Miriam didn’t start out seeing herself as someone who could beat MCI. It didn’t even feel like a possibility.
But early one day in September, she logged into a support group on Facebook to share the good news.
Here’s exactly how she put it:
Miriam’s outcome, which took more than four years of hard work to achieve, isn’t the most common for someone with mild cognitive impairment.
But it isn’t the rarest either.
A recent study shows that over roughly that period of time, about half of the people diagnosed with MCI are likely to see their memory loss stabilize, and about a third will return to cognitively normal — as Miriam did — or at least fluctuate between MCI and cognitively normal.
So Miriam is not an outlier. Rather, she’s an inspiration. She shows us that MCI can indeed be reversed. More importantly, she shows us how.
That’s why I tracked Miriam down after I saw her post on Facebook, and why I’m glad she was willing to talk to me. I wanted to understand what worked for her — how she did it.
Not because she’s found some secret formula that anyone else can follow and get exactly the same result she did. But because Miriam took so many of the fundamental things people with MCI are encouraged to do, and threw herself into them.
For her, they worked. And she’s convinced they can work for others, too.
“When I started on this journey of recovery, my goal was to keep myself from getting worse; that’s all I wanted,” Miriam says.
“But what happened was, I got better and it reversed, and I wasn’t expecting that. I want people to know if that happened to me, it could happen to you.”
For Miriam, the odyssey back to cognitively normal involved long, vigorous walks with her husband. It required her to radically improve her eating habits, giving up meat and eventually moving to an entirely plant-based diet. She had to learn ways to manage stress, and practice them faithfully.
So make no mistake about Miriam’s journey. It was a long, arduous one. And it began with memory problems that sent her stress level shooting off the charts, and a frightening diagnosis involving a condition she knew nothing about.
Miriam’s memory begins to falter
Miriam was 50 years old, married with three adult children and working as an accountant in the southwestern U.S. when her memory began to slip.
“I was working a very stressful job,” she says. “The thing I remember most is that I would have to run meetings and when someone else was talking, I couldn’t write down what people were saying because I couldn’t remember what they said.”
She wasn’t the only one to notice. “At one point, my manager said, ‘Miriam, they just told you that,’” she recalls. “But I couldn’t write it down. It was gone. I thought, ‘You didn’t used to do this. Something is wrong.’ I started to get really stressed out.”
Miriam immediately assumed the worst. Alzheimer’s runs strongly in her family, on both sides. “But it really threw me, because I thought it was happening too soon,” she says. “It didn’t hit my family until they were in their 70s, and I was 50.”
She talked to her doctor, who sent her for an MRI and referred her to a neuropsychologist for cognitive testing. The following month, the results came in and she received her diagnosis — mild cognitive impairment due to vascular disease and depression.
It wasn’t the news she was hoping for. “Even though I thought something was wrong, I had hoped it wasn’t that bad,” Miriam says. “I hoped it was just me being too worried. I guess I was a little shocked, even though I wasn’t completely shocked.”
Based on her family history, Miriam knew all about Alzheimer’s. But MCI? She’d never heard of it.
“I had no clue what MCI is,” she says. “I started reading everything I could find about it on the Internet. I think probably at that time I saw something about the percentage of people with MCI who went on to Alzheimer’s, and I knew I was at high risk. I thought, ‘So this is how it starts.’”
The hard realities of living with MCI
If the concept of MCI was vague and confusing, the reality of living with it hit her in ways she has no trouble describing.
“I was tired. I was fatigued,” Miriam says. “I tried to exercise but it felt like there was a weight on me. I couldn’t focus properly. I couldn’t think properly. I was scared. I had to write everything down, because I couldn’t remember. I could not come home and cook dinner. I would come home and sit and watch TV. At that particular point, it was strictly that I wasn’t able to thrive.”
The company Miriam worked for at the time was a high-tech startup, and it was struggling. Her manager got laid off. Soon after that, she was laid off too.
“During the time when I was let go, I was feeling so much anxiety,” Miriam says. “I decided I didn’t want to start another job yet. I wanted to get some of this anxiety down. I started searching to see if I could find a doctor, someone who I could trust, who knew something about dementia. I knew there really was no cure, but I thought if I could find someone who was really into it, they would be on the front line and be aware of something if it did come up.”
She was fortunate to find a memory specialist who was well-versed in MCI and dementia, and that helped put her on a better course. Miriam began to understand that even if there’s no medicine approved for the treatment of MCI, there’s ample evidence that lifestyle changes have the potential to slow or halt it.
She took up an exercise program, and coupled that with dramatic changes to her diet.
“I started walking with my husband,” Miriam says. “We would walk three times during the week, three or four miles. On weekend days, we’d walk four to eight miles each day. It was hard. I felt like I had weights on my legs.”
But she persevered. Those regular walks turned into a healthy habit she continues today, and that fatigue has been replaced by a feeling of fitness. “I still do about that much walking, but I walk a lot faster now,” she says. “I’m not dragging. I have pep. I have energy. I feel a lot younger.”
For Miriam, an even bigger turning point came when a physician assistant who worked for her memory specialist recommended a primarily plant-based diet, with no meat, but fish two or three times a week. She gave Miriam the book “The Perfect Gene Diet,” by Pamela McDonald, and told her to follow the diet recommended for people with the APOE4 gene. That gene is associated with a higher risk of Alzheimer’s.
“Four months after being on The Perfect Gene Diet — and I followed it strictly — I was no longer on an anti-depressant,” Miriam says. “The diet cleared up my depression, so I continued doing the diet. I followed the diet, except no meat whatsoever. I only did fish.”
Finding ways to tackle her stress
While exercise and diet were beginning to benefit Miriam, that wasn’t the whole picture. She was working a new job now, and she continued to struggle with work-related stress and the emotional toll of everything she was dealing with in her life. She realized that she had to address those things if she was going to get better.
“Around mid-2016, I started going to a therapist,” she says. “I did individual therapy for two and a half years, and I also did about a year of group therapy. That helped me in this whole process of growing and changing things in my life, and moving forward and getting well.”
She also learned a couple of stress-reduction techniques, and began to use them regularly.
One was a visualization technique that taught her how to leave her stress at work. “I was bringing things home from work mentally,” she says. “So I would visualize putting whatever that concern was in a jar, putting the lid on the jar and setting that jar on the desk at my office before I left work.”
She began using a very simple breathing technique as well. “Breathe in, breathe out slowly, and letting go, just relaxing,” she says.
All of these things were making a difference, though Miriam still had a ways to go. “I felt a little bit better, my mind was a little clearer,” she say, “but I was still having some trouble.”
An energetic neurologist with fresh approaches
The final turning point came when Miriam found a new neurologist. The memory specialist she worked with previously decided to stop taking patients and focus full-time on research. So Mariam had gone a while without seeing a specialist, and her general practitioner wanted her to go back to a neurologist again. “I hadn’t been able to find anyone else,” Miriam says, “so she recommended this nice young neurologist, right out of school.”
Miriam found her new neurologist to be energetic and full of fresh approaches. About the same time, she discovered the teachings of Dr. Dale Bredesen, author of “The End of Alzheimer’s.” She read the book, and a lot of what Bredesen teaches made sense to her, so she asked her neurologist about his protocol. “She had heard about it, and she said it was very expensive, but she said she believed in it,” Miriam says.
Based on the expense and other considerations, Miriam choose not to seek out a medical specialist trained in the Bredesen protocol. Still, she felt there were parts of it she could incorporate into her life without that help. “I decided I would just have to see if I could figure it out on my own,” she says.
By then, Miriam had fully committed herself to a healthier lifestyle, and she had a lot of support and encouragement along the way. While she was dealing with MCI, her husband was diagnosed with a blood disorder, so they motivated each other to stick with the improvements in exercise and diet that both of them were making.
She had other family support as well. “My half-brother, who is nine months older than me, was diagnosed with early onset Alzheimer’s,” she says. “He became another inspiration for me. He’s an electrical engineer, and by changing his diet, and exercise and all the extra things he does, he was still able to work, so he encouraged me. He was always reaching out to me to make sure I was following the protocol.”
The final piece of the puzzle
Yet even at this point, there still was one piece of the puzzle missing for Miriam. And the new neurologist helped her find it.
“After I started seeing her, she began running all these different test,” Miriam says. “She told me, ‘I have some blood work I want to do on you.’ It’s called a dementia profile. She did my blood work in April. Because I was eating fish all the time, she wanted to be sure my mercury levels and my lead levels were OK.”
The test results came back, and showed there indeed was a problem. Miriam had high levels of mercury, not to mention arsenic. Her neurologist moved immediately to address the problem. “She told me, ‘Stop eating that fish,” Miriam says.
Her neurologist predicted it would take six months to a year for Miriam to flush the mercury from her body. But a month later, she says, “my brain was clear.”
And Miriam says once the mercury was completely out of her system, it was like a curtain being lifted. “I noticed I was getting better and better,” she says.
One encouraging indication after another
After that, all the indications began to turn positive for her.
She’d been working with a speech therapist on issues related to cognition, memory and speech, but her therapist told her that she didn’t need further help with those. “She said, ‘You are not having any problems,’” Miriam remembers.
Miriam also had changed jobs, and found the new position to be less stressful. “Now I was in a job that’s perfect for me, and it was going well,” Miriam says. “I was having hour-long meetings, and I could talk about everything. I couldn’t do that before. I am able to do that now.”
The most encouraging indication, though, came this summer, when Miriam’s former memory specialist reached out to her. The specialist had found a study that she thought Miriam would be a good candidate for, and wanted to screen Miriam for it.
Miriam had always been open to participating in a clinical trial, but most studies are looking for people age 65 or older, so she hadn’t been eligible. This one was open to people her age, who either had mild cognitive impairment or in some cases hadn’t even received that diagnosis yet.
So Miriam volunteered to be screened for the study. But it turns out she didn’t qualify — for the best possible reason. “They ran me through some of the testing,” she says, “and then they told me, ‘We’re sorry, but your memory is too good for our research.’
“I could tell even when I was being asked the questions, I was getting more answers right,” she says. “I was like, ‘Wow, I’m remembering more.’ I knew I was doing better, so I wasn’t surprised.”
Skipping down the hall like a schoolgirl
I asked Miriam what it felt like to experience that, and she was giddy in her reply. She described one day at work, when she was so happy and doing so well, she found herself skipping along the corridor like a schoolgirl.
“I am thrilled. I’m just thrilled,” she says. “I knew how well I was doing. I was skipping down the hall because I felt so well.”
I also invited Miriam to reflect back on all the hard work she had put in over those four-plus years, and all the ups and downs, and the fears and the frustrations of facing MCI. I asked her what she thought had made the difference for her.
“The diet was a big piece of it — a big, big, big piece of it,” she says.
Asked to describe how she eats now, she says: “I’m on a whole-food, plant-based vegan diet. I strongly limit processed foods. I don’t eat meat, fish, dairy, eggs, sugar or oil. I eat all fresh fruit, all vegetables and whole grains such as rice, oats, quinoa, bulgar, and beans, nuts and seeds. I limit bread and pasta.”
And of course, there was a bigger picture than that, in terms of how she fought to defend her cognition.
“It wasn’t just the diet,” she says. “It also was the exercise and the help that I got with stress and overcoming the anxiety and just dealing with my whole thought process.”
Not a prescription, but an allegory
To put Miriam’s experience in perspective, it’s important to understand that no one can promise you the results she got. But remember, reversing MCI wasn’t even her goal in the first place.
She was just hoping to slow it down or keep it from getting worse. And for people with MCI, it’s not an unrealistic goal. That is actually the more frequent outcome.
Earlier this year, researchers at the University of Pittsburgh published a study showing that across a broad general population of adults with mild cognitive impairment, relatively few of them went on to develop dementia over a period of five years.
“Most people with MCI do not progress to dementia in the near term, but rather remain stable with MCI or revert to normal cognition,” the study says.
In fact, according to the study, of nearly 900 adults with mild cognitive impairment:
There was a time when MCI was routinely referred to as a “precursor” to dementia, or an “intermediate stage” leading to dementia. We know better now.
For people with mild cognitive impairment, the odds of slowing, halting or reversing it are actually pretty good. And you can improve those odds even more by adopting healthy habits that promote brain health.
One of the quotes I like to share as often as I can comes from Dr. Joel Salinas, a neurologist at Massachusetts General Hospital. He told the Harvard Health Letter that only about 15 percent of people over the age of 65 who have MCI will progress to dementia.
Salinas says he’s seen plenty of patients “stay in the MCI stage for many years, even when we presume it was a neurodegenerative disease,” and by that, he means even in cases where the doctors assumed the person had Alzheimer’s.
Salinas goes on to add: “The people who spend the most time cognitively stable are often the ones who stick to lifestyle recommendations.”
In other words, people like Miriam.
Again, it’s important to understand her experience is not a prescription for how to beat MCI. It’s more of an allegory.
It’s an example of what becomes possible when someone struggling with cognitive loss:
- gets an accurate diagnosis
- finds a good doctor versed in the latest approaches to the treatment of MCI
- and commits to healthy habits that can help defend cognition.
“I had no earthly anticipation that I would be back to where I was before I began having this difficulty and getting this diagnosis,” Miriam says.
“I just want people to know that if you have mild cognitive impairment, there’s something you can do and you don’t have to spend a lot of money to do it,” she says. “I hope someone hears my story, and it inspires them to make the changes that are necessary. I hope it helps someone else. I really do.”