A year ago, a 65-year-old man came to see me, with well documented early Alzheimer’s disease: ApoE 4/3, +amyloid PET, +FDG-PET, abnormal neuropsych testing, having difficulty at work, + family history (both parents died with dementia), and his MRI showed that his hippocampi had atrophied to 17th percentile for his age. This hippocampal atrophy is an important prognostic sign, and indicates that his prognosis was not good.
He has now been on the MEND program for one year, and he has done very well (except when he went off for a few weeks and had an episode in which he left the car running in the driveway). His function is much better, he is back working full time and doing very well, and his biochemistry is very good.
I asked him to get follow-ups on the imaging studies so that we could see where things stand with his amyloid, brain utilization of glucose, etc. He argued with me and said there is no way that his atrophied hippocampus could show improvement—brains don’t grow back, he argued. But I told him that there has been some evidence of modest improvement in non-Alzheimer’s patients with exercise, so we should see if we could even keep him from the natural history of further reduction below the 17th percentile. He just found out that his hippocampus is now at the 75th percentile for his age. He could not believe it, and asked the MRI technician if there was some fluke; the technician said he could not explain it, and it was no fluke.
We’ll see what his other follow-up tests show; however, the dramatic improvement in hippocampal volume—the very thing lost in AD—is further support that what we are doing is working very well. [Emphaisis mine]
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