioneers conjured hope from hopelessness, each sent a ripple through the reality we live with day to day, creating endless possibilities that did not hitherto exist, and altering the world’s future irrevocably.
The seven survivors you’ll read about in The First Survivors of Alzheimer’s—in their own words—are pioneers as well. You’ll hear from Kristin—the very first person who adopted our protocol (“Patient Zero”)— who had watched her mother sink into dementia, and then was told by her own physician that she was on her way to suffering the same fate, without hope for treatment. How would each of us feel to receive such news from our physician? You’ll also hear from Deborah, who suffered as her beloved father and grandmother were both lost to Alzheimer’s, and then was horrified as she developed the same symptoms they had manifested, wondering what lay in store for her children. And from Edward, who was told to close his businesses and get his affairs in order. And Marcy, who piled up dozens of parking tickets because she could never remember to feed the parking meters. And Sally, a nurse educator who taught her students that medicine had no effective treatment to offer Alzheimer’s patients, then developed it herself and failed a drug trial. And Frank, who had plans to write a book chronicling his own descent into dementia. And finally from Julie, who asked an expert neurologist if he could simply help her to avoid further decline and was told, “Good luck with that.” The thoughts, concerns, emotions, and ultimate triumphs these survivors experienced are described with a depth of feeling that only those who lived them could express.
All of these pioneers are still on the trail—they survived “terminal” PET scans, MRI scans, family histories, and the prognostications of their physicians, thanks to their own inquisitiveness and industry to find a new solution, their courage to address the underlying drivers of their cognitive decline, and their determination to stick with a novel protocol.
Thanks to these first survivors, the way is now clear for the millions more in need, for both prevention and reversal of cognitive decline. These pioneers are catalyzing a paradigm shift in the way we think about, evaluate, prevent, and treat Alzheimer’s disease and the pre-Alzheimer’s conditions, MCI (mild cognitive impairment) and SCI (subjective cognitive impairment).
But why did it take so long? Alzheimer’s disease was first described way back in 1906, yet the first survivors did not begin treatment until 2012, over a century later. Why so long? The fundamental difference between the way people were treated from 1906 until 2012 (and, unfortunately, the way most are still treated, unsuccessfully, today) and the therapeutics used for all of the survivors, is an obvious one: with all previous approaches, patients were given a Procrustean prescription for a single drug, such as Aricept, that has nothing to do with what is actually causing the cognitive decline.
In contrast, each of the survivors was evaluated for the various factors that were causing the decline itself, then those contributors were targeted with the personalized, precision medicine protocol we dubbed ReCODE (for “reversal of cognitive decline”). Some had undiagnosed infections—Marcy,
for example, as you’ll see from her story, had an undiagnosed infection from a tick bite, a relatively
common one called ehrlichiosis, and treating that, along with her multiple other contributors, was important for best outcome; Sally, on the other hand, had exposure to mycotoxins (toxins produced by some molds), and removing her exposure was critical to her success. Each of the survivors you’ll hear from had a different set of contributors, so that the optimal protocol for each survivor was different.
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Excerpted from THE FIRST SURVIVORS OF ALZHEIMER’S by arrangement with Avery Books, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright © 2021, Dale E. Bredesen