A 69 year old entrepreneur and professional man presented with 11 years of slowly progressive memory loss, which had accelerated over the past one or two years. At age 58, he had been unable to recall the combination of the lock on his locker, and he felt that this was out of the ordinary for him. At age 59, a FDG-PET brain scan was reported as showing early Alzheimer's Disease, with reduced glucose utilisation in the parietotemporal cortices bilaterally and left > right temporal lobes, but preserved utilisation in the frontal lobes, occipital cortices, and basal ganglia. At age 58, 62 and 68, he had quantitative neuropsychological testing, which showed a reduction in CVLT (California Verbal Learning Test) from the 84 percentile to the 1 percentile, a Stroop colour test at 16 percentile, and auditory delayed memory at 13 percentile. He was heterozygous for apoE4 (3/4). He noted that he had progressive difficulty recognising the faces at work, and had to have his assistants prompt him with the daily schedule. He also recalled an event in which he was several chapters into a book before he realised that it was a book he had previously read. In addition, he lost an ability he had had for most of his life: to add columns of numbers rapidly in his head.
He began Dr Dale Bredesen's program, and after six months, his wife, co-workers, and he all noted improvement. He lost 10 pounds. He was able to recognise faces at work, was able to remember his daily schedule, and was able to function at work without difficulty. He was also noted to be quicker with his responses. His life-long ability to add numbers rapidly in his head, which he had lost during his progressive cognitive decline, returned. His wife pointed out that, although he had clearly shown improvement, the more striking effect was that he had been accelerating in his decline over the prior year or two, and that this had been completely halted.
After 22 months on the program, he returned for followup quantitative neuropsychological improvement: his CVLT-IIB increased from 3rd percentile to 84th percentile (3 standard deviations), total recognised hits from < 1st percentile to 50th percentile. CVLT-II from 54th percentile to 96th percentile, auditory delayed memory from 13th to 79th percentile, reverse digit span from 24th to 74th percentile, and processing speed from 93rd to 98th percentile. His business, which had been in the process of termination, was reinvigorated, and a new site was added to the previous sites of operation.
Reversal of Cognitive Decline: A novel therapeutic program. Dale E. Bredesen. Aging, September 2014, Vol 6 N 9.
69 yr old Entrepreneur
A 74 yo attorney presented with a five year history of memory loss and word finding difficulty. His family history was positive for dementia in his mother, beginning at the age of 75 years. He had been evaluated at an Alzheimer's disease centre at the onset of his memory loss, and was found to be ApoE 4/4, with MRI showing ventricular enlargement and temporal lobe atrophy, right > left, and FDG-PET showing reduced glucose utilisation in the temporal lobes and the precuneus, compatible with Alzheimer's Disease. Neuropsychological testing was compatible with a diagnosis of amnestic MCI. He was treated with donepezil, memantine and intravenous immunoglobulin, and his MMSE fell from 27 to 23 over three years. He noted no improvement with the treatment.
He began the program, and after six months, his MMSE was 29. He returned three months later, and his MMSE was 30. He then returned three months after that, complaining that he had taken a trip, gone off much of the protocol, come under stress, and that he felt his memory had declined. His MMSE had decreased to 28. Over the ensuing 12 months on the program, his MMSE remained at 30.
Reversal of Cognitive Decline in Alzheimer's Disease. Dale E. Bredesen et al. Aging, June 2016, Vol 8 N 6.
A 68 yo business executive presented with a five year history of progressive memory loss, forcing him to retire from his company. He had difficulty navigating while driving. Amyloid PET imaging was positive. His ApoE genotype was 3/4.
After six months on the programme, his BMI improved from 27.7 to 24.6, and his HbA1c improved from 5.9 to 5.7%. Both he and his family noted improvement in memory and navigation. His improvement was documented by on-line neuropsychological testing which showed increase from 0 (baseline) to 2221, which represented 52nd percentile for his age.
Reversal of cognitive decline in Alzheimer's Disease. Bredesen D. et al. Aging, June 2016, Vol 8 No 6
74 yr old Attorney
68 yr old Executive
Alzheimer's Disease Case Studies
The following case studies describe patients treated by Professor Bredesen (Professor of Neurology, University of California, Los Angeles) and were published in the peer reviewed medical literature. The Hart Clinic's dementia program is based on Professor Bredesen's protocol.