I think they should be used in combination because they are complementary to each other. Lifestyle interventions are very effective in increasing blood flow in the brain, things like exercise. They’re important for reducing inflammation in the brain, such as eating a Mediterranean diet. They’re important in improving the glymphatic waste management system in the brain by improving sleep...
I think they should be used in combination because they are complementary to each other. Lifestyle interventions are very effective in increasing blood flow in the brain, things like exercise. They’re important for reducing inflammation in the brain, such as eating a Mediterranean diet. They’re important in improving the glymphatic waste management system in the brain by improving sleep. And so they’re working on multiple aspects of brain function. And amyloid drugs are effective in reducing amyloid. We know that some lifestyle interventions can reduce amyloid, but not to the same extent as the ones for anti-amyloid medications. So I think that a combination therapy is going to be the way we’ll treat patients in the future. I’m very hopeful about the future of Alzheimer’s disease. I believe that in the future we will treat Alzheimer’s disease patients the same way we treat patients with heart attack or diabetes. We will have biomarkers for early diagnosis and when we diagnose patients we have a combination of lifestyle interventions and medications to offer our patients so that they slow the rate of their decline or reverse their decline and actually get better. In the future we will not be so fearful of Alzheimer’s disease as we are today because we have a combination of lifestyle interventions and medications. As to which one I would use first, I would definitely start with lifestyle dimensions early on. For people in their 20s and 30s, you want to have a strong brain foundation as you approach your midlife and just like with treating patients with heart disease you want to make sure you know people are physically fit, their cholesterol levels are normal, they sleep well, their stress is low and all the interventions that are good for the heart are also good for the brain so lifestyle interventions are not just targeting amyloid, they’re targeting the whole body, the brain, the heart, the liver, spleen, skin, muscles, everything. So lifestyle interventions are the core of what we should do for our patients. And then the medications for amyloid are similar to medications for cholesterol. They’re a nice add-on to the powerful effect of lifestyle interventions.
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