Inspirational Senior Living Facility Offers Hope for Dementia

What do you specialize in and why?

The mission of MARAMA is to create an immersive experience in the approach proven to reverse dementia. We are dedicated to curating the best lifestyle treatments for those suffering with dementia. The goal is not just to be a more comfortable patient suffering with dementia, but to have a chance to improve. In most residential care facilities the expectation is decline and then eventually death. At MARAMA we offer hope that some residents will be able to return to independent living. 

We offer a setting where we dementia patients can immerse themselves in the lifestyle described by Dr. Bredesen in his book “The End of Alzheimer’s”. We have an organic garden, lots of safe outdoor space, a fully organic Keto-flex menu, organic mattresses and linens, daily treatments with devices like the Vie light, LiveO2 oxygen contrast and meditation. The biggest benefit is that you don’t need to do it all yourself. We’ve done it for you, all you need to do is show up and participate! 

What do we know about dementia?

We can all agree that AD is a devastating and incurable disease that leaves patients and their families feeling hopeless and terrified. We also all agree that AD starts decades before patients experience symptoms and that is good treatment is good prevention. 

Currently, there is no consensus in the scientific community about the causes and best treatments for AD and there is no pill you can take to get better. 

The conventional wisdom has been beta-amyloid plaques, tau proteins and neurofibrillary tangles characterize the pathophysiology of Alzheimer’s dementia. Unfortunately, despite billions of dollars having been invested into the development of medications targeting these processes, the outcomes have been conclusively disappointing. Essentially years and billions of dollars later we have learned that we need to go back to the drawing board when it comes to our understanding of how to treat AD.

“The multiple failures of previous anti-beta amyloid drugs may suggest that in the AD brain, the accumulation of beta amyloid could be secondary to an unknown initial disrupting event. The increase in brain beta amyloid concentrations could be a reactive compensatory response of neurons damaged by unknown causes.”

It is time to think outside of the conventional paradigm and assumptions to take a holistic look at both our understanding of the disease process and the treatment. We know that stress, diet, exercise, toxic burden and other lifestyle factors play a role in the development of AD and addressing them has the potential lead to cognitive improvement. Why not put that to work? 

Why did you start Marama? 

The first patient I saw had severe dementia. I saw her for the first time and was saddened by how severe her dementia was and impressed by how dedicated her husband was to helping her so we put together an aggressive plan. When I met with them again three weeks later she had transformed. She wasn’t 100% better but she was unequivocally better. I wondered, “If this was possible for her, who else was it possible for? What could I do to make the approach accessible to more people and families who were suffering?”

Seeing patients in the clinic, I noticed that those who had a better chance were able to implement complex and time consuming diet, supplement and exercise protocols at home. Those who weren’t able because of logistical, cognitive or financial constraints were less likely to benefit. When you are suffering with cognitive dysfunction these things are challenging. Having them done for you in a facility makes perfect sense. 

I started MARAMA because there was no care facility I was comfortable recommending families send their loved ones when they could no longer care for them at home. I looked around for residential care facilities where they were serving organic food and incorporating Dr. Bredesen’s insights. I couldn’t find one! It takes a lot of work and it isn’t the typical retirement home where lots of hours are spent watching TV and eating ice cream. It takes dedication and some experience to create this type of program. I wondered how hard it could be to make it happen and started looking into it. A lot of the challenging pieces of starting an entirely new venture fell into place quickly.  

What is the research behind the method used at Marama?

Dr. Dale Bredesen popularized and helped to centralize the integrative and individualized approach to treating dementia in his book “The End of Alzheimer’s” published in 2017. In scientific journals he has published several case series on the reversal of cognitive decline using his model. Clinical outcomes and peer reviewed published science inform his approach across many specialties including immunology, sleep medicine, toxicology, nutrition, psychology and exercise science.

 We are eagerly awaiting further publications of studies taking a group of patients through the approach so we can answer the question, If I make these changes and put in the effort, how likely am I to get better? My clinic, North County Natural Medicine, is also currently recruiting patients for an observational trial on our approach to dementia. 

Due to the individualized model of care it doesn’t lend itself well to randomized, placebo-controlled trials. There are many variables considered and treated at once and so many of the interventions are lifestyle based. It isn’t practical to blind someone into increased activity, ketogenic diets and doing brain games. The new assumption is that this disease cannot be treated with one pill because it doesn’t have one cause. It has many causes that are not mutually exclusive. In one patient’s case they may have high glucose and insulin levels causing toxicity in the brain and in another patient’s case they may not have enough nutrients or hormones signaling the brain to create healthy neurons. In another patient’s case it may be both of those things and a genetic predisposition. 

In the clinical setting at North County Natural Medicine we determine which factors are contributing to an individual’s imbalance. At MARAMA in the residential setting we help patients put a care plan into action and we are set up so that the environment is non-toxic, the food is the best possible food for brain health and regular exercise, meditation and other lifestyle based routines are the default. 

What makes MARAMA treatment different? 

MARAMA is different because

1. We expect improvement. 
2. We prioritize balance and wellness. 
3. We have created a non-toxic environment. 
4. We are constantly reevaluating how we can do better. 
5. A doctor who has the clinical experience of seeing dementia patients get better created MARAMA. 

Is full recovery expected? Or what levels of recovery?

We are new at this and so I don’t know exactly what to expect. I wish I could tell families with more certainty how likely it is that their loved one will get better. We are on the cutting edge and we are learning as we go. I am committed to taking the information we get and new literature as it is published into account so we can offer the best experience possible. 

Clinically, I didn’t expect many patients to get better and then they did. Not everyone, of course but more than I ever expected. Patients with dementia improved when that isn’t supposed to happen. 

The earlier we are in the disease process when we start intervening the more improvement I expect. 

Personally my mom was noticing cognitive decline and she would joke about it here and there, but I could tell it scared her. She was still working, driving, etc. just noticing changes in her own cognition. She moved into my house for 6 weeks when I had a baby. I was adamant there wasn’t a single food item brought into the house that wasn’t organic, so we ate great food both for her brain and of course for my brand new baby.  

When my mom left 6 weeks later she was no longer complaining of forgetting things. She went home and admitted to me a few months later that she had binged at work on Cheetos and Dr. Pepper (eeewwwww!) and noticed her memory issues come back! She’s a complete convert now and one of my most enthusiastic patients. She sends Dr. Bredesen’s book to anyone who shows a glimmer of interest. She’s currently trying to get all of her siblings and their spouses to move into MARAMA. There are 12 of them, so they will take up all of my beds if she’s successful.

What are the potential barriers for others to start a facility like MARAMA?

I hope the barriers are low. My primary goal is that memory care and residential care for the elderly changes at an industry level. My hope is that we have lots of care facilities following our lead. It makes so much sense to make the best care available to dementia patients available in the places where dementia patients live. 

Barriers, of course, include access to the financial resources it takes to start any business and the ability to navigate confusing and sometimes infuriating state licensing requirements. I looked at about 20 facilities before finding the one I thought would work best.

What do you expect for the future? 

Unfortunately, I expect the number of dementia patients to rise over the next 5-10 years if nothing changes. There are currently 6 million dementia patients and that number is expected to be 10 million by 2025. It is an epidemic and we need smart solutions. I don’t expect solutions to come in the form of a pill. 

I hope that we can publish robust research that proves how beneficial and relatively simple these lifestyle interventions can be. At a societal level, if we make changes in things like the food system, toxic exposure and prioritizing health over mass consumption we can prevent this horrible disease and make it rare. 

References: 

PMID: 28826585
Trends Pharmacol Sci. 2017 Oct;38(10):849-851. doi: 10.1016/j.tips.2017.07.002. Epub 2017 Aug 18.
Amyloid in Alzheimer's Disease: Guilty Beyond Reasonable Doubt?
Behl C1.

PMID: 31405021
Int J Mol Sci. 2019 Aug 9;20(16). pii: E3892. doi: 10.3390/ijms20163892.
Ketogenic Diet in Alzheimer's Disease.
Rusek M1,2, Pluta R3, Ułamek-Kozioł M4,5, Czuczwar SJ1.

PMID: 30554068
Nutrition. 2019 Apr;60:118-121. doi: 10.1016/j.nut.2018.10.003. Epub 2018 Oct 10.
The ketogenic diet as a potential treatment and prevention strategy for Alzheimer's disease.
Broom GM1, Shaw IC2, Rucklidge JJ1.

PMID: 31551781
Front Pharmacol. 2019 Sep 10;10:976. doi: 10.3389/fphar.2019.00976. eCollection 2019.
Risk Factors for Alzheimer's Disease: Focus on Stress.
Caruso A1, Nicoletti F1,2, Gaetano A1, Scaccianoce S1.

PMID: 26770163
Integr Med (Encinitas). 2015 Oct;14(5):26-9.
Dale E. Bredesen, md: Reversing Cognitive Decline.
Gustafson C.

PMID: 25324467
Aging (Albany NY). 2014 Sep;6(9):707-17.
Reversal of cognitive decline: a novel therapeutic program.
Bredesen DE1.

PMID: 27294343
Aging (Albany NY). 2016 Jun;8(6):1250-8. doi: 10.18632/aging.100981.
Reversal of cognitive decline in Alzheimer's disease.
Bredesen DE1,2, Amos EC3, Canick J4, Ackerley M5, Raji C6, Fiala M7, Ahdidan J8.

PMID:26045577
Hot Topics in Research: Preventive Neuroradiology in Brain Aging and Cognitive Decline. Raji CA, Eyre H, Wei SH, Bredesen DE, Moylan S, Law M, Small G, Thompson PM, Friedlander RM, Silverman DH, Baune BT, Hoang TA, Salamon N, Toga AW, Vernooij MW. AJNR Am J Neuroradiol. 2015 Oct;36(10):1803-9. doi: 10.3174/ajnr.A4409. Epub 2015 Jun 4. Review.

PMID: 30283265
Clinical Lifestyle Medicine Strategies for Preventing and Reversing Memory Loss in Alzheimer's. Shetty P, Youngberg W.
Am J Lifestyle Med. 2018 May 11;12(5):391-395. doi: 10.1177/1559827618766468. eCollection 2018 Sep-Oct.