Stabilization of Cognitive Function up to 15 Years in a Series of MCI and Mild AD Patients Treated with a Multimodal Integrative Rehabilitation Program

Valentin Bragin1, Ilya Bragin1,2,3

1. Stress Relief and Memory Training Center, Brooklyn, NY, USA
2. Staten Island University Hospital, Department of Rehabilitation Medicine, Staten Island, NY, USA
3. Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA

Poster presentation at the Alzheimer’s Association International Conference. Chicago, Illinois July 22- 26, 2018

Background: Alzheimer’s disease (AD) is a multi-faceted, whole brain and body illness. Given the complexity and uncertainty of the pathogenesis of AD, we developed a treatment program which is based on the assumptions of compromised cerebral blood flow and hypoxia in dementia patients. The four pillars of this program, the “four M’s” consist of simultaneous interventions, related to memory, movement, mood and mitochondria. This innovative therapeutic program initially developed in 2000 was intended for medically ill people with different stages of dementia and depression, with the goal of slowing or arresting cognitive decline. Previously, over the time we have shown the preservation of cognitive performance in demented and depressed patients for as long as 6 years of therapy. Here we present a series of six patients who have undergone very long therapy ranging from 10 to 15 years.

Methods: 6 Patients (4 females, 2 males, mean age of 71 upon initiation of therapy) multiple chronic medical comorbidities (cardiovascular pathology, diabetes, osteoarthritis etc.) underwent integrative treatment which consisted of standard anti dementia medications and antidepressants, along with non-pharmacological interventions. These modalities included office and home-based physical and cognitive exercises, diet modifications, vitamins, and nutritional supplements. Cognitive testing (MMSE, clock drawing test, semantic and phonemic verbal fluency) was performed yearly.

Results: Patients had 12.67 years of education. By the end of the observation period, all 6 patients had the same MMSE score (± 1 point). The clock drawing task scores remained stable as well. Semantic (Animals) verbal fluency scores were stable in half the patients. Phonemic verbal fluency (Letters) was stable in 3 of 5 patients. All patients remained living in the community.

Conclusions: We have for the first time demonstrated stabilization of cognition function in MCI and Dementia for up to 15 years of therapy. Combined therapy is a viable treatment option for medically ill people with dementia until new effective medications become available.

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