Ornish study shows lifestyle changes improved cognition in early Alzheimer’s patients

By Alex Branch, ACLM Director of Communications

A randomized, controlled clinical trial study directed by lifestyle medicine pioneer Dean Ornish, MD, FACLM, founder of the Preventive Medicine Research Institute, demonstrated for the first time that an intensive lifestyle intervention, without drugs, significantly improved cognition and function in many patients with early dementia and Alzheimer’s disease.

The groundbreaking findings were published Friday, June 7 in Alzheimer’s Research and Therapy, the leading peer-reviewed Alzheimer’s translational research journal.

“I’m cautiously optimistic and very encouraged by these findings, which may give many people new hope and new choices,” Dr. Ornish said.  “We do not yet have a cure for Alzheimer’s, 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.”

About the study

For the trial, the research team randomly assigned 51 men and women with a diagnosis of mild cognitive impairment or early dementia due to Alzheimer’s disease to two groups: an intensive lifestyle intervention group with no drugs added or a usual-care control comparison group who were told not to make any lifestyle changes.

The intensive lifestyle program consisted of a whole-food, minimally processed plant-based diet, moderate aerobic exercise and strength training, stress management including meditation, stretching, breathing and imagery, and support groups for patients and their spouses or study partners. Meals were provided to participants and their spouses.

Findings

After 20 weeks, results showed overall statistically significant differences between the intervention group and the randomized control group in cognition and function in three of the four standard tests used in FDA trials, as well as differences of borderline significance in the fourth test. Excluding a mathematical outlier, all four measures showed significant differences in cognition and function in the experimental group.

Of the patients who experienced improvement, many reported regaining lost cognition and function. Specific examples included several patients who previously struggled to read books because they would forget what they just read now being able to finish the book and retain most of the information. Others reported regaining the ability to manage finances.

“Adding to the biological plausibility of the findings was a dose and response correlation between the degree of change in lifestyle and the degree of change in improvement in all four measures of cognitive function,” Dr. Ornish said.

Findings showed 71% of patients in the intervention group improved or were unchanged. None of the patients in the control group improved and 68% worsened.

Regaining sense of self

Dr. Ornish noted that memory loss is such a disruptive occurrence that for some people a diagnosis of Alzheimer’s disease of dementia becomes self-fulfilling. Their world shrinks. They don’t go out for fear of embarrassment or getting lost and they enter a downward spiral.

But one trial participant, a former business executive, reported in the study that he regained the ability to manage his own finances and investment. He was back to reconciling his family’s monthly expenses and, as a result, he said “a lot of self-worth comes back.”

One woman said she had returned to preparing financial reports for her family business, which she had been unable to do for five years. “A deep sense of identity is returning,” she said. “It’s given me a new lease on life, and yet it’s a familiarity and something I’ve always prided myself on.  I’m coming back like I was prior to the disease being diagnosed.  I feel like I’m me again—an older but better version of me.”

Reframing prevention

New artificial intelligence-enabled technology tools are making it possible to predict that someone is likely to get Alzheimer’s disease 10 years before it becomes clinically apparent, Dr. Ornish said. But many people are reluctant to find out because they believe there is nothing they can do about the result.

“Now we have shown you may be able to in many cases reverse the progression of early stage Alzheimer’s disease,” Dr. Ornish said. “The implication for prevention is that the earlier you intervene, the more likely it is to be positive in terms of protection, so the less you need to change in your lifestyle. I think clinicians can reframe their approach and encourage patients to find out if they have a family history.”

For everyone

The study noted that Alzheimer’s disease is the fifth-leading cause of death among Americans aged 65 and older. In addition to its physical and emotional devastation, it is an expensive problem with an annual cost of more than $345 billion. By 2050, costs are projected to skyrocket to $1.1 trillion annually.

“A big obstacle that I struggle with – and that I am sure is familiar to ACLM – is people who hear ‘diet and lifestyle’ and think that is kind of boring; how powerful could that be,” Dr. Ornish said. “They think it has to be high tech and expensive to be powerful. Our unique contribution is to use these state-of-the art, high-tech scientific measures to prove how powerful these simple lifestyle changes can often be.

“I designed this intervention so you don’t have to have a lot of money to do it,” Dr. Ornish said. “This is for everyone.”

For more information visit www.pmri.org and www.ornish.com