The Empowering Neurologist – David Perlmutter, M.D. and Dr. Dale Bredesen
It’s exciting to watch new developments in medicine, especially when new treatments for diseases are developed. Unfortunately, there is no treatment that has any merit for Alzheimer’s disease. Think of it, this disease that affects close to 5.8 million Americans is a disease for which we have no meaningful treatment whatsoever.
As many of you know, Dr. Dale Bredesen has pioneered a novel approach to Alzheimer’s disease. Rather than offering up a single treatment, he has created a multi-pronged program that is proving successful in reversing this disease. Yes, I’ll repeat, this program has reversed Alzheimer’s disease.
I previously interviewed Dr. Bredesen about his book, The End of Alzheimer’s, and his new book, The End of Alzheimer’s Program, focuses more on providing hands-on information with respect to what each of us can do today to preserve our brains as well as what can be done for patients with existing Alzheimer’s dementia.
Like the original book, I am certain that this new work will soon be a best seller, worldwide. And I was asked to provide its foreword, appearing below with permission:
Never before has the practice of medicine been as polarized by the dichotomy between reductionism and holism as exists today with relation to the treatment of Alzheimer’s disease.
Reductionism, as it is applied to the practice of medicine, takes the position that in order to best understand a disease process and ultimately formulate and implement an appropriate therapeutic intervention, both the disease and the intervention need to be reduced to the simplest operative parts and mechanisms. Many have credited the sixteenth-century French philosopher René Descartes with codifying this paradigm. Descartes, in part V of his Discourse, described the world as being nothing more than a clockwork machine that could be understood in its entirety through an exploration of its individual components. And clearly the progress of the science of medicine historically and in the present is deeply punctuated by landmark advances characterized by dedication to this approach.
Whether we are speaking of Antonie Philips van Leeuwenhoek, using a single-lensed microscope to discover animalcules (microbes), or the sequencing of the human genome, the underpinnings of Western medicine continue to honor the notion that looking deeper and deeper at constituent parts will ultimately provide a knowledge base that will reveal sought-after solutions to challenging disease processes.
To be sure, microscopy led to an understanding of pathophysiology that directly resulted in wondrous advances leveraged for salubrious outcomes. But myopically engaging a philosophy centered on drilling down to unity in terms of parts and processes inevitably segues to sanctioning a therapy equally centered on the validation of the singular. Simply stated, embracing reductionism in medicine supports the ideology of monotherapy, the idea that the goal of modern medical research should be the development of single, magic bullets that are designed and marketed to counter single diseases.
As Harvard physician Dr. Andrew Ahn put it in a paper exploring the limits of reductionism in medicine:
Reductionism pervades the medical sciences and affects the way we diagnose, treat, and prevent diseases. While it has been responsible for tremendous successes in modern medicine, there are limits to reductionism, and an alternative explanation must be sought to complement it.
As of this writing, no disease process highlights the limitations of a reductionist approach as it relates to therapy more than senile dementia of the Alzheimer’s type. To be sure, the deep dive to unravel the etiology of this now-epidemic disease has been under way for decades and underwritten by hundreds of millions of dollars. Applying a reductionist approach has indeed revealed fascinating mechanisms that are likely involved in what ultimately manifests as this disease that now affects 5.5 million Americans. But alas, no single or combination pharmaceutical therapy has any effect whatsoever on modifying the inexorable course of Alzheimer’s disease.
As a testament to the tenacity of the pharmaceutical industry, several drugs are marketed to Americans and indeed globally with the idea that they somehow “treat” Alzheimer’s disease. But while these medicines may minimally affect Alzheimer’s symptoms, again they provide no benefit whatsoever with respect to actually improving the ultimate outcome. As Dr. Michal Schnaider-Beeri recently revealed in an editorial in the journal Neurology: “Despite great scientific efforts to find treatments for Alzheimer disease (AD), only 5 medications are marketed, with limited beneficial effects on symptoms, on a limited proportion of patients, without modification of the disease course.”
More recently, the concern for the lack of efficacy of these medications was overshadowed by a report appearing in The Journal of the American Medical Association revealing that not only do the commonly prescribed Alzheimer’s drugs lack efficacy, but their utilization is actually associated with more rapid cognitive decline.
In contradistinction to reductionism, holism places more value on exploring the forest as opposed to focusing on the single tree. To be sure, a holistic approach to health and disease absolutely embraces the discoveries of deep scientific pursuits, but the fundamental difference in comparison to reductionism is found when examining how science is utilized as it relates to actually treating a malady. Whereas reductionism looks for the one home-run solution, holism considers any and all options available if there’s something positive to offer.
As you will soon discover in the pages that follow, for the first time ever a therapeutic intervention has been developed that successfully treats Alzheimer’s disease. The protocol developed by Dr. Bredesen is by definition holistic. His program incorporates the discoveries of research across a multitude of disciplines that have bearing on Alzheimer’s pathogenesis. Our most highly respected scientific research has clearly delineated the specific mechanisms whereby a vast array of seemingly unrelated processes contributes to the ultimate manifestation of this disease. And it is precisely because Alzheimer’s disease manifests from the confluence of multiple factors that its remediation requires the orchestration of diverse instruments.
Although the source of the quote “The definition of insanity is doing the same thing over and over again and expecting a different result” has been questioned, its relevance to the pursuit of a single drug approach to the treatment of Alzheimer’s disease is unquestionable. Sanity now prevails with Dr. Bredesen’s challenge to the status quo that may well bring an end to Alzheimer’s disease.
David Perlmutter, MD
Naples, Florida January 2019
(Excerpt from THE END OF ALZHEIMER’S PROGRAM by arrangement with Avery Books, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright © 2020, Dale E. Bredesen)