Intensive Lifestyle Changes May Reverse Early Alzheimer's Symptoms

Key Takeaways

• Strictly adhering to a Mediterranean-style diet, daily exercise, and regular stress reduction helped slow or reverse early cognitive decline in a small study.
• These strategies have also been shown to reduce the risk of heart disease, which shares risk factors with Alzheimer's disease.
• It's unclear if adopting a less-rigorous version of such a lifestyle overhaul would produce similar benefits.

Some people with mild cognitive impairment or early dementia due to Alzheimer's disease may be able to improve their brain function and daily lives by radically overhauling their lifestyle habits, a small study suggests.

The study randomly assigned 51 people in the early stages of Alzheimer's disease to either stick to their usual routines for 20 weeks or make intensive changes to adopt four new habits:

• Eat a minimally processed, plant-based diet with lots of whole foods and limited refined carbohydrates, alcohol, and sweeteners
• Practice moderate intensity aerobic exercise and strength training for at least 30 minutes daily
• Devote one hour daily to stress management activities like meditation , stretching , and breathing exercises
• Attend three hour-long group therapy sessions per week

At the start of the study, and again at the end, participants completed four different cognitive function tests. Overall, the intervention group (those who overhauled their lifestyle) significantly improved their cognitive function on three tests, and made gains on the fourth test, even though the results weren't as strong. In addition, one test found significantly less disease progression.

Participants in the control group that didn't make any lifestyle changes scored worse on all four cognitive function tests by the end of the study, according to results published in Alzheimer's Research & Therapy .

‘New Hope' for People With Alzheimer's Disease

"I'm cautiously optimistic and very encouraged by these findings, which may empower many people with new hope and new choices," lead study author Dean Ornish, MD , founder and president of the Preventive Medicine Research Institute and a clinical professor of medicine at the University of San Francisco, said in a statement .

"We do not yet have a cure for Alzheimer's," Dr. Ornish said. "But as the scientific community continues to pursue all avenues to identify potential treatments, we are now able to offer an improved quality of life to many people suffering from this terrible disease."

Several people in the intervention group reported improvements in cognitive function that made a big difference in their ability to resume daily activities that had become difficult to perform due to Alzheimer's, according to the statement.

For example, many people who reported being unable to read a book or watch a movie because they forgot the plot points necessary to keep up with the narrative said that they could resume these activities and retain most of the story line by the end of the study, according to the statement.

Other participants who worked with numbers for a living and had lost their ability to easily manage complex financial information reported regaining these skills by the end of the study, according to the statement.

"This study is quite exciting to me, as I have been telling my patients to exercise, eat a Mediterranean diet of whole foods, and use mindfulness and other techniques to reduce stress for the past decade or so," says Andrew Budson, MD , a professor of neurology at Boston University and a coauthor of Seven Steps to Managing Your Aging Memory .

While it isn't entirely plant-based, a Mediterranean diet emphasizes plant-based proteins and leaner animal proteins like chicken and fish, fresh fruits and vegetables, whole grains, beans, and nuts. And like the diet in the study, it also encourages limiting processed foods, sugars, and red meat.

"I'm so pleased that the scientific data has finally caught up to my recommendations," says Dr. Budson, who wasn't involved in the new study.

The Study Had Some Limitations

Not all of the participants improved with intensive lifestyle changes. Two people in the intervention group dropped out of the study because they couldn't stick to the new diet. However, lifestyle changes either improved or stopped the progression of Alzheimer's symptoms for 71 percent of the participants in this group. By contrast, two-thirds of the people in the control group got worse and the rest saw no symptom improvement.

Beyond its small size and relatively brief duration, the study does have several other limitations. Scientists didn't use brain scans to objectively assess the progression of Alzheimer's disease. And participants were aware if they were assigned to the intervention group, so it's possible this influenced how they responded.

However, all of the lifestyle interventions tested in the study are well established tools to improve early heart disease , and may also improve brain health, says Yu Chen, PhD, MPH , a professor of epidemiology at New York University Grossman School of Medicine, who wasn't involved in the new study.

"Because Alzheimer's and coronary heart disease share similar mechanisms, like inflammation and high cholesterol , interventions that can reverse early coronary heart disease might also help with early cognitive decline," Dr. Chen says. "This suggests that lifestyle changes such as diet and exercise, known to be effective for heart disease, could potentially slow or even reverse the progression of mild cognitive impairment or early dementia."

One question left unanswered by the study, however, is whether less intensive lifestyle changes, like exercising every other day or eating meatless meals a few times a week, might help when it comes to Alzheimer's disease symptoms.

"It's possible that a less intensive program could still have an effect, but more research is needed to confirm this," Chen says. "Long-term lifestyle changes and consistent maintenance are crucial for any intervention to be effective."

To promote brain health as you age - whether you have early Alzheimer's or not - it's best to focus on committing to whatever healthy lifestyle habits you can, even if the intense changes used in the study don't seem achievable, Chen recommends.

"For those concerned about brain health, staying physically active, eating well, managing stress, maintaining social connections, engaging in mentally stimulating activities, and scheduling regular healthcare checkups are key practices," Chen says.

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Sources

1. Ornish D et al. Effects of Intensive Lifestyle Changes on the Progression of Mild Cognitive Impairment or Early Dementia Due to Alzheimer's Disease: A Randomized, Controlled Clinical Trial. Alzheimer's Research & Therapy . June 7, 2024.