This story springs from a published paper on 10 case studies of patients who followed a program to reverse memory loss associated with Alzheimer’s disease.
To its credit, the story does note significant limitations with the study and quotes an independent source who casts some cold water on the findings.
But, the story was problematic on several fronts. Most importantly, it contains several errors. For example, it incorrectly states that all 10 patients showed brain scan improvements after following the therapy; in fact just one patient met that benchmark. And it skipped any mention of costs, potential harms, conflicts of interest, or funding sources.
Overall, it follows a tired formula of teasing readers with hopeful statements about a potential cure, only to conclude with the caveat that more study is needed to determine whether the idea will actually work.
No effective medications are available to stop the progress of Alzheimer’s disease, which is expected to affect 13.8 million by the year 2050, barring medical breakthroughs to prevent or cure it, according to the Alzheimer’s Association.
The enormous human and financial toll of this condition could explain interest in this tiny study, which reported “unprecedented” improvement in a handful of patients with mild symptoms who followed an extensive individualized protocol of 36 dietary, sleep, hormonal, exercise-related and other interventions, dubbed “metabolic enhancement for neurodegeneration,” or MEND.
As we stated in our recent review of a news release on the study from the Buck Institute for Research on Aging, there’s evidence that non-drug interventions that are designed to fight inflammation and improve blood sugar regulation like those in the MEND program could be effective. However, the MEND treatment protocol involves so many factors it may be difficult to determine which ones are effective.
The story doesn’t discuss costs. Although the MEND protocol appears to involve many inexpensive interventions, such as reducing processed carbohydrates, practicing yoga, and taking over-the-counter supplements such as melatonin, those expenses aren’t within the reach of millions of Americans. Moreover, the costs of hormones and supplements as well as health coaches to guide patients through the individualized program would be significant. The story also does not mention that the researchers recommend widespread genetic testing to determine risk for Alzheimer’s, which comes at a cost, too.
In its attempt to quantify the benefits, the story wrongly says 10 patients who were experiencing age-related memory decline showed brain scan improvements after following the MEND program for 5 to 24 months. It gives an “example” of one patient whose MRI showed hippocampal volume increase from the 17th to the 75th percentile for his age during 10 months in the program. In fact, just one patient showed improvement in a brain scan, according to the study. Six of the patients demonstrated improvements in memory tests, and three showed only self-reported improvements in cognitive function.
The story does not mention any potential risks of any aspect of the protocol. It does say that MEND “requires the use of supplements which are not well studied and do not require FDA approval.” It does not mention what supplements these are and what risk they might present.
Also, the authors of the study suggest testing for the APOE gene, and that those with a certain gene variance be treated with this protocol. The majority of those with the variance, though, will not get Alzheimer’s, so this is potential overtreatment and exposure to harms for little-to-no benefit. Several of the 10 people in the study did not complete the protocol, and some of that might have been due to adverse effects, but that was not mentioned.
The story does not give readers enough detail to establish the quality of the research method used.
Most importantly, the story should have cautioned readers early in the story that large clinical trials are needed to prove with statistical significance that this approach actually works, and if so, how long results can be maintained.
Instead, the story mentions these important caveats only at the very end, and it left out other downfalls of the research, such as the fact that many of the improvements in this tiny patient group were based on self-reported data, which is subject to bias. There’s also the reality that it would be difficult to perform a rigorous clinical trial on this protocol since it’s reportedly tailored to each patient and involves 36 potential interventions.
The story does tell us that “none of the patients were able to stick to the entire protocol. The significant diet and lifestyle changes, and multiple pills required each day, were the two most common complaints.”
There’s no exaggeration of the seriousness of Alzheimer’s. However, the story should have been more careful in its wording. Calling a cure for Alzheimer’s “the holy grail in disease research” isn’t accurate. There are plenty of horrible illnesses for which cures are being actively sought.
The story does include an independent source, Florida Atlantic University professor James E. Galvin, M.D., M.P.H., who’s quoting saying that personalized approaches are promising, but more study is needed. “Not all things from the (MEND) approach have a lot of scientific support behind them,” he says in the story.
But, the story does not describe funding sources, which include the National Institutes of Health (NIH) and the Accelerate Fund, an early-stage investment fund based in Canada. As we reported in our earlier news release review, lead researcher Bredesen also apparently stands to benefit from sales of a book set to be released in May 2017 through a mainstream book publisher.
The story does not mention alternatives. But many interventions, including drugs, have been tried to reverse memory loss and none have been found to work, so we’ll rate this as N/A.
The story quotes Bredesen saying “his team has a couple of larger trials planned to confirm or refute the results in the current study and to address key questions about how long results can be maintained and how late in the course of cognitive decline reversal is possible.”
But the story could have served readers better if it had pressed Bredesen for specifics about when these trials might occur. The complexity of the protocol, the expense and time involved and questions about insurance coverage all make availability a very key question.
The story does not provide enough context about this intervention’s novelty–besides the one 2014 study mentioned, what else has been tried that uses this approach? We don’t get a sense of where this concept fits into the larger research effort.
Because an independent sources was included, the story does not appear to rely solely on a news release. However, it does cite the news release directly.
Systematic, Criteria-Driven
We’ve written about the hype of liquid biopsies for years (see link in comment below). And now this…. https://www.statnews.com/2022/01/12/medicare-shouldnt-cover-liquid-biopsies-early-cancer-detection/
Case counts still matter. “(There) are stories that may not be told adequately if only hospitalizations and deaths are emphasized.” @garyschwitzer interviewed by @dbauder of @AP. https://apnews.com/article/omicron-changing-news-outlets-covid-data-da9272f7c4c8a109c3bfb56bed9e9c76
My friend Gary @garyschwitzer wrote to his city council representative in a Minnesota town about a Viva Las Vegas event scheduled for January.
The response he got seems to perfectly capture where we are now.
https://www.healthnewsreview.org/2021/12/2021-ends-with-covid-craziness-in-sports-and-politics/
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like