There's a new clinical trial result showing that Bredesen's approach is able to at least partially cure common forms of Alzheimer-like dementia. (Press release here). It has not received as much attention as it deserves.

The 9 month study seemed a bit less impressive than what I'd hoped for, but the outcomes still support the claim that common forms of dementia are partly curable.

Out of 25 patients, 21 or 19 improved their cognition compared to the start of the trial, depending on which measure I look at, and 2 or 3 declined.

Side effects included occasional improvements in hypertension and diabetes, enough to allow patients to stop taking medications for those conditions.

1.

Compared to my prediction in 2017, the trial happened a bit later than I expected, but achieved much higher patient compliance than I expected. If I had predicted the study size, I'd have likely said something way too optimistic (a thousand?).

The trial registration reports an actual enrollment of 30 patients, whereas the paper reports 28 were recruited, 3 of whom dropped out within 3 months. I don't see any explanation for that difference. For comparison, it looks like Biogen's phase 3 trials had completion rates of less than 60%.

The pandemic started in the middle of the trial, impairing compliance. Exercise seems likely to have been reduced. Two patients showed reversal of their improvement that was attributed to sheltering in moldy homes. The pandemic reportedly hurt patients' diets. I'm unsure what to make of that. Restaurant closures would have reduced access to food that tempts people to cheat - my diet better resembles Bredesen's when I'm cooking at home. But the effect would likely be the opposite for those who don't cook, as I'm guessing they'd eat more junk food.

2.

The study does not report ADAS-Cog results. ADAS-Cog seems to be the usual measure for clinical trials. It may be inappropriate for milder impairment due to ceiling effects - I'm unclear whether that's a reason for them to have avoided it.

They used several measures that seem to be fairly common tests of cognition, and they pre-registered those, so it doesn't look like they ran a lot of tests and selected those that favored the protocol.

3.

Their criteria for excluding people includes statin use, unless eligible to discontinue. Yet they report one patient discontinuing statin use after the treatment apparently improved...

Dementia