![]() However, after five months, he discontinued the majority of the program for approximately three weeks. He noted that his work came more easily to him. He began the MEND protocol, lost 18 pounds, and after three months his wife reported that his memory had improved. His hs-CRP was 9.9mg/l, albumin: globulin ratio was 1.6, homocysteine 15.1μmol/l, fasting glucose 96mg/dl, hemoglobin A1c 5.5%, fasting insulin 32mIU/l, 25-hydroxychole-calciferol 21ng/ml, TSH 2.21mIU/l, and testosterone 264ng/dl. His neuropsychological testing was compatible with a diagnosis of MCI. An MRI showed hippocampal volume at only 17 th percentile for his age. He was an ApoE4 heterozygote (3/4), his amyloid PET scan was markedly positive, and his fluorodeoxyglucose (FDG) PET scan showed temporoparietal reduced glucose utilization indicative of Alzheimer's disease. There was a positive family history of dementia in both parents. The results also support the need for a large-scale, personalized clinical trial using this protocol.Ī 66-year-old professional man presented with what he described as “senior moments” (for example, forgetting where his keys were or forgetting appointments) of two-years duration, and difficulty performing his work. The results provide further support for the suggestion that such a comprehensive approach to treat early Alzheimer's disease and its precursors, MCI and SCI, is effective. The initial results for these patients show greater improvements than have been reported for other patients treated for Alzheimer's disease. After 22 months on the MEND protocol, he showed marked improvement in his neuropsychological testing, with some improvements reaching three standard deviations from his earlier testing. Another patient had well documented early Alzheimer's disease, with a positive FDG-PET scan and markedly abnormal neuro-psychological testing. One patient had well documented mild cognitive impairment (MCI), with a strongly positive amyloid-PET (positron emission tomography) scan, positive FDG-PET scan (fluorodeoxyglucose PET scan), abnormal neuropsychological testing, and hippocampal volume reduced to 17th percentile after 10 months on the MEND protocol, his hippocampal volume had increased to 75th percentile, in association with a reversal of cognitive decline. Here we report the initial follow-up of ten patients who were treated with this metabolic programmatics approach. reorganization, and progressive in that continued optimization is sought through iterative treatment and metabolic characterization. The approach is personalized, responsive to suboptimal metabolic parameters that reflect a network imbalance in synaptic establishment and maintenance vs. This treatment is based on connectomic studies and previous transgenic findings as well as epidemiological studies of various monotherapeutic components of the overall program. Įffective treatment of Alzheimer's disease has been lacking, but recently a novel programmatic approach involving metabolic enhancement was described, with promising anecdotal results. There are approximately 5.2 million Americans with AD, but this estimate ignores the many young Americans destined to develop AD during their lifetimes: given the lifetime risk of approximately 15% when including all ApoE genotypes, as many as 45 million of the 318 million Americans now living may develop AD during their lifetimes if no prevention is instituted. These results have far-reaching implications for the treatment of Alzheimer's disease, MCI, and SCI for personalized programs that may enhance pharmaceutical efficacy and for personal identification of ApoE genotype.Īlzheimer's disease is now the third leading cause of death in the United States, following only cardio-vascular disease and cancer. The magnitude of the improvement is unprecedented, providing additional objective evidence that this programmatic approach to cognitive decline is highly effective. Here we report the results from quantitative MRI and neuropsychological testing in ten patients with cognitive decline, nine ApoE4+ (five homozygous and four heterozygous) and one ApoE4−, who were treated with the MEND protocol for 5-24 months. The patients, their spouses, and their co-workers all reported clear improvements. Patients who had had to discontinue work were able to return to work, and those struggling at work were able to improve their performance. The therapeutic approach used was programmatic and personalized rather than monotherapeutic and invariant, and was dubbed metabolic enhancement for neurodegeneration (MEND). Recently, the first description of the reversal of cognitive decline in patients with early Alzheimer's disease or its precursors, MCI (mild cognitive impairment) and SCI (subjective cognitive impairment), was published. Alzheimer's disease is one of the most significant healthcare problems nationally and globally. ![]()
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