{"id":1012,"date":"2024-05-20T11:39:31","date_gmt":"2024-05-20T11:39:31","guid":{"rendered":"https:\/\/retirednurseblog.com\/index.php\/2024\/05\/20\/signs-of-alzheimers-were-everywhere-then-his-brain-improved\/"},"modified":"2024-05-20T11:39:31","modified_gmt":"2024-05-20T11:39:31","slug":"signs-of-alzheimers-were-everywhere-then-his-brain-improved","status":"publish","type":"post","link":"https:\/\/retirednurseblog.com\/index.php\/2024\/05\/20\/signs-of-alzheimers-were-everywhere-then-his-brain-improved\/","title":{"rendered":"Signs of Alzheimer\u2019s were everywhere. Then his brain improved"},"content":{"rendered":"
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Preventive neurologist Dr Richard Isaacson stared at the numbers on the fax in astonishment. Blood biomarkers of telltale signs of early Alzheimer\u2019s disease in the brain of his patient, 55-year-old entrepreneur Simon Nicholls, had all but disappeared in a mere 14 months. <\/p>\n

\u201cI had to catch my breath. It was a complete shock: The blood tests on his brain had normalized,\u201d said Isaacson, director of research at the Institute for Neurodegenerative Diseases in Boca Raton, Florida. <\/p>\n

Was this stunning result the work of some new miracle drug designed to combat dementia? Not at all. This is a story of old-fashioned grit and determination. <\/p>\n

\u201cSimon was on a mission, as if the Grim Reaper was peering over his shoulder. He was going to kick ass and take names,\u201d Isaacson said. <\/p>\n

Nicholls reduced his risk of developing Alzheimer\u2019s via lifestyle changes recommended by Isaacson, including diet, exercise, reducing stress and optimizing sleep, along with a few strategically chosen supplements and medications prescribed by his cardiologist. <\/p>\n

\u201cI have a 3-year-old son and an 8-year-old <\/strong>son. It\u2019s really important for me, as I get older, to try and be there for them in the future,\u201d he said. \u201cThere are many [changes] in lifestyle you can do to hopefully push the disease backwards and give yourself more time, which is all we need until we find a cure.\u201d <\/p>\n

Unlucky genes<\/h3>\n

When it came to genetics and dementia, Nicholls had drawn the short straw. He carried two copies of the APOE4 gene, one from each parent, which may increase the risk of developing Alzheimer\u2019s at least tenfold. <\/p>\n

\u201cSadly, my mum passed away from what we think is Alzheimer\u2019s in her 70s,\u201d Nicholls said. \u201cFor the last 10 years of her life, she just sat in a chair, rocking, while on about 14 medications. I\u2019d much rather have a longer health span and then just go quickly.\u201d <\/p>\n

Not everyone with one or even two copies of APOE4 <\/strong>develops Alzheimer\u2019s, however, creating a tantalizing opportunity. Can a person diminish their genetic risk for Alzheimer\u2019s via lifestyle and various medical interventions, especially if started early, before too much damage is done? <\/p>\n

Isaacson, who also has a family history of Alzheimer\u2019s, believes the answer is yes. He began the first US clinic devoted to Alzheimer\u2019s prevention in New York City in 2013 before moving his program to Florida in 2021. His research has shown that following a dozen or more lifestyle interventions, when practiced 60% or more of the time, can improve cognitive function, especially in women. <\/p>\n

Today, scientists around the world are also investigating the impact on cognition of such lifestyle changes as a healthy plant-based diet,\u00a0stress reduction,\u00a0strength training, aerobic exercise and quality sleep habits \u2014 behaviors that Isaacson and his team outlined in a recent review\u00a0<\/strong>published in Nature. <\/p>\n

\u201cI don\u2019t use the term \u2018reverse.\u2019 I don\u2019t know what reverse means when it comes to the field of Alzheimer\u2019s,\u201d Isaacson said. \u201cBut the results we\u2019ve seen with Simon and some other patients in our research are extremely exciting.\u201d <\/p>\n

How the heart and the brain are intertwined<\/h3>\n

Alzheimer\u2019s isn\u2019t the only pathway to a life of dwindling memory and the inability to think, plan and interact with loved ones. <\/p>\n

Vascular dementia, the second most common type of dementia after Alzheimer\u2019s disease, can be caused by atherosclerosis, a buildup of plaque in the arteries that can lead to heart attacks, stroke, blood clots and more, all of which can further damage the body and brain. <\/p>\n

Poor hearts and their consequences can run rampant in a family over generations, a fact Nicholls knew all too well. <\/p>\n

\u201cMy whole family had endless heart attacks, resulting in my grandfather on my mother\u2019s side dying around age 50,\u201d he said. \u201cMy mother had three heart attacks, the first at age 50, then a triple bypass before she went on to develop dementia.\u201d <\/p>\n

Carrying an APOE4 gene further increases the risk for heart disease as well as dementia, experts say. <\/p>\n

\u201cMy sister had three heart attacks, and when I was 40, I was told that I had atherosclerosis, with a ridiculously massive coronary artery calcium score of like 1,500 and occlusions in about 96% of my arteries.\u201d A normal coronary artery calcium score is zero. <\/p>\n

For a man in the prime of his life, the news was crushing. Doctors tried to use lifestyle changes and statins to reverse the plaque buildup but finally resorted to surgery, opening three of Nicholls\u2019 arteries with stents. He also began using an injectable drug called evolocumab, designed to boost the liver\u2019s ability to remove \u201cbad\u201d \u00a0low-density lipoprotein, or LDL, from the body. <\/p>\n

\u2018It was time to turn to my brain\u2019<\/h3>\n

Slowly, Nicholls\u2019 heart condition began to improve, but the bad news didn\u2019t end there. A brain scan found telltale signs of vascular damage in Nicholls\u2019 brain, which occurs when the tiniest blood vessels are starved of oxygen. <\/p>\n

\u201cThe doctors said I had too many white matter lesions.\u00a0I told myself that since I now had my heart more or less under control, it was time to turn to my brain,\u201d Nicholls said. <\/p>\n

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<\/span>video <\/div>\n<\/p>\n<\/div>\n

Related video<\/span> A new potential Alzheimer\u2019s test can find symptoms before they begin to show<\/span> <\/p>\n<\/p>\n<\/div>\n

In January 2023, Nicholls became participant No. 34 in a novel clinical trial at Isaacson\u2019s Florida center. The trial is designed to uncover cognitive risk factors and counter them with a personalized plan of attack. (Full disclosure: I am participant No. 20 in the same trial; you can read about my experience here.) <\/p>\n

\u201cThe overall goal of the study is democratize access to preventive neurology care by eventually using at-home blood testing to cost-effectively reach the most people,\u201d Isaacson said. <\/p>\n

As part of the trial, Nicholls underwent a battery of tests, including a unique blood test that can track levels of amyloid, tau\u00a0and other\u00a0<\/strong>hallmark biomarkers for Alzheimer\u2019s disease and other degenerative conditions. Deposits of amyloid can begin accumulating in the brain decades before symptoms begin,\u00a0even in a person\u2019s 30s and 40s. <\/p>\n

\u201cSimon\u2019s first test came back with a score of 70. Anything over 58 was positive for amyloid in the brain,\u201d Isaacson said.\u00a0\u201cThe results backed up the amyloid PET scan Simon had taken in 2019, where I could see the plaque in his brain.\u201d <\/p>\n

10,000 steps a day: \u2018I\u2019m very consistent\u2019<\/h3>\n

Nicholls needed to loose weight, so he began taking tirzepatide (the active ingredient in the medications Mounjaro and Zepbound), one of the newer injectable drugs that suppress appetite by stimulating hormones that control blood sugar levels. <\/p>\n

At the same time, Nicholls was encouraged to step up his physical activity by incorporating strength training three times a week while adding 45 to 60 minutes a day of zone 2 exercise, in which you briskly walk, ruck, jog or cycle at 60% to 70% of your heart rate. <\/p>\n

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Related article<\/span> Gait speed is one of your vital signs, so make sure yours is OK<\/span> <\/p>\n<\/p>\n<\/div>\n

\u201cI love going for a walk every morning at sunrise for an hour and a half with a podcast. I get in 10,000 steps or more every day. I\u2019m very consistent,\u201d Nicholls said. \u201cI also do a very slow full-body workout with weights three times a week for an hour\u2019s time.\u201d <\/p>\n

Avoiding sugar, artificial sweeteners, alcohol and ultraprocessed foods is a must, as is following a plant-based meal plan such as the Mediterranean diet. <\/p>\n

\u201cWhen I first saw Simon, he had a bit of a middle, like most guys in their 50s,\u201d Isaacson said. \u201cWhen I saw him at nine weeks, I did a double take. He was totally buff, ripped even. <\/p>\n

\u201cWithin those nine weeks, he had lost 21 pounds, about 80% of that fat, and put on muscle, which was excellent,\u201d Isaacson added. \u201cI almost didn\u2019t recognize him.\u201d <\/p>\n

The weight loss and increased muscle mass lowered Nicholls\u2019 fasting blood sugar levels, ending his march toward diabetes, while some tweaks to his cholesterol medications further optimized his good and bad cholesterol numbers. <\/p>\n

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Related article<\/span> Certain vegetarian diets significantly reduce risk of cancer, heart disease and death, study says<\/span> <\/p>\n<\/p>\n<\/div>\n

In August 2023, it was time to repeat the blood test for amyloid. By then, the company that administers the tests had added a measurement for tau, another key hallmark sign of Alzheimer\u2019s, frontal lobe dementia and Lewy body disease. <\/p>\n

\u201cSimon\u2019s amyloid probability score on the new APS2 test had dropped to 53, which was phenomenal,\u201d Isaacson said. \u201cBut he was still positive, as anything between 48 and 100 is considered to reflect a high probability of amyloid brain plaques on a brain scan.\u201d <\/p>\n

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Within six months, Nicholls had dropped the levels of amyloid in his blood from 70 to 53.<\/span> <\/div>
CNN\/Dr. Richard Isaacson<\/figcaption><\/div>\n<\/p>\n<\/div>\n

\u2018Turn on the screws\u2019<\/h3>\n

Now that the big concerns of cholesterol, insulin, diet, exercise and fat mass were addressed, it was time \u201cto turn on the screws,\u201d Isaacson said, with personalized recommendations based on Nicholls\u2019 biology. <\/p>\n

\u201cWe optimized Simon\u2019s omega-3 fatty acid levels, which is especially important for people with APOE \u03b5<\/em>4, as they need more omega-3. We also added B complex vitamins to control elevated homocysteine in his blood,\u201d Isaacson said. \u201cHowever, we would not give B complex vitamins to anyone who did not have higher homocysteine levels.\u201d <\/p>\n

Elevated homocysteine, which is an amino acid used by the body to make protein, is a risk factor for brain atrophy, cognitive impairment and dementia. A September 2010 randomized controlled trial found that supplementation slowed brain atrophy in people with mild cognitive impairment. <\/p>\n

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Related article<\/span> Should I take supplements to help me sleep? A doctor explains<\/span> <\/p>\n<\/p>\n<\/div>\n

In the meantime, Nicholls, an avid researcher who loves to read medical journals, was adding some interventions of his own. <\/p>\n

\u201cI have steam and sauna rooms in my home, I do a lot of that. I love it,\u201d he said. \u201cI\u2019ve tried cold water plunges, and I have lists of things to do I get from podcasts, from walking to sleeping to gratitude to yoga to sleep routines. <\/p>\n

\u201cBut there\u2019s one thing I do that Dr. Isaacson doesn\u2019t agree with: I get stem cell injections twice a year,\u201d Nicholls added. \u201cSadly, I have arthritis in my hands, and that definitely feels better when I use stem cells, and I like to think they may be helping my brain, as well.\u201d <\/p>\n

There was one more big issue to tackle: Nicholls\u2019 sleep, or lack of it, which studies have shown can hasten cognitive decline and Alzheimer\u2019s. <\/p>\n

With business around the world, Nicholls is a frequent flyer with \u201cterrible sleep\u201d due to jet lag and insomnia.\u00a0\u201cI\u2019m also a worrier type of person,\u201d he confessed. <\/p>\n

Adding a sleep medication approved for insomnia helped, \u201cbut Simon really needs to tackle his sleep by improving his sleep hygiene with a more regular sleep schedule,\u201d Isaacson said. <\/p>\n

An unbelievable result<\/h3>\n

On Halloween 2023, the next APS2 score arrived. Amazingly, Nicholls had reduced the amount of amyloid and tau in his blood to 40: He was testing negative in blood for signs of Alzheimer\u2019s. <\/p>\n

Shocked and amazed, Isaacson remained skeptical. \u201cI was very cautious. You know, promise not to overpromise. I needed to retest.\u201d <\/p>\n

A few days before Christmas, the repeat test results arrived. When it too was a negative finding of 40, Isaacson decided to tell Nicholls in person. <\/p>\n

\u201cDr. Isaacson drove all the way from Boca Raton to Miami excited, very happy,\u201d Nicholls said. \u201cWe walked on a beach together, and we were ecstatic that we\u2019d actually been able go from positive to negative for amyloid.\u201d <\/p>\n

Although Nicholls is ecstatic about the improvements, he\u2019s also very humble about his efforts to improve his health. <\/p>\n

\u201cI\u2019m really not all that compliant. To comply is just horrendously difficult, right? Of course I want to have a beer or a hamburger or something stupid. I love gummy bears and eating crappy food,\u201d he said. <\/p>\n

\u201cIt\u2019s helped that I have some great doctors to help me, but to be honest, my biggest motivator are my children,\u201d Nicholls added. \u201cI\u2019d love to see my sons get married and have their own kids, and to do that, I have to put in the work to stay the way I am now.\u201d <\/p>\n

Even lower amyloid levels and a larger hippocampus<\/h3>\n

It appears Nicholls is well on his way toward that goal. In March, his APS2 score had dropped to 25, an unbelievably low number. <\/p>\n

Not only was Nicholls blood negative for amyloid and tau, the test suggested that his brain amyloid might be normal, with no distinguishable signs of the disease. The only way to definitively prove this, however, would be to repeat his amyloid PET scan, Isaacson said. <\/p>\n

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<\/div>\n
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Simon Nicholls’ March blood tests showed that his brain had continued to improve.<\/span> <\/div>
CNN\/Dr. Richard Isaacson<\/figcaption><\/div>\n<\/p>\n<\/div>\n

\u201cWhat really drove his score down was the amyloid value,\u201d Isaacson said. \u201cIt normalized at .101, which is like crazy good. That\u2019s not matter for discussion; for amyloid, .1 or above is normal.\u201d <\/p>\n

Even more startling: Brain volume scans showed that the hippocampus, the tiny seahorse-shaped organ responsible for memory, had actually grown in volume in Nicholls\u2019 brain since he started the intervention. <\/p>\n

In early Alzheimer\u2019s stages, the hippocampus loses tissue rapidly and then atrophies as the disease progresses. <\/p>\n

Despite these amazing outcomes, Isaacson remains cautious. After all, this is one person, and similar findings have not been been replicated in a larger, more controlled sample and published in a peer-reviewed journal. <\/p>\n

\u201cI don\u2019t believe in the term \u2018reverse\u2019 because I don\u2019t know what will happen if the person stops doing the intervention,\u201d Isaacson said. \u201cI also don\u2019t know if the brain might normalize for a short period of time and then, five years later, catch up. Until I have more data, I don\u2019t think that reverse is the right word.\u201d <\/p>\n

That doesn\u2019t stop his wonder at the results and his gratitude to Nicholls for his continuing dedication to the study and the personalized interventions. <\/p>\n

\u201cI still can\u2019t believe it. I\u2019d seen this before, but only in people who are taking anti-amyloid medications,\u201d Isaacson said. \u201cWhen you work your entire career and are told by everyone, \u2018It\u2019s not possible to do this,\u2019 and then you see it \u2014 well, I\u2019m still humbled and amazed.\u201d <\/p>\n

Alzheimer\u2019s and brain health resources<\/h3>\n
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  • Want to learn more about brain health? Visit Isaacson\u2019s\u00a0free online course.<\/li>\n
  • Consider joining Isaacson\u2019s latest online clinical trial, designed to provide cognitive assessments and personalized advice via smartphones. People over 21 who meet certain criteria can sign up for the study at\u00a0Retain Your Brain.<\/li>\n
  • The National Institute on Aging\u00a0<\/strong>currently supports nearly\u00a0500 active clinical trials\u00a0on Alzheimer\u2019s disease and related dementias. For information,\u00a0go here.<\/li>\n
  • The\u00a0Alzheimer\u2019s Association\u00a0is looking for individuals living with Alzheimer\u2019s, their caregivers and those without cognitive decline to\u00a0volunteer for clinical trials.<\/li>\n<\/ul>\n<\/div>\n
    This post appeared first on cnn.com<\/div>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"

    Preventive neurologist Dr Richard Isaacson stared at the numbers on the fax in astonishment. Blood biomarkers of telltale signs of early Alzheimer\u2019s disease in the brain of his patient, 55-year-old entrepreneur Simon Nicholls, had all but disappeared in a mere 14 months. \u201cI had to catch my breath. It was a complete shock: The blood …<\/p>\n","protected":false},"author":1,"featured_media":1013,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"loftocean_post_primary_category":0,"loftocean_post_format_gallery":"","loftocean_post_format_gallery_ids":"","loftocean_post_format_gallery_urls":"","loftocean_post_format_video_id":0,"loftocean_post_format_video_url":"","loftocean_post_format_video_type":"","loftocean_post_format_video":"","loftocean_post_format_audio_type":"","loftocean_post_format_audio_url":"","loftocean_post_format_audio_id":0,"loftocean_post_format_audio":"","loftocean-featured-post":"","loftocean-like-count":0,"loftocean-view-count":620,"tinysalt_single_post_intro_label":"","tinysalt_single_post_intro_description":"","tinysalt_hide_post_featured_image":"","tinysalt_post_featured_media_position":"","tinysalt_single_site_header_source":"","tinysalt_single_custom_site_header":"0","tinysalt_single_custom_sticky_site_header":"0","tinysalt_single_custom_sticky_site_header_style":"sticky-scroll-up","tinysalt_single_site_footer_source":"","tinysalt_single_custom_site_footer":"0","footnotes":""},"categories":[35],"tags":[],"class_list":["post-1012","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-news"],"_links":{"self":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts\/1012","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/comments?post=1012"}],"version-history":[{"count":0,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/posts\/1012\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/media\/1013"}],"wp:attachment":[{"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/media?parent=1012"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/categories?post=1012"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/retirednurseblog.com\/index.php\/wp-json\/wp\/v2\/tags?post=1012"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}