The Fastest Way to Get Alzheimer’s (Most People Do This Daily) | Dr. Dale Bredesen

1. RCDr. Rangan Chatterjee0:00

   In your latest book, The Ageless Brain, you write something that I think some people will regard as a little bit provocative. Okay?

2. DBDr. Dale Bredesen0:10

   Yeah.

3. RCDr. Rangan Chatterjee0:10

   You write this, "I've often noted that everyone knows a cancer survivor, but no one knows an Alzheimer's one. But let me tell you a secret, I do. In fact, I know many of them."

4. DBDr. Dale Bredesen0:26

   Yeah. Not only do I know many of them, um, they have started their own group. Um, and in fact, there is a group called the Alzheimer's Survivor Foundation, which is a nonprofit, which is, uh, putting the word out. These are people who themselves have survived, improved their cognition, and sustained the improvement. The first patient I treated was in 2012. She's still doing well. She's just turned 81, and she's actually walking from the Pacific Ocean to the Atlantic Ocean to raise awareness that cognitive decline can be improved, and she's actually about two-thirds of the way. She's currently in Louisiana. She expects to hit the Atlantic Ocean in November. A truly remarkable woman. Uh, but there are many others now. Uh, and these people have another group, which is a support group, so that they can continue on the overall protocol, continue to optimize things. And you know, as you well know, with functional medicine, we see things that haven't been seen before. Reversing diabetes, people who have lupus. Our own daughter had early lupus and had -- no longer has lupus. She turned out to have a very leaky gut and had reasons for her autoimmunity, which are no longer present. Um, we see people improve in their cardiovascular status, uh, and so forth and so on. And so the problem is when you see this paradigm shift in diseases that we all as physicians were taught were untreatable or poorly treatable, it, it is difficult because you have to say, "Look, here's what we're actually seeing." And yet the doctors who haven't seen it yet understandably are skeptical. So there's been a lot of skepticism even while data are being published. We have, uh, two different proof of concept trials that have been published, one from our group, one from another group, and now we're just finishing up a randomized controlled trial at six sites around the US and we already-- because we've got 95% of the data in already, we can already calculate the treatment effect in that group and compared to the control group. So we have a huge treatment effect, which is actually 8.5 times the effect of the US POINTER trial, 6.5 times the effect of Leqembi, and 3.5 times the effect of Kisunla. So this is far better than anything that has been looked at and published previously. And yes, you're going to have people be skeptical until they see it for themselves.

5. RCDr. Rangan Chatterjee3:07

   Yeah. Dale, you mentioned a lot there, including the new research that's coming out.

6. DBDr. Dale Bredesen3:12

   Yes.

7. RCDr. Rangan Chatterjee3:13

   And we're, we're gonna try and get through to everything in this conversation, but I wanna take things step by step. So let's just kind of break this down from the top, okay?

8. DBDr. Dale Bredesen3:23

   Yeah.

9. RCDr. Rangan Chatterjee3:24

   So for many years, Dale, it has been assumed that Alzheimer's is, for many people, an inevitable part of aging, and also-

10. DBDr. Dale Bredesen3:37

    Mm-hmm

11. RCDr. Rangan Chatterjee3:37

    ... if and when it happens, there's nothing you can do about it. Okay? So that's a belief that I still think unfortunately exists out there, um, and you're saying that's simply not true, right?

12. DBDr. Dale Bredesen3:52

    Exactly, yes. And in fact, as we now understand this better, we can see exactly why that has happened. And, and let me just state for one moment that part of the problem here is when you wait for the dementia phase, which is the fourth and final phase, of course it's more difficult. It's, it's as if you said, "We're not gonna call it cancer until it's widely spread throughout your body. Okay, what do we do to cure cancer?" Well, the best thing we can do to cure cancer is to prevent it to begin with or treat it very early on. So when you develop Alzheimer's disease, you go through four phases, and Alzheimer's is a pathology. The first phase, you're entirely asymptomatic, and you can already begin to pick up markers, biochemical markers such as phosphotal, that will tell you, yes, you're in the early throes of this, just like you would pick up insulin resistance as you're headed for type 2 diabetes. Same idea. The second phase is called SCI, subjective cognitive impairment, and that lasts on average ten years. What that means is you know that something's not quite right, but you're still able to pass the normal cognitive test. You still score well on cognitive testing. The third phase is MCI, mild cognitive impairment, where by definition, you're now scoring abnormally on cognitive tests, but you still are able to perform your activities of daily living, so you don't have dementia yet. The fourth and final phase is dementia. Nobody should wait that long anymore. We have fantastic early tests. We have the ability to reverse the cognitive decline, especially in the early stages. No surprise, the more you wait, the more difficult and less complete the outcome tends to be. But we do have people now, as I mentioned earlier, uh, who are, you know, 13 years. We started in, uh, 2012, so 13 and a half years is the, the first patient, um, and she's still doing very, very well. Now, she didn't wait until she was in late stage dementia, thankfully, and the ones that we are improving in our trial are in the MCI and early dementia phase, very much the same as in the drug trials.

13. RCDr. Rangan Chatterjee6:07

    Yeah, this is, this is, this is amazing, Dale. Right? So you mentioned these four phases, okay? So-I just wanna make sure we've landed this point. So people who listen to my show regularly will know this idea that in modern medicine we tend to get involved quite late. We often wait for-

14. DBDr. Dale Bredesen6:25

    Yeah

15. RCDr. Rangan Chatterjee6:25

    ... symptoms and disease before we start treating you. Type 2 diabetes being a classic example whereby you may have been living with insulin resistance for maybe 10 years before you get a diagnosis, but we, we say, "Oh, your tests are normal, your labs are normal," until your HbA1c, the average marker of your blood sugar, tips into the diabetic range. At that point we say, "Hey, you've got type 2 diabetes, let's treat you." So I think listeners to my show are familiar with that concept, and what you're now saying, Dale, is that Alzheimer's dementia follows the same type of process, right? And actually we're getting involved in stage four, but actually you're saying your work is helping people in stage three and early stage four. But what's really exciting is that there are these two stages before that, asymptomatic and then subjective cognitive impairment, which lasts up to 10 years, that second phase, right?

16. DBDr. Dale Bredesen7:31

    Yeah.

17. RCDr. Rangan Chatterjee7:32

    What a window of opportunity. So let's just go back to, to stage one then. Asymptomatic. Because I think a lot of people aren't even aware of this. How on earth can we pick things up in stage one?

18. DBDr. Dale Bredesen7:46

    Yeah. So there are a number of ways now. You can pick it up with abnormal blood testing now. A- as you know, just within this past year, phospho-tau, Abeta 42 to 40 ratio, GFAP and NfL have emerged as simple blood-based biomarkers. So I had mine checked just a couple of months ago at my kitchen table. You can get your blood drawn very simply and see whether you have this. We, we have a set of tests we call, we call Brain Scan, but it's a, a simple idea. You can get phospho-tau at many, many different laboratories and there are some very sensitive ones, um, that can look to see, "Okay, Rangan, are you in the earliest stages or not?" And you know, people say, "Well, I don't wanna hear the A word. I don't want to know where I stand." But this is no different than knowing that you've got early insulin resistance, and down the road you could develop type 2 diabetes. The earlier you find out, the better. Now secondly, you can also have a spinal tap. That's been known for years, but who wants a spinal tap and do, do that every few years? You could also do a PET scan, an amyloid PET scan or an FDG PET scan or a tau PET scan, any of those. Uh, you can also do something called ASL. This is a MRI approach, arterial spin labeling, which is very sensitive. We're looking at slight changes in blood flow in specific regions of the brain that correlate with Alzheimer's disease. So there are lots of ways for people to find, and the easiest is the blood-based biomarkers. And my argument, and I mention it in the book, every five years, check your markers just like you'd check for insulin resistance. Don't allow yourself to get to that fourth phase. And I should mention, in the first two phases, we don't see people, when we treat those, we don't see people progress. They do well. So the people who are asymptomatic, we've never had someone treated optimally who then goes on to develop dementia.

19. RCDr. Rangan Chatterjee9:43

    Yeah.

20. DBDr. Dale Bredesen9:43

    With SCI, virtually 100% of these people improve and stay improved. So again, early, it's the, that's the key.

21. RCDr. Rangan Chatterjee9:52

    This is really exciting. Okay. So, Dale, one of the other prevailing ideas out there, and it was certainly there when I was at medical school, or certainly as a junior doctor, the school of thought was there's no point checking because if you find out you've got the genes that increase your risk of dementia, what on earth are you gonna do about it? So instead of living with that weight behind you your entire life, why not enjoy your life and actually-

22. DBDr. Dale Bredesen10:20

    Yeah

23. RCDr. Rangan Chatterjee10:20

    ... get the best out of life that you can before fate delivers its, you know, its harsh blow or however you wanna look at it. But essentially what you're saying is that belief system is there because people think and thought that you can't do anything about it. If you change that belief, if suddenly it's like, wait a minute, there is so many things we can do. A lot of them are quite simple actually. We'll get to all of the practical things shortly.

24. DBDr. Dale Bredesen10:51

    Mm.

25. RCDr. Rangan Chatterjee10:51

    If you know that there are things that you can do about it, well, the early testing then has huge value because if you're starting to move up that continuum-

26. DBDr. Dale Bredesen11:01

    Yeah

27. RCDr. Rangan Chatterjee11:01

    ... you can do something about it. You can go, "Wait a minute, I'm not gonna wait 30 years now until I get Alzheimer's like my mom or like my auntie or my uncle," whatever it might be, it's, it could be the extra bit of motivation someone needs in their 30s and 40s to start making changes to their lifestyle.

28. DBDr. Dale Bredesen11:19

    That's exactly right, and that is, I think, one of the most important points because just what you said, because there has been nothing that can be done, and the belief by many is that that's still the case. Everything has been backward, and so this is what we are trying to fix. They say, "Don't check your genetics because nothing can be done. Don't check to see where you stand. Don't check to see until late. If you've got problems, it's probably not Alzheimer's. If it gets worse, come in." And I've seen so many people went into the doctor year after year and they said, "Well, you're not that bad yet. Come back next year." And then finally they come back and say, "Well, now, yes, you are bad, and there's nothing we can do about it." This is really sad to see, and it no longer has to be the case. So now we need to change everything. Yes, you need to check your genetics. Everybody should know their genetics if they're 35 years of age or older.Yes, you should check your status. What is your p-tau? What is your Aβ42 to 40 ratio if you're 35 years or over? And I recommend checking it every five years so that you can see things coming. You know, I've said to my wife, who, who's a huge fan of yours, uh, Dr. Lachine, uh, I've said to her, "You know, uh, Alzheimer's is becoming optional. If you just check it early, if you just look, you don't have to allow this to progress until that third and fourth phase." And she says, "No, that's too radical. You cannot say that." Well, the reality, that's what the data show. If we check early, if we use the appropriate tests, if we get on the appropriate therapeutic, uh, early on, um, there's no need to progress to that final stage of dementia. And that is what doctors have not recognized yet, have not admitted yet, despite the fact that, in fact, publication after publication is showing exactly that. Just as things like, well, look what Pap smear did for cervical cancer, from a highly, a, a disease with high morbidity and mortality to a disease with very little morbidity and mortality. That's what's happened. Look what happened with pre-diabetes. The same thing is now happening with cognitive decline, and we need to recognize that and act on it.

29. RCDr. Rangan Chatterjee13:34

    Yeah. It's ... I'm just trying to think through this issue and really trying to get my head round why there is such a difference between where the scientific literature is and where current clinical practice is, because that gap is widening all the time, Dale. It's, it's really frustrating on many levels, isn't it?

30. DBDr. Dale Bredesen14:02

    It's very frustrating. I, I completely agree with you. Now, as you know, Rangan, we, we've now trained over 2,000 physicians in 10 different countries and all over the U.S. and yet the standard of care does not include this approach, and therefore, there are many people who are declining needlessly. Now, when we've looked at our clinical trials, in our first trial, 84% of people improved, and that's even at the stage three and early stage four, as I mentioned earlier. Um, in general practice, we're finding it's more like 50%. Of course, the, the more you've got people who are really up to snuff, the g- more you've got a wonderfully trained team, the better your outcomes are, and of course, the earlier you start.

Episode duration: 2:00:37