A groundbreaking clinical trial has revealed that an intensive lifestyle intervention could positively affect the progression of mild cognitive impairment (MCI) or early dementia caused by Alzheimer's disease (AD). The study, conducted by Ornish et al. and published in Alzheimer’s Research & Therapy, marks the first randomized, controlled trial to examine the potential benefits of extensive changes in diet, exercise, stress management, and social support on Alzheimer’s progression.

The trial involved 51 participants aged 45-90, diagnosed with MCI or early dementia due to AD, with an average age of 73.5 years. Half of the group underwent a 20-week intensive lifestyle program, while the control group continued with their usual care. The program included a diet low in harmful fats and refined sugars, moderate exercise, stress management techniques, and participation in support groups.

After 20 weeks, the intervention group showed significant improvement in cognition and function as measured by various tests. Notably, there were significant differences in Clinical Global Impression of Change (CGIC) (p=0.001), Clinical Dementia Rating–Sum of Boxes (CDR-SB) (p=0.032), and Clinical Dementia Rating Global (CDR-G) (p=0.037) tests, with borderline significance in the Alzheimer’s Disease Assessment Scale (ADAS-Cog) test (p=0.053).

Surprisingly, plasma biomarkers, specifically the Aβ42/40 ratio, which is strongly associated with AD diagnosis, improved in the intervention group and worsened in the control group, further confirming the diagnosis. Moreover, adherence to the program correlated with the degree of benefit seen in cognitive function and plasma biomarkers.

This research suggests intensive lifestyle changes might significantly improve cognition and function in patients with MCI or early dementia due to AD. However, the study’s small size and short duration, along with its limited ethnic diversity, mean further research is needed to confirm these findings and their generalizability.

The authors of the study, including Dean Ornish and colleagues, call for larger and longer-term clinical trials to determine whether these intensive lifestyle changes could offer a viable treatment pathway for Alzheimer’s disease.

For more detailed information, the full study can be accessed at https://doi.org/10.1186/s13195-024-01482-z.

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Jeff Caba, DHSc, PA-C.

Jeff brings to Buoy over 20 years of clinical experience as a physician assistant in urgent care and internal medicine. He also has extensive experience in healthcare administration, most recently as developer and director of an urgent care center. While completing his doctorate in Health Sciences at A.T. Still University, Jeff studied population health, healthcare systems, and evidence-based medi...

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References

Ornish, D., Madison, C., Kivipelto, M., Kemp, C., McCulloch, C. E., Galasko, D., ... & Arnold, S. E. (2024). 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, 16, Article 122. https://doi.org/10.1186/s13195-024-01482-z