A related question to this discussion that we are trying to answer: whether in the absence of neurodegeneration and other brain diseases, age-related cognitive decline occurs! Such an obvious thing, but we do not have any answer for it yet!
How can we work with and around aging-related cognitive decline?
An important question would be – is the age-related cognitive decline we’re seeing really part of the “aging” process, or an accumulation of environmental factors? Elucidating why the trend is getting worse and seen in younger and younger people is essential. See Alzheimer’s Striking Younger People but Action Now Reverses Trend of Dementia Symptoms
The work of Dr. Dale Bredesen is one of the most important one around reversing dementia and Alzheimer’s, in my opinion. He identified 36 factors including lifestyle, micronutrients and many more which can reverse AD in patients. See https://www.ahnphealth.com/dr-bredesen.html Still early but very promising.
Finally, we need to study the root causes of brain dysfunction, on a physical level. Are environmental toxins partially to blame? Accumulation of waste, biological debris and heavy metals? What about the brain’s main clearance system called the glymphatic system, which has been discovered in 2015 and might be underworking and preventing normal brain detoxification?
A lot more science needs to be done about root causes, although an approach which clears out brain plaque might also be a good idea.
@NickPineault - absolutely.
@NickPineault How would you design a study to look at a disease’s root causes? It’d be tricky to identify people to study, for example, if they are only just at the beginning stages of a disease, and may not know themselves that they are a good candidate–for several years even, depending on the disease…
@SamBlake I’m not a scientist so study design is not my area of expertise. I think that fundamental studies looking at what makes a brain healthy VS unhealthy are important. The many root causes of brain dysfunction can be identified by looking at their mechanisms – how they increase inflammation, contribute to the creation of plaque, etc.
I think that we need to get away from the very myopic view that one drug will fix all of our problems. Dr. Dale Bredesen’s approach and doctors who practice functional medicine are getting closer to a real “cure” to Alzheimer’s than pharmaceutical approaches.
Designing observational or clinical trials is achievable. What is difficult, is finding questions and interventions that can be rigorously examined and can further our understanding of cognitive interventions in ageing. For example, speed of processing (SP) is an important ability underlying most higher cognitive faculties including memory and executive functions. Can we improve SP? Well, there are different methods including a billion $ market of computerized training that claim they can! Does such training get translated into actual daily living activities? So far, the answer is NO SURE! Is it because of the way computerized trainings are designed or because one can not teach an old dog a new trick? Or, do we need more than training the brain on a tablet for such interventions to be effective? The research is not conclusive, so far! So, one important aspect that has been overlooked in such research, when designing lifestyle, psychological or cognitive exercises of any sort, is how much they resemble real life circumstances (ecological validity, as neuropsychs call it).
On Bredesen’s approach, my understanding is that it is based on good science but is not scientifically proven! We donot know whether Bredesen’s approach works and if it does, it is better than other approaches! So far we have only seen anecdotal evidence for it that may not prove much!