Hopeful new research highlights the benefits of a multifaceted lifestyle intervention for those suffering from age-related cognitive decline. In a series of clinical case studies of older adults diagnosed with varying degrees of clinical cognitive impairment researchers tested the feasibility of a multidisciplinary approach to slowing cognitive decline.
The study recently published in the Open BioMedical (OBM) journal Integrative and Complementary Medicine included five patients over the age of 55 with diagnosed clinical cognitive decline ranging from mild cognitive impairment (MCI) to early Alzheimer’s disease, who were treated in a functional medicine setting designed to include a multifaceted intervention.
Researchers examined changes in cognitive skills, brain connectivity, and daily functioning following an anti-neuroinflammatory intervention that included six pillars. Patients adhered to a protocol of 1) physical exercise, 2) mental exercise in the form of cognitive training, 3) a grain-free/sugar-free diet, 4) anti-inflammatory nutritional supplements, 5) sleep optimization, and 6) stress management, all within the context of a functional medicine practice.
Key findings were threefold: Improvement and stability in cognition, improved daily functioning and outlook, and changes in brain connectivity visible on fMRI.
After the nine-month intervention, three of the five patients were no longer classified as cognitively impaired, while a fourth patient improved from moderately-to-severely impaired to just mildly impaired. The fifth patient who entered the study with Stage 2 Alzheimer’s remained stable. Identical neuropsychological assessments were administered to all patients to enable statistical analysis of the outcomes.
Randolph James, MD, of True Life Medicine in Woodland Park, CO, the primary author on the research study, was pleased with patient compliance and results. “When looking at the spectrum of age-related cognitive decline, an intervention that maintains cognitive stability is certainly a win,” he said. “To see improvements with this functional medicine and brain-training approach is remarkable and encouraging indeed.”
The intervention was an adaptation of the Bredesen Protocol, a novel multifaceted approach to reversing Alzheimer’s disease by targeting inflammation. However, the study expanded on these research protocols by including structured cognitive training delivered by clinicians in scheduled clinic appointments.
“We wanted to increase compliance to this critical pillar of the intervention by adding the human delivery element. We weren’t convinced that computer games could provide the intensity, complexity, and motivation required to drive neuroplasticity, so we opted for human-delivered cognitive training,” said cognitive psychologist Amy Moore, PhD, with Gibson Institute of Cognitive Research. “It paid off. Patients were 100% compliant with this aspect of the intervention.”
The current study also used functional magnetic resonance imaging (fMRI) to compare pre and post resting state functional connectivity for the group of patients. The comprehensive fMRI analyses revealed changes in the brain that suggest improved efficiency, as well as changes in network connectivity that directly correlated with changes on neuropsychological tests.
“The MRI findings were indeed exciting,” said neuroscientist Christina Ledbetter, PhD, of LSU Health Science Center. “Not only that we could use functional MRI to detect changes in connections between regions of interest in the brain, but also that those changes directly correlated with changes on dementia assessments.”
Patients also reported improved memory, attention, mental clarity, as well as increased energy, better mood, and improved outlook on life. Family members commented on recovery of basic life-skills such as remembering appointments, personal responsibility, engagement in conversation, and improved relationships.
“Quality-of-life improvements are perhaps the most impactful outcomes for these patients,” said qualitative researcher Terissa Miller, MS Psy, with Gibson Institute of Cognitive Research. “Improved test scores and neurological changes are exciting, but patients and family members dealing with age-related cognitive decline are hoping to enhance daily functioning. This multi-faceted intervention delivered that hope!”
Terissa Michele Miller, MS Psy
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