Study Highlights the MEND Approach to Reversing Alzheimer's Disease

Some research is hailing the MEND approach as a possible way to treat, and even reverse, the symptoms of Alzheimer's disease.

Person examining a scan of a person's brain with a magnifying glass
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Alzheimer's disease is a progressive condition that affects approximately 5.3 million Americans. Its symptoms include memory loss, confusion, disorientation, and communication problems. Left unchecked, Alzheimer's leads to complete deterioration of both the brain and the body, as well as eventual death.

Unfortunately, several new drugs to treat Alzheimer's disease have been tested over the last decade and thus far have generally failed to make much of a difference in their clinical trials. In fact, the Alzheimer's Association describes Alzheimer's disease as the only one of the top ten causes of death without an effective cure or treatment. Only a handful of medications have been approved by the Food and Drug Administration (FDA) to treat Alzheimer's, and their effectiveness is quite limited.

However, in a study published in June 2016, a team of researchers is reporting that they may be changing that. The study reports significant improvement—to the point that the authors labeled it a "reversal" of symptoms—in persons who had been previously been diagnosed with Alzheimer's or mild cognitive impairment. (Mild cognitive impairment is a condition where some decline in thinking and memory has been detected. It increases the risk that Alzheimer's will develop.) Furthermore, the researchers reported that these cognitive improvements have remained stable while the participants of the study continued to follow the MEND approach.

What Is MEND? Why Might It Work?

MEND is an abbreviation that stands for metabolic enhancement for neurodegeneration. The goal of the MEND approach is to look at many facets of a person's health, rather than seeking a miracle drug that targets just one particular area, such as the amyloid beta protein that builds up and develops plaques in the brains of people with Alzheimer's.

The researchers behind MEND compare their approach to that of other chronic illnesses such as cancer, HIV/AIDS, and cardiovascular disease. Successful treatment of these conditions often involves the development of a cocktail-type of approach consisting of a combination of medications and non-drug interventions that is individualized based on the specific conditions of each person.

Similarly, when we look at what causes Alzheimer's disease, many researchers think it's unlikely that there is one single factor that is responsible. More likely, multiple factors contribute to the development of Alzheimer's and other types of dementia.

Combining multiple factors seems to make sense as well when we look at how several different approaches (such as diet, physical exercise, and mental exercise) have demonstrated some limited success in improving cognitive functioning. If the different approaches are combined, it's possible that a greater level of success in treating Alzheimer's will be achieved since each approach may target a different aspect of what triggers, or contributes to, cognitive decline.

Some of the areas that MEND evaluates and targets include:

The Research Study

Ten participants were involved in this research study. At the start of the study, each of them had a diagnosis of Alzheimer's or mild cognitive impairment. The diagnoses were substantiated by a variety of tests including hippocampal brain volume, MRIs, PET scans, Stroop tests, homocysteine levels, digit span test, auditory memory test, MMSE, reports of subjective memory decline, and word-finding difficulties. The participants were also tested to identify if they were APOE4 gene carriers. The APOE4 gene increases the likelihood that a person will develop Alzheimer's disease, but it does not make it a certainty.

Each of the ten people involved in this study participated in a personalized treatment plan that involved multiple components according to their test results. Some of their directives included increasing their amount of sleep per night, taking melatonin (a natural supplement) to improve sleep, improving their diet to reduce sugar, gluten, meat, and simple grains, and to increase fruits, vegetables, blueberries, and non-farmed fish, fasting prior to sleep at night for at least 3 hours and a total of 12 hours overnight, daily supplements of vitamin D3, C and/or E, daily doses of citicoline, improved dental hygiene, daily doses of coconut oil and curcumin (turmeric), hormone therapy, stress management such as yoga, regular physical exercise, and regular mental exercise.

The Results

Each of the ten people involved in this study experienced significant improvements in their cognition, based both on their own reports and that of their loved ones, as well as the results of cognitive testing. These improvements were such that at the end of the study, most participants didn't meet the criteria for a diagnosis of Alzheimer's or mild cognitive impairment. Additionally, their cognitive functioning has remained stable for up to four years now, which is the longest time one of the individuals has been on this protocol. This maintained improvement is essentially unheard of when discussing the treatment of Alzheimer's disease.

Some examples of the notable improvements in this study include a Mini Mental State Exam (MMSE) score of 23 (which would indicate mild Alzheimer's disease) that improved to a 30 ( a perfect score), a MMSE score of 22 that improved to a 29, and a significant increase in size of the hippocampus in the brain of another one of the participants. The study reported that this person's hippocampal volume began at the 17th percentile and increased to the 75 percentile. This is notable because the hippocampus is an area in the brain that's typically associated with the ability to remember information, and smaller size has been correlated with decreased memory.

Finally, prior to participating in this study, several of the participants were having problems at work or at home related to their cognitive functioning. At the study's conclusion, several had experienced improvement in their ability to function well at work and at home.

A Similar Research Study

In 2014, a similar research study was conducted by Dale E. Bredesen and published in the journal Aging. (Bredesen was one of the authors of the study published in 2016 as well.) The 2014 study also involved 10 participants with Alzheimer's, mild cognitive impairment or subjective cognitive impairment. The MEND protocol was applied to each of these persons, and all but one experienced improved cognition. The tenth person, a gentleman with late stage Alzheimer's disease, continued to decline despite the MEND protocol.

The study's report identified an important and notable change after the MEND protocol was utilized—the ability to successfully work at a job. It pointed out that six of the ten people had either had to quit their jobs or were experiencing significant problems in their work due to their cognitive problems. After their involvement with the MEND approach, all six were able to return to work or experienced notable improved cognitive functioning in their jobs.

The Pros

Clearly, this study's success (and that of the earlier one, as well) in reversing the progression of Alzheimer's disease in its participants is exciting and potentially a large step forward in our efforts to treat, cure, and prevent Alzheimer's disease. Additionally, the idea behind the study of being able to combine the different aspects of what we already know about brain health seems to make sense, especially given the lack of success of other clinical trials of possible treatments.

The Cons

While the results are very encouraging, there are some in the scientific community who are questioning this study as unclear and biased since it is not a double blind research study. A double blind study is where neither the researchers nor the participants, know who is receiving the treatment. It prevents the possibility that the results of the study are influenced by the biases of the researchers, as well as the possibility that the participants are affected by the placebo effect (where they expect to improve and therefore they do).

Some also are critiquing the study because it doesn't explain how the subjects for the study were chosen, and the sample size is very small at only 10. And, when the same cognitive tests are repeated, there is the tendency for the test-takers to improve their performance.

There's also a concern that the researchers are seeking to capitalize on the study's results since the MEND protocol is trademarked and marketed by Muses Labs as an approach for medical providers in which they can achieve their certification and then offer the protocol to their patients.

The researchers involved in this study also caution that the protocol is complex and difficult to follow. Indeed, they point out in the study's description that none of the participants fully followed all of the directives for the MEND protocol.

Finally, it's interesting to note that most of the participants of both of the studies were younger than many who experience Alzheimer's and other types of dementia. That could also raise the question of if the MEND protocol could be effective when applied to persons who are of older age, or if the younger ages of the participants played a role in the success of the MEND approach.

What's Next?

Despite these questions and critiques, the results of this study are encouraging. They highlight the need to re-evaluate our approach to treating Alzheimer's disease, and they also provide hope in an area where success has been very limited.

Continued research in this area with a larger group of participants via a controlled clinical trial is a critical next step to determining the true effectiveness of this approach to Alzheimer's disease.

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  • Bredesen DE, Amos EC, Canick J, et al. Reversal of cognitive decline in Alzheimer's disease. Aging (Albany NY). 2016;8(6):1250-8.

  • Bredesen DE, John V. Next generation therapeutics for Alzheimer's disease. EMBO Mol Med. 2013;5(6):795-8.

  • Bredesen DE. Reversal of cognitive decline: a novel therapeutic program. Aging (Albany NY). 2014;6(9):707-17.

  • Muses Labs. The MEND Protocol.

  • Science Blogs. June 24, 2016. The MEND protocol for Alzheimer’s disease: Functional medicine on steroids? (revisited)

By Esther Heerema, MSW
Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer's disease and other kinds of dementia.