What is the Bredesen protocol, and who is it for?
Explore the Bredesen approach to brain health, its developing evidence and how CogMission uses personalised assessment to address cognitive risk.
- Updated
- 3 min read
- By Charmaine Shepherd, IFM Certified Practitioner
The Bredesen approach investigates multiple possible contributors to cognitive decline, including metabolic health, sleep, nutrition and vascular risk. At CogMission, we use this framework to develop individual plans for prevention and early cognitive changes. Research is developing, and improvement cannot be promised, but there are meaningful factors we can assess and address.
When someone is worried about their memory, they want to know what they can do now.
I have trained in the Bredesen approach, and at CogMission we use it to look beyond a single explanation for cognitive symptoms. Two people with similar memory concerns may have very different health histories and priorities.
What is the Bredesen protocol?
Developed by Dr Dale Bredesen and often called ReCODE, this approach considers whether several pressures are contributing to cognitive decline at the same time.
The assessment brings together your history, cognitive testing and relevant investigations. We then develop a plan that addresses the findings, rather than give everyone the same diet or supplements.
Our starting point is a cognoscopy, a detailed brain health assessment. Read What is a cognoscopy?
What does the protocol look at?
| Area | What we may assess |
|---|---|
| Metabolic health | HbA1c, glucose regulation and insulin where relevant |
| Vascular health | Blood pressure, lipids, ApoB, Lp(a) and appropriate imaging |
| Sleep and oxygen | Sleep quality, snoring and possible sleep apnoea |
| Nutrients | B12, folate, vitamin D and other markers guided by history |
| Hormones | Thyroid blood tests; sex hormone or cortisol assessment where appropriate |
| Inflammation and immunity | Medical history, inflammatory markers and relevant conditions |
| Gut and oral health | Digestive symptoms, absorption and periodontal health |
| Exposures and infections | Targeted investigation when the history supports a concern |
| Genetics | Optional ApoE testing with informed discussion |
| Daily life | Movement, hearing, vision, social connection and cognitive activity |
The plan may include nutrition, strength and aerobic activity, sleep treatment, health coaching and targeted supplementation. Significant medical findings need appropriate clinical treatment.
What does the evidence show?
The early Bredesen publications were small case series. A 2022 pilot study in 25 people reported improvements in cognitive outcomes over nine months, but had no control group.
A newer randomised study involving 73 participants has been reported as a preprint. It found improvements on several cognitive measures, while the MoCA result was not statistically significant. The report is not yet peer-reviewed, so it is an encouraging development that needs further scrutiny and replication, rather than proof of a cure.
There is stronger established evidence for addressing multiple brain health risks. The FINGER trial tested a combined lifestyle and vascular risk programme in older adults at increased risk. The 2024 Lancet Commission estimated that addressing 14 modifiable factors could potentially prevent or delay around 45% of dementia cases at population level.
These findings give us reasons to act on the factors we can change. They do not guarantee an individual outcome or validate every test used in a personalised protocol.
Who is the Bredesen protocol for?
It may suit people with early cognitive changes, mild cognitive impairment or a strong interest in prevention because of family history or other risk factors.
It involves sustained work and support. We adapt the plan to your capacity, nutritional needs and circumstances. Strict fasting or a restrictive diet is not appropriate for everyone, particularly someone who is frail or losing weight.
With advanced dementia, priorities may centre more on comfort, adequate nourishment, function and support for the family.
How does this fit with NHS care?
A detailed prevention plan can proceed alongside medical assessment and prescribed treatment. Progressive memory symptoms need investigation so we understand the diagnosis and identify treatable conditions.
At CogMission, our role includes making your findings understandable and helping you implement the parts of the plan that matter most.
Call 999 for sudden confusion, speech problems or weakness.
Common questions
Does the Bredesen protocol reverse Alzheimer’s?
Some studies report cognitive improvement, particularly in early decline. It should not be described as a proven cure or a guaranteed reversal of Alzheimer’s disease.
How much does the Bredesen protocol cost?
Costs depend on the assessment, testing and support required. Contact CogMission for an individual outline before committing.
Do I need to know my ApoE4 status?
No. Testing is optional. We discuss what the result can and cannot tell you and whether knowing would help your plan.
Is the Bredesen protocol available on the NHS?
It is offered privately. NHS assessment and treatment can continue alongside it.
Worried about your memory or family history? Book a free discovery call to discuss a proactive brain health assessment.
Sources
Can Your Gut Influence Parkinson’s Disease?
Depression, Inflammation and Brain Fat
From Stardust to Brain Health: The Forgotten Power of Lithium
This article is for general information and isn't a substitute for personal medical advice. Please don't start or stop any medication without speaking to your GP or prescriber.