Can Lifestyle Changes Reverse Early-Stage Alzheimer's Disease

NCT ID: NCT04606420

Last Updated: 2022-09-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

51 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-08

Study Completion Date

2023-09-30

Brief Summary

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The objective of this study is to determine if comprehensive lifestyle changes may slow, stop, or reverse the progression of early-stage Alzheimer's disease.

Detailed Description

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51 patients who have early Alzheimer's disease (MoCA above 17) in the San Francisco Bay area were enrolled over time and are randomly assigned to one of two groups.

After baseline testing, the first group then receives this lifestyle medicine program for 20 weeks, four hours/day, three days/week (all done virtually via Zoom since March 2020 due to COVID-19).

The second group will not receive the lifestyle program for 20 weeks and will serve as a randomized control group during this phase of the study.

Both groups will be re-tested after 20 weeks.

Then, the second group will "cross over" and receive this lifestyle medicine program for 20 weeks and the first group will continue the lifestyle program for 20 additional weeks. After a total of 40 weeks, both groups will be re-tested again and compared. Those initially randomly assigned to the control group will receive the intervention for 40 weeks and then be re-tested at that time.

Conditions

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Alzheimer Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

In this randomized crossover design, 51 patients with early Alzheimer's disease were randomly-assigned to one of two groups. After baseline testing, the first group receives the lifestyle program for 20 weeks (via Zoom since 2/20 due to COVID-19). The second group does not and is a randomized control group during this phase. Both groups are re-tested after 20 weeks. Then, the second group "crosses over" and receives this program for 20 weeks and the first group continues the program for 20 additional weeks. After 40 weeks, both groups are re-tested again. Patients initially randomly assigned to the control group will receive the intervention for a total of 40 weeks and then be re-tested.

Due to challenges in recruiting patients, including Covid-19, we recently terminated recruitment after 51 patients were recruited. This decision was based on recruitment and funding issues, without review of any of the data. This trial will continue until all 51 patients have completed it.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Since this is a behavioral intervention, it is not possible to blind the participant and the care provider from whether or not they are receiving the intervention. However, everyone involved in testing patients (Outcome Assessors) is blinded to group assignment.

Study Groups

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Experimental (Intervention) Group

These patients will receive the comprehensive lifestyle medicine intervention from day 1 through the end of the study. They will be tested at baseline, after 20 weeks, and after 40 weeks.

Group Type EXPERIMENTAL

Lifestyle medicine

Intervention Type BEHAVIORAL

Diet: A low fat (10-15%) whole foods vegan diet, high in complex carbs and low in refined carbs (fruits, vegetables, whole grains, legumes, soy, seeds \& nuts). Calories unrestricted. Multivitamin, fish oil, curcumin, vitamin C, B12, CoQ10, lion's mane, probiotic, and magnesium. 21 meals/week and supplements provided to participants and caregivers at no cost to them.

Exercise: Aerobic (e.g., walking) and strength training 30 minutes/day based on a personalized prescription from an exercise physiologist or certified personal trainer and registered nurse.

Stress Management: Meditation, gentle yoga-based poses, progressive relaxation, breathing exercises, and meditation (with optional glasses) 1 hour per day, supervised by a certified stress management specialist.

Group Support: Participants and their spouses/caregivers participate in a support group one hour/session, 3 days/week, supervised by a licensed mental health professional in a supportive, safe environment.

Control (Non-Intervention) Group

These patients will be asked to continue their current diet and lifestyle without making any changes for 20 weeks. They will be tested at baseline and after 20 weeks. Then, they will "cross over" and receive the same lifestyle medicine intervention for 20 weeks and will be tested again after 20 weeks of the intervention and also after 40 weeks of the intervention. After 20 weeks in the randomized control group, patients who no longer meet these eligibility criteria (e.g, a MoCA score \<18) will not cross over and will not receive the lifestyle intervention; their data during the first 20 weeks in the control group (when they met the entry criteria) will be used.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Lifestyle medicine

Diet: A low fat (10-15%) whole foods vegan diet, high in complex carbs and low in refined carbs (fruits, vegetables, whole grains, legumes, soy, seeds \& nuts). Calories unrestricted. Multivitamin, fish oil, curcumin, vitamin C, B12, CoQ10, lion's mane, probiotic, and magnesium. 21 meals/week and supplements provided to participants and caregivers at no cost to them.

Exercise: Aerobic (e.g., walking) and strength training 30 minutes/day based on a personalized prescription from an exercise physiologist or certified personal trainer and registered nurse.

Stress Management: Meditation, gentle yoga-based poses, progressive relaxation, breathing exercises, and meditation (with optional glasses) 1 hour per day, supervised by a certified stress management specialist.

Group Support: Participants and their spouses/caregivers participate in a support group one hour/session, 3 days/week, supervised by a licensed mental health professional in a supportive, safe environment.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Current diagnosis of mild dementia or mild cognitive impairment due to Alzheimer's disease/process (McKhann and Albert criteria), with MoCA score above 17 (i.e., 18 or higher)
* Willingness and ability to participate in all aspects of the intervention
* Availability of spouse or caregiver who can provide collateral information and assist with study adherence

Exclusion Criteria

* severe dementia
* physical disability that precludes regular exercise
* clear evidence for other causes of neurodegeneration or dementia, e.g., severe cerebrovascular disease, Parkinson's disease
* significant ongoing psychiatric or substance abuse problems
Minimum Eligible Age

45 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, San Francisco

OTHER

Sponsor Role collaborator

Harvard Medical School (HMS and HSDM)

OTHER

Sponsor Role collaborator

University of California, San Diego

OTHER

Sponsor Role collaborator

The Cleveland Clinic

OTHER

Sponsor Role collaborator

Renown Health

OTHER

Sponsor Role collaborator

Preventive Medicine Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dean Ornish, MD

Role: PRINCIPAL_INVESTIGATOR

President, Preventive Med Res Inst; Clinical Prof Medicine UCSF

Catherine Madison, MD

Role: STUDY_DIRECTOR

Chief Neurologist, Preventive Medicine Research Institute

Rudolph E Tanzi, PhD

Role: STUDY_DIRECTOR

Co-Director, McCance Center for Brain Health, Harvard Medical School/Mass General Hospital

Steven E. Arnold, MD

Role: STUDY_DIRECTOR

Director, Alzheimer's Clinical and Translational Research Unit, Harvard Medical School/Mass General Hospital

Jonathan Rosand, MD

Role: STUDY_DIRECTOR

Kistler Endowed Chair in Neurology, Harvard Medical School/Mass General Hospital

Douglas Galasko, MD

Role: STUDY_DIRECTOR

Professor of Neurology, University of California, San Diego

David A Sinclair, PhD

Role: STUDY_DIRECTOR

Co-Director, Paul Glenn Labs for the Biology of Aging, Harvard Medical School

Jonathan Artz, MD

Role: STUDY_DIRECTOR

Renown Health Institute of Neurosciences

Locations

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University of California, San Diego

San Diego, California, United States

Site Status

Preventive Medicine Research Institute

Sausalito, California, United States

Site Status

McCance Center for Brain Health, Harvard Medical School/Mass General Hospital

Boston, Massachusetts, United States

Site Status

Renown Health Institute of Neurosciences

Reno, Nevada, United States

Site Status

Countries

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United States

References

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Other Identifiers

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20172897

Identifier Type: -

Identifier Source: org_study_id

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