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MEND is UCLA's 25-step personalized program to reverse memory loss. Nine of 10 participants displayed significant memory improvements. Learn how. Includes a chart summing-up the 25 steps.

MEND is a novel, personalized and comprehensive program to reverse memory loss. In a recent MEND study, nine of 10 participants displayed subjective or objective improvement in their memories, beginning within three to six months after the program's start. Of the six patients who had to discontinue working or were struggling with their jobs at the time they joined the study, all were able to return to work or continue working with improved performance.

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Improvements have been sustained, and as of this writing, the longest patient follow-up is two and one-half years from initial treatment. These first ten included patients with memory loss associated with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), or subjective cognitive impairment (SCI; when a patient reports cognitive problems). One patient, diagnosed with late stage Alzheimer's, did not improve.

MEND: 25-Step Memory Program

Goal	Approach	Notes
Optimize diet: minimize simple carbohydrates, minimize inflammation.	Patients given choice of several low glycemic, low inflammatory, low grain diets.	Minimize inflammation, minimize insulin resistance.
Enhance autophagy, ketogenesis	Fast 12 hr each night, including 3 hr prior to bedtime.	Reduce insulin levels, reduce Aβ.
Reduce stress	Personalized—yoga or meditation or music, etc.	Reduction of cortisol, CRF, stress axis.
Optimize sleep	8 hr sleep per night; melatonin 0.5mg po qhs; Trp 500mg po 3x/wk if awakening. Exclude sleep apnea.
Exercise	30-60' per day, 4-6 days/wk
Brain stimulation	Posit or related
Homocysteine <7 font="">	Me-B12, MTHF, P5P; TMG if necessary
Serum B12 >500	Me-B12
CRP <1 .0="" a="">1.5	Anti-inflammatory diet; curcumin; DHA/EPA; optimize hygiene	Critical role of inflammation in AD
Fasting insulin <7 font="" hgba1c="">	Diet as above	Type II diabetes-AD relationship
Hormone balance	Optimize fT3, fT4, E2, T, progesterone, pregnenolone, cortisol
GI health	Repair if needed; prebiotics and probiotics	Avoid inflammation, autoimmunity
Reduction of Aβ	Curcumin, Ashwagandha
Cognitive enhancement	Bacopa monniera, MgT
25OH-D3 = 50-100ng/ml	Vitamins D3, K2
Increase NGF	H. erinaceus or ALCAR
Provide synaptic structural components	Citicoline, DHA
Optimize antioxidants	Mixed tocopherols and tocotrienols, Se, blueberries, NAC, ascorbate, α-lipoic acid
Optimize Zn:fCu ratio	Depends on values obtained
Ensure nocturnal oxygenation	Exclude or treat sleep apnea
Optimize mitochondrial function	CoQ or ubiquinol, α-lipoic acid, PQQ, NAC, ALCAR, Se, Zn, resveratrol, ascorbate, thiamine
Increase focus	Pantothenic acid	Acetylcholine synthesis requirement
Increase SirT1 function	Resveratrol
Exclude heavy metal toxicity	Evaluate Hg, Pb, Cd; chelate if indicated	CNS effects of heavy metals
MCT effects	Coconut oil or Axona

KEY:
Hg, mercury; Pb, lead; Cd, cadmium; MCT, medium chain triglycerides; PQQ, polyquinoline quinone; NAC, N-acetyl cysteine; CoQ, coenzyme Q; ALCAR, acetyl-L-carnitine; DHA, docosahexaenoic acid; MgT, magnesium threonate; fT3, free triiodothyronine; fT4, free thyroxine; E2, estradiol; T, testosterone; Me-B12, methylcobalamin; MTHF, methyltetrahydrofolate; P5P, pyridoxal-5-phosphate; TMG, trimethylglycine; Trp, tryptophan

Encouraging Findings

The study, which comes jointly from the UCLA Mary S. Easton Center for Alzheimer's Disease Research and the Buck Institute for Research on Aging, is the first to suggest that memory loss in patients may be reversed, and improvement sustained, using a complex therapeutic program that involves comprehensive changes in diet, brain stimulation, exercise, optimization of sleep, specific pharmaceuticals and vitamins, and multiple additional steps that affect brain chemistry.

The findings, published in the current online edition of the journal Aging, "are very encouraging. However, at the current time the results are anecdotal, and therefore a more extensive, controlled clinical trial is warranted," said Dale Bredesen, the Augustus Rose Professor of Neurology and Director of the Easton Center at UCLA, a professor at the Buck Institute, and the author of the paper.

In the case of Alzheimer's disease, Bredesen notes, there is not one drug that has been developed that stops or even slows the disease's progression, and drugs have only had modest effects on symptoms. "In the past decade alone, hundreds of clinical trials have been conducted for Alzheimer's at an aggregate cost of over a billion dollars, without success," he said.

Combination Therapy

Other chronic illnesses such as cardiovascular disease, cancer, and HIV, have been improved through the use of combination therapies, he noted. Yet in the case of Alzheimer's and other memory disorders, comprehensive combination therapies have not been explored. Yet over the past few decades, genetic and biochemical research has revealed an extensive network of molecular interactions involved in AD pathogenesis. "That suggested that a broader-based therapeutics approach, rather than a single drug that aims at a single target, may be feasible and potentially more effective for the treatment of cognitive decline due to Alzheimer's," said Bredesen.

While extensive preclinical studies from numerous laboratories have identified single pathogenetic targets for potential intervention, in human studies, such single target therapeutic approaches have not borne out. But, said Bredesen, it's possible addressing multiple targets within the network underlying Alzheimer's may be successful even when each target is affected in a relatively modest way. "In other words," he said, "the effects of the various targets may be additive, or even synergistic."

Given this, Bredesen thought that rather than a single targeted agent, the solution might be a systems type approach, the kind that is in line with the approach taken with other chronic illnesses -- a multiple-component system.

"The existing Alzheimer's drugs affect a single target, but Alzheimer's disease is more complex. Imagine having a roof with 36 holes in it, and your drug patched one hole very well -- the drug may have worked, a single "hole" may have been fixed, but you still have 35 other leaks, and so the underlying process may not be affected much."

“The shift to applying a broad combination therapy to Alzheimer’s is a crucial turning point towards effectively treating Alzheimer’s disease,” says Dr. Marwan N. Sabbagh, Research Professor of Neurology at the University of Arizona College of Medicine in Phoenix

Personalized Approach

Bredesen's approach is personalized to the patient, based on extensive testing to determine what is affecting the plasticity signaling network of the brain. As one example, in the case of the patient with a demanding job who was forgetting her way home, her therapeutic program consisted of some, but not all of the components involved with Bredesen's therapeutic program, and included:

(1) eliminating all simple carbohydrates, leading to a weight loss of 20 pounds;
(2) eliminating gluten and processed food from her diet, with increased vegetables, fruits, and non-farmed fish;
(3) to reduce stress, she began yoga;
(4) as a second measure to reduce the stress of her job, she began to meditate for 20 minutes twice per day;
(5) she took melatonin each night;
(6) she increased her sleep from 4-5 hours per night to 7-8 hours per night;
(7) she took methylcobalamin each day;
(8) she took vitamin D3 each day;
(9) fish oil each day;
(10) CoQ10 each day;
(11) she optimized her oral hygiene using an electric flosser and electric toothbrush;
(12) following discussion with her primary care provider, she reinstated hormone replacement therapy that had been discontinued;
(13) she fasted for a minimum of 12 hours between dinner and breakfast, and for a minimum of three hours between dinner and bedtime;
(14) she exercised for a minimum of 30 minutes, 4-6 days per week.

Pluses & Minuses

The results for nine of the 10 patients reported in the paper suggest that memory loss may be reversed, and improvement sustained with this therapeutic program, said Bredesen. "This is the first successful demonstration," he noted, but he cautioned that the results are anecdotal, and therefore a more extensive, controlled clinical trial is needed. "The current, anecdotal results require a larger trial, not only to confirm or refute the results reported here, but also to address key questions raised, such as the degree of improvement that can be achieved routinely, how late in the course of cognitive decline reversal can be effected, whether such an approach may be effective in patients with familial Alzheimer's disease, and last, how long improvement can be sustained," he said.

The downside to this program is its complexity. It is not easy to follow, with the burden falling on the patients and caregivers, and none of the patients were able to stick to the entire protocol.

On the other hand, the fact that there was such great memory improvement in so many patients shows that this is not an all-or-nothing program. Even doing some of the program's steps was enough to improve memory.

Even better, said Bredesen, are the program's side effects: "It is noteworthy that the major side effect of this therapeutic system is improved health and an optimal body mass index, a stark contrast to the side effects of many drugs."

Big Trial, Rapid Results

Muses Labs will soon launch a two-year observational study to conduct a large-scale trial of the MEND program. The trial will include 200+ participants with Alzheimer's disease, at selected medical facilities across the country.

Says Muses Labs’ CEO Vik Chandra, “Muses Labs intends to utilize the Internet and recent technology innovations to make personalized combination therapy practical and accessible to every individual with Alzheimer’s disease around the world.”

As the therapy does not rely upon new drugs, but rather an innovative combination of existing pharma and broader-based therapeutics, wider availability is only a couple of years away.

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