Can Alzheimer’s really be reversed, as a new documentary claims?

Dementia and Alzheimer’s have been the leading killers in the UK for the last ten years, accounting for 11.4% of deaths in 2022. Although new drugs can reduce the disease’s progression, more evidence is emerging that something as simple as integrating a healthy lifestyle can 'reverse' symptoms of Alzheimer’s.

By Rahul Sidhu for The Conversation

Sheffield: Two people diagnosed with Alzheimer’s claim to have conquered the disease through simple lifestyle changes.

Dementia and Alzheimer’s have been the leading killers in the UK for the last ten years, accounting for 11.4 per cent of deaths in 2022. Although new drugs can reduce the disease’s progression, more evidence is emerging that something as simple as integrating a healthy lifestyle can “reverse” symptoms of Alzheimer’s.

Alzheimer’s disease can be split in two subgroups, familial and sporadic. Only 5% of patients with Alzheimer’s are familial, inherited, and 95% of Alzheimer’s patients are sporadic, due to environmental, lifestyle and genetic risk factors. Consequently, the most effective tactic for tackling Alzheimer’s is preventative and living a healthy lifestyle. This has led researchers to study risk factors associated with Alzheimer’s.

Two Alzheimer’s sufferers, Cici Zerbe and Simon Nicholls, claim to have beaten the deadly disease with straightforward lifestyle changes. The pair have detailed their journey in a CNN documentary The Last Alzheimer’s Patient.

Zerbe experienced a reversal of symptoms after participating in a clinical trial in the US. The trial explores the effects of intensive lifestyle changes on mild cognitive impairment or early dementia due to Alzheimer’s disease. The study has not yet been published.

Lifestyle changes include switching to a plant-based diet, regular exercise, group support sessions, yoga and meditation. Zerbe said that she feels “much better” than she did before taking part in the trial five years ago, when she was diagnosed with the disease.

Remarkable improvements

Simon Nicholls, aged 55, is another person with Alzheimer’s who is featured in the CNN documentary and who took part in the trial. Nicholls carries two copies of a gene variant called ApoE4, which is known to significantly increase the risk of Alzheimer’s. However, after adopting healthy lifestyle changes, Nicholls saw remarkable improvements in his symptoms.

About 25 per cent of the population carry at least one copy of the ApoE4 gene variant (called an “allele”) and 5% carry two copies. Carrying one ApoE4 allele is associated with a three to four times increased risk of developing Alzheimer’s. Carrying two copies increases the risk up to 12-fold , rendering it the greatest genetic risk factor for Alzheimer’s.

These statistics amplify the remarkable and noteworthy nature of Nicholls’s achievement in reversing his symptoms of Alzheimer’s simply through his lifestyle choices. His biomarkers for Alzheimer’s disappeared in 14 months, which is considerably more effective than most treatments for Alzheimer’s.

Nicholls highlighted physical activity and dietary changes as paramount to his journey. At first, he was prescribed tirzepatide, a drug designed to suppress appetite by regulating blood sugar levels. He also incorporated regular exercise, including strength training three times a week, walking 10,000 steps daily and jogging or cycling every morning.

Cardiovascular disease is a major risk factor and potential future predictor of Alzheimer’s. The heart-brain connection is crucial for providing brain cells with energy and oxygen through cerebral blood flow. Thus, poor heart health could increase the risk of Alzheimer’s as brain cells receive less energy to function. This explains why Nicholls’s improved heart health and increased cardiovascular activity have improved his symptoms.

He also enforced dietary changes – removing sugar, alcohol and processed foods – and embraced the Mediterranean diet.

The Mediterranean diet is high in antioxidants, which protect brain cells from damage and research suggests the nutrients gained from the diet help maintain memory and cognitive skills. A recent extensive study on 60,000 Britons showed that adhering to a Mediterranean diet decreases the risk of dementia by 23 per cent.

Nicholls has also been implementing good sleep hygiene to try and improve his irregular sleep pattern, as some studies show that sleep deprivation is linked to Alzheimer’s.

The dominant theory is that during sleep toxic proteins, such as amyloid, can be flushed away with the glymphatic system. These would otherwise accumulate and cause dementia. Although, it should be noted that a recent study in mice draws this theory into question.

Scientists from Imperial College London found that clearance of toxins was actually reduced during sleep, suggesting that sleep may reduce dementia risk through other mechanisms currently unknown.

These lifestyle changes had significant effects on Nicholls’s life. In just nine weeks, he lost almost 10kg and 80% of his body fat and reduced his fasting blood sugar levels.

Nicholls and Zerbe arguably did “reverse” their symptoms of Alzheimer’s. This is because conditions such as obesity, hypertension, cardiovascular disease, high cholesterol and insomnia are all risk factors for dementia, and can be modified through a healthy lifestyle.

However, it is important to interpret these findings with caution. These are only results from two people on the trial. Without the specifics of the claimed results, it is difficult to determine whether these lifestyle choices have truly “reversed” the progression of the disease.

The effect of lifestyle on cognition is gaining attention, with more scientists investigating the benefits. Combining the advent of new disease-modifying drugs with strict lifestyle changes may significantly reduce symptoms and the progression of Alzheimer’s.

(Rahul Sidhu is a PhD Candidate in Neuroscience at University of Sheffield)