Since it was first described over 100 years ago, Alzheimer's disease has been without an effective treatment. That may finally be about to change.

In the first, small study of a novel, personalized and holistic program to reverse memory loss, nine of 10 participants who had problems with memory and disorientation displayed marked improvement in their memories beginning within three to six months.

Among the ten patients with memory loss associated with Alzheimer's disease, six patients had discontinued working or had been struggling at their jobs at the time they joined the study; all were able to return to their jobs or continue working with improved performance, and their improvements have been sustained.

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It is the first study to suggest that memory loss in patients may be reversed - and improvement sustained - using a complex, 36-point therapeutic program that involves comprehensive diet changes, brain stimulation, exercise, sleep optimization, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.  The patient in treatment the longest has been receiving the therapy for two-and-a-half years.

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The study was conducted by Dr. Dale Bredesen of UCLA's Center for Alzheimer's Disease Research and the Buck Institute for Research on Aging, with the findings published in the October 2014 online edition of the journal Aging.

Bredesen said the findings are "very encouraging," but he added that the results are anecdotal, and a more extensive, controlled clinical trial is needed.

Although other chronic illnesses such as cardiovascular disease, cancer and HIV have been improved through the use of combination therapies, comprehensive combination therapies have not been explored for Alzheimer's and other memory disorders. However, over the past few decades, genetic and biochemical research has revealed an extensive network of molecular interactions involved in the development of Alzheimer's.

"That suggested that a broader-based therapeutic approach, rather than a single drug that aims at a single target, may be feasible and potentially more effective for the treatment of cognitive decline due to Alzheimer's," Bredesen said.

It's possible that addressing multiple targets that may contribute to Alzheimer's may be successful even when each target is affected in a relatively modest way, "with effects being additive, or even synergistic."

The uniform failure of drug trials in Alzheimer's influenced Bredesen's desire to better understand the fundamental nature of the disease. His laboratory has found evidence that Alzheimer's stems from an imbalance in nerve cell signaling. In the normal brain, specific signals foster nerve connections and memory making, while balancing signals support memory loss, allowing irrelevant information to be forgotten. But in people with Alzheimer's, the balance of these opposing signals is disturbed, nerve connections are suppressed and memories are lost.

That finding is contrary to the popular belief that Alzheimer's is caused by the accumulation of sticky plaques in the brain. Bredesen believes the amyloid beta peptide, the source of the plaques, has a normal function in the brain, as part of a larger set of molecules that promote signals that cause nerve connections to lapse. Thus, the increase in the peptide that occurs in Alzheimer's shifts the balance in favor of memory loss.

Bredesen therefore thought that, rather than a single targeted agent, the solution might be a multiple-component system approach, in line with the approach for other chronic illnesses.

"The existing Alzheimer's drugs affect a single target, but Alzheimer's disease is more complex. Imagine having a roof with 36 holes in it, and your drug patched one hole very well," he said. "The drug may have worked, and a single hole may have been fixed, but you still have 35 other leaks, and so the underlying process may not be affected much."

Bredesen's approach is personalized to the patient and may include:

Bredesen said the program's downsides are its complexity and that the burden falls on patients and caregivers to follow it. In the study, none of the patients was able to stick to the entire protocol. Their most common complaints were the diet and lifestyle changes, and having to take multiple pills each day. One patient who had been diagnosed with late stage Alzheimer's did not improve.

The good news, though, said Bredesen, are the side effects: "It is noteworthy that the major side effects of this therapeutic system are improved health and an improved body mass index, a stark contrast to the side effects of many drugs."

The results suggest that memory loss may be reversed and improvement sustained with the therapeutic program, but Bredesen cautioned that the results need to be replicated.

"The current, anecdotal results require a larger trial, not only to confirm or refute the results reported here, but also to address key questions raised, such as the degree of improvement that can be achieved routinely, how late in the course of cognitive decline reversal can be effected, whether such an approach may be effective in patients with familial Alzheimer's disease, and last, how long improvement can be sustained," he said.

Originally published by UCLA News – Story tip from Lee Katchen

Photo credits: (Top) bravenewtraveler, via CC flickr (bottom) Sun Star / Story tip from Aryeh Katchen