Dr. Heather Sandison focuses on lifestyle and metabolic approaches to cognitive decline. Influenced by Dale Bredesen's work, she views Alzheimer's as a complex condition that may be influenced by multiple factors, including metabolic health, inflammation, sleep, exercise, nutrition, stress, and environmental exposures.
Rather than relying on a s
Dr. Sandison was the lead author of a 2023 clinical trial in which 23 people with mild cognitive impairment or early dementia completed a six-month personalized lifestyle program. Participants improved on several measures of cognition. The results are encouraging, but because the study was small and did not include a randomized control group, it did not prove that the program can reverse Alzheimer's disease.
Sandison emphasizes that cognitive decline can have many contributing factors. Her approach attempts to identify potentially modifiable problems in each individual rather than treating every patient the same way.
Areas commonly addressed include insulin resistance and metabolic health, nutrition, physical activity, sleep, stress, nutrient deficiencies, inflammation, social connection, and cognitive stimulation.
Her approach draws substantially on the work of Dr. Dale Bredesen and his personalized program for cognitive decline.
Metabolic health is an important part of Sandison’s program. She often recommends a low-glycemic or ketogenic diet designed to improve insulin sensitivity and provide ketones as an alternative fuel for the brain.
This reflects growing interest in the relationship between insulin resistance, impaired brain glucose metabolism, and Alzheimer’s disease.
Sandison considers exercise one of the most important interventions for maintaining brain health. Her program combines aerobic activity, strength training, balance, and activities that challenge the brain and body simultaneously.
Sleep is another priority. Poor sleep is associated with cognitive decline, while adequate sleep supports memory, metabolic health, and normal brain function.
Mental stimulation, social engagement, and stress reduction are also important parts of her program.
In a study published in the Journal of Alzheimer’s Disease in 2023, Sandison and colleagues evaluated a personalized lifestyle intervention in people with mild cognitive impairment or early dementia.
Thirty-four people enrolled in the study, and 23 completed the six-month program and were included in the final analysis. The intervention addressed diet, exercise, sleep, stress, supplements, brain stimulation, and other individualized health factors.
Participants who completed the program showed statistically significant improvements on several measures of cognition.
The study provides promising preliminary evidence that an intensive lifestyle program may improve cognitive function in some people with early cognitive decline. However, it was small, uncontrolled and non-randomized, and 32% of those enrolled did not complete the study. It therefore did not prove that the program can slow, stop, or reverse Alzheimer’s disease.
Many of the lifestyle practices Sandison recommends are associated with maintaining brain health as we age:
Regular physical activity
Good metabolic health
A nutritious, minimally processed diet
Adequate sleep
Maintaining social connections
Staying mentally active
Managing cardiovascular risk factors
These measures cannot guarantee that someone will avoid Alzheimer’s, but they provide good reasons to view brain health as something we can actively influence.
Reversing Alzheimer’s: The New Toolkit to Improve Cognition and Protect Brain Health
Dr. Heather Sandison presents a practical, lifestyle-based approach to improving cognitive health, including nutrition, exercise, sleep, stress reduction, metabolic health, and other potentially modifiable factors associated with dementia risk.
A JA 2023 study led by Dr. Heather Sandison found improvements in several measures of cognition among participants with cognitive decline following a six-month personalized lifestyle intervention involving diet, exercise, sleep, stress management, supplements, and other individualized treatments.
Dr. Sandison discusses research on her personalized lifestyle approach to Alzheimer’s and the encouraging cognitive improvements reported in her clinical trial.
Dr. Sandison and Dr. Bredesen discuss the ideas in Reversing Alzheimer’s and their shared approach to identifying and addressing multiple factors that may contribute to cognitive decline.
Dr. Sandison describes her clinical approach to Alzheimer’s and explains how diet, exercise, sleep, metabolic health, and other lifestyle factors are incorporated into individualized treatment programs.
A San Diego residential memory-care program founded by Dr. Heather Sandison that incorporates nutrition, exercise, sleep, social engagement, and other lifestyle approaches into care for people with cognitive decline.