In September 2014, researchers from the University of California reported the development of the MEND protocol, short for Metabolic Enhancement for Neurodegeneration. MEND was designed to combine the results of multiple studies to create a comprehensive set of guidelines for enhancing cognitive function in elderly adults. The program was also intended to be personalized to each patient based on his or her lifestyle and medical history. The MEND protocol includes the following guidelines, among many others:
- Eat a diet rich in high-antioxidant foods, such as blueberries and kidney beans, and anti-inflammatory foods, such as tumeric and salmon.
- Minimize or eliminate simple carbohydrates, such as white bread and pasta, as well as foods with a high glycemic index, which are quickly digested and cause blood sugar spikes.
- Fast for 12 hours each night, including at least 3 hours before bedtime. For example, if you typically eat breakfast at 7am, you should not eat anything after 7pm the previous night.
- Reduce stress through yoga, meditation, or other methods.
- Get 8 hours of sleep every night. Seek treatment for insomnia or sleep apnea. (See: How Sleep “Cleans” Your Brain and Fends Off Alzheimer’s)
- Maintain healthy digestion using prebiotics and probiotics. (See: Probiotics May Improve Cognitive Function and Alzheimer’s Disease)
- Optimize oral hygiene through regular, thorough brushing and flossing. (See: How Oral Hygiene Protect Your Brain from Dementia)
A small clinical trial was created to test the effects of the MEND program on cognitive function. Ten middle-aged or elderly adults with Alzheimer’s disease or other forms of cognitive impairment worked with the researchers to develop personalized plans based on MEND’s guidelines. Most of the subjects and their families began noticing improvement within three to six months of starting the program, and several were able to return to work after previously having to discontinue. Though promising, the evidence of this study was short-term and anecdotal, requiring confirmation by additional data.
The study published this month reports on follow-up exams of the original ten subjects after following the MEND protocol for between 5 and 24 months. The researchers used MRI scans as well as neuropsychological testing to evaluate the subjects’ cognitive function. For two of the subjects, the results were dramatic. The volume of one patient’s hippocampus (the part of the brain most associated with memory) went from the 17th to the 75th percentile after following the program for only 10 months. Another patient with diagnosed Alzheimer’s disease experienced substantial improvement on cognitive exams after 22 months on the program, even moving from the 3rd to the 84th percentile on one of the tests. Though the changes observed in the other eight subjects were more modest, all ten subjects showed some level of improved cognition during the follow-up exams, and none of them experienced any cognitive decline. Additionally, most of the subjects had at least one copy of the APOE4 allele, a strong genetic risk factor for Alzheimer’s, demonstrating that we may be able to combat the effects of our genes through healthy lifestyle choices (see The Genetics of Alzheimer’s Disease).
Due to the very small sample size, larger trials need to be conducted before broad conclusions can be drawn. It also remains to be seen whether this cognitive improvement is permanent or temporary. However, these results give new hope to the prospect of reversing cognitive decline, which previously was deemed impossible for people already experiencing cognitive impairment. If you or a loved one is noticing memory troubles or has been diagnosed with dementia, consider implementing some of the MEND guidelines to possibly reverse the effects of cognitive decline. For more details on reducing your Alzheimer’s risk, see How to Reduce Your Dementia Risk in 2018.