Can the Bredesen Protocol Reverse Alzheimer’s Disease?

Jules Walters headshot

Jules Walters • March 4, 2024

If you or someone in your family, receives a diagnosis of Alzheimer’s disease, your future is grim. You’re commonly told to go home and get your affairs in order; that there’s nothing to be done. Alzheimer’s is a one-way street, and the only way forward is downhill.

But now there are glimmers of hope that there could be an alternative. A Californian doctor called Dale Bredesen has been working for decades on trying to understand what’s behind the loss of memory in Alzheimer’s and similar problems with cognitive function. He’s come up with what’s known as the Bredesen protocol, and marketed as the ReCODE program, that’s garnering attention. But is there anything to it?

What is the Bredesen protocol?

The Bredesen protocol is said to help, not just those with early Alzheimer’s disease, but anyone with signs of cognitive decline and prepared to try moving the needle in the opposite direction.

The protocol started with the 2017 publication of Dr Bredesen’s book The End of Alzheimer’s. (It became a New York Times bestseller.) The book outlines multiple metabolic factors that impact brain health; including food, exercise, and sleep. The guidance is pretty sensible and do-able for anyone interested in a healthy lifestyle.

Dr Bredesen is also the Chief Science Officer of Apollo Health. The company has packaged his research into a program called ReCode, to make it available to consumers.

Dr Dale Bredesden – Head shot and name caption

Who is Dr Bredesen?

Dr Dale Bredesen MD has classical medical credentials; studying medicine at Duke University Medical Center, where he earned the MD. He then went on to complete a post-doctoral fellowship at the University of California, San Francisco (UCSF).

Dr Bredesen taught at UCSF before directing the Program on Aging at the then Burnham Institute; now Sanford Burnham Prebys in San Diego. When the Buck Institute opened its doors in 1999 as the world’s first independent biomedical research institute dedicated to aging, he became its founding President and CEO.

No one could argue with his academic and professional pedigree. What has caused controversy more recently is his claim that his protocol can reverse cognitive decline and even herald the end of Alzheimer’s. The Canadian Alzheimer Society says the Bredesen protocol offers false hope, concluding his research is limited and based on anecdotal case studies.

Brain model demonstrated on table

What proof is there that the Bredesen approach works?

In December 2023, the documentary Memories for Life: Reversing Alzheimer’s brought to the fore some older people who believe the Bredesen protocol has saved their minds. The program interviews several people who believe their memories have improved through following the protocol. (Canadian singer Michael Bublé, whose grandmother had the devastating condition is the narrator.) It’s hard to argue with their testimonies.

Retired medical doctor Dr Nadu Tuakli is one of those featured. Her memory was fading and she received a diagnosis of Alzheimer’s in 2008. She would read a book one day and the next day not remember anything she’d read. Through adhering to the protocol, Dr Tuakli says she started to feel better almost straight away. MRI scans confirmed the improvement.

In 2022, a pilot project of 25 patients with dementia or mild cognitive impairment who trialed the same methodology was reported in the Journal of Alzheimer’s Disease. The results showed statistically significant improvement in validated measures, including the Montreal Cognitive Assessment (MoCA).

The authors of the paper concluded the early results called for a larger, randomized, controlled trial to investigate further. So, it’s fair to say that the case studies to date have been limited.

Memories for Life documentary – Promotional banner

What is the criticism of the Bredesen protocol?

What the medical establishment doesn’t like is the way Dr Bredesen has started to market his program without doing the classic scientific studies. The traditional approach is to design a double-blind, placebo-controlled clinical trial with thousands of volunteers. They usually take years, if not decades, to complete.

The pharmaceutical industry has tried this classical approach for decades and just about every one of the hundreds of resulting trials has failed. There are recently two Food and Drug Administration (FDA)-approved treatments for Alzheimer’s in the US, which may help to reduce symptoms, but they are not a cure.

It’s widely accepted that that more answers are needed before there’s a cure for Alzheimer’s disease; and the scale of the problem is huge. The Alzheimer’s Association estimates about seven million Americans aged 65 and older are living with this most common form of dementia. Two-thirds of those are women.

And the number of people reaching over 65 in age continues to rise. Forecasters put the number who will live with Alzheimer’s in 2050, in the US alone, at around 13 million people.

Clinical trial researcher holding blank drug container- Generic image

How does the Bredesen protocol work?

Bredesen’s team first does a deep dive into each participant enrolling in ReCODE, including an evaluation of their cognitive health that uses an online question tool. So far, that’s no different from what more traditional clinicians do in assessing Alzheimer’s.

Where ReCODE differs is that lab tests then assess biological markers of brain health, as Bredesen believes that Alzheimer’s is not a single disease but has different subtypes.

ReCODE index – infographic

Blood draws will reveal the drivers of the condition, which can differ from person to person. Some of the measures include:

High sensitivity C-reactive protein (hs-CRP)

Hs-CRP is a general marker of inflammation in the body and not limited to the brain. Inflammation is believed to accelerate aging in the body and can be driven by a leaky gut, poor diet or eating foods that don’t agree with you, like gluten and dairy. Chronic inflammation can contribute to Alzheimer’s disease.

Toxicity

We face toxins each day from the air we breathe to traces of heavy metals in our food, through big ocean fish such as tuna. Bredesen calls these dementogens. Our body, if working well, should be eliminating most of these toxins but some could be stored. Tests can tell.

Nutrition

Some nutrients like zinc and vitamin B12 are vital for brain health. It follows that deficiencies in these nutrients may contribute to declining cognition. Compensating for them may play a key role in reversing the symptoms.

Exercise

Medical researchers know that exercise increases a protein by the name of brain derived neurotrophic factor (BDNF). Benefits include increasing blood flow and supporting signaling pathways. The ReCODE program incorporates movement as part of its remedy.

Frequently Asked Questions (FAQs)

How much does the Bredesen protocol cost?

See Apollo Health’s own FAQ page here for a table of costs.

I live outside the US. Is the Bredesden protocol available internationally?

Yes. But, if you live outside the United States, you will need to identify a trained practitioner local to you who can order lab tests and run a report.

Do health insurers or Medicare cover the protocol’s costs?

For anyone who qualifies for Medicare in the US, some of the tests the Bredesden protocol recommends may receive partial cover; subject to the plan’s deductibles. Under commercial health insurance policies, diagnostic tests often don’t qualify for reimbursement. So, anyone not qualifying for Medicare, or who lives outside the US, will need to check first with their insurer if their policy covers any of the testing costs. (See Apollo Health’s FAQ page for more on this.)

If I can’t afford ReCODE, are there other ways to start?

Yes, talk to your doctor and see if you can have some of the tests included in the Bredesen protocol. These tests are widely available. You could also buy his book to read up on it.

What else can I do to prevent cognitive decline?

There’s a growing body of research that points to brain health not being dependent on just one thing. The pointers to preventing and even reversing cognitive decline include everything from maintaining a healthy diet and good oral hygiene, to regular brain stimulation (social and mental stimuli), stress reduction, and aerobic exercise.

The US National Institute on Aging page on this subject has more information, but summarizes it this way:

  • Take care of your physical health
  • Manage your blood pressure
  • Eat healthy foods
  • Be physically active
  • Keep your mind active
  • Stay connected with social activities
  • Manage stress
  • Reduce risks to your cognitive health (risks that include smoking and drinking alcohol)