ReCODE: a plain guide for families
- First, get the treatable causes checked. (Thyroid, low B12, sleep apnea, hearing, medicines that cloud thinking. Usually covered by insurance.) Your next steps.
- Start the free parts this week. (A daily walk, natural sleep, Mediterranean-style food, blood pressure, time with people.)
- Protect natural sleep, and avoid nightly sleeping pills. (Deep sleep is when the brain clears waste.) Why sleep matters.
- If you try ReCODE, budget first. (Labs from $945, supplements $150 to $450 a month, a one-year contract. Medicare rarely pays.) The costs.
- Know what the doctor visit looks like. (Two to three hours, a big blood panel, a written plan, follow-ups every one to three months.) What to expect.
- Track changes to see if it is working. (Review at three and six months.) The tracker.
ReCODE, also called the Bredesen protocol, treats dementia as the result of many causes at once, and goes after each one. Some families see real gains.
What it is
- Test. A "ReCODE Report" built from more than 150 factors, including blood tests and genetics.
- Treat what turns up. Blood sugar, inflammation, hormones, low nutrients, infections, toxins, sleep apnea.
- Change daily life. A mostly-plant, low-carb food plan with an overnight fast (KetoFLEX 12/3), exercise, sleep, stress care and brain training.
- Add supplements chosen from the results.
- Who runs it. Neurologist Dr. Dale Bredesen created it. Apollo Health, where he is Chief Scientific Officer, trains the doctors and produces the reports.
More: the drivers it looks for
The 2022 study lists them: inflammation, chronic infection, gut imbalance, insulin resistance, sugar damage to proteins (glycation), blood-vessel disease, low oxygen at night (usually sleep apnea), hormone problems, nutrient shortfalls, and toxin exposure. Each person's report ranks which ones matter most for them.
Dr. Bredesen explains his approach
A neurologist asks Dr. Bredesen why one drug is unlikely to fix Alzheimer's, and what ReCODE does instead. Long, and fine in pieces.
The Empowering Neurologist · David Perlmutter, MD, 2021What the studies show
Encouraging, and growing. The first studies had no comparison group. Two randomized trials since then compared a many-part programme with usual care, and the programme group did better in both.
- 2021 real-world report. 255 people in ReCODE practices. Of those who started with milder loss (MoCA 19 or higher), half improved, a quarter held steady and a quarter declined.
- 2022 pilot. 25 people with mild cognitive impairment or early dementia, nine months. The average MoCA score rose from 24.6 to 27.6, and 21 of 25 improved on a computer thinking test. No serious side effects.
- 2023 study. 34 people with cognitive decline followed a personal, many-part plan. Their average thinking score rose from 19.6 to 21.7 (on the MoCA test) over six months.
- 2024 randomized trial (Ornish). 51 people with mild cognitive impairment or early dementia due to Alzheimer's, 20 weeks of an intensive lifestyle programme. 10 of 24 improved on the doctor's overall rating, and none of 25 in the comparison group did. The comparison group got worse on all four main tests.
- 2025 ReCODE randomized trial. 73 people with mild cognitive impairment or early dementia, nine months: 50 on ReCODE, 23 on usual care. On a computer thinking test, the ReCODE group's overall score rose from 92 to 106, and usual care fell from 97 to 92. Memory, planning, thinking speed and partner-rated symptoms also improved more on ReCODE. On the shorter MoCA test both groups gained, ReCODE slightly more. Posted in full online, December 2025.
- Large prevention trials. FINGER (1,260 people, 2015) and US POINTER (2,111 people, 2025) found a structured lifestyle programme helped thinking more than lighter advice, in older adults at risk.
What it means: many people in these studies got better. The free parts carry little risk, so start them now and track what changes.
More: what a comparison group adds
Retaking a test, a bad week passing and extra attention can all lift scores. A comparison group tested on the same schedule takes those out. Both randomized trials above had one.
Dr. Dean Ornish on lifestyle and Alzheimer's
The doctor who showed heart disease can be reversed with lifestyle talks about doing the same with early Alzheimer's.
Lifers with Christina Farr, 2025Patients' stories on the Bredesen protocol
People who improved, in their own words, as shared by Dr. Bredesen in his practitioner training.
Apollo Health, the company behind ReCODE, 2024Pros and cons
- Many people improve: clearer thinking, steadier mood, more of their day back.
- It reasons from the person's own results, and hunts for treatable causes a rushed visit can miss.
- It treats the whole person, not one symptom.
- Most of it helps the body anyway. In the trial, blood pressure, weight and blood sugar improved on ReCODE, not on usual care.
- Cost. Labs $945 (or "patient pay" at LabCorp or Quest, often partly covered by insurance), repeated about every six months. Supplements $150 to $450 a month. Plus a monthly fee and doctor fees.
- Medicare rarely pays.
- Work. A big change in food and routine, often run by the caregiver. In the trial, 7 of 50 stopped early, three over trouble keeping up.
- Side effects. In the trial, upset stomach and tiredness while adjusting to the diet were the most common. Most were mild or moderate.
- Hard to tell which parts help. It is tested as one bundle, so you may pay for parts your person does not need.
- Supplements can clash with prescriptions. Some plans also add prescription hormones, or antibiotics or antivirals for an infection. Show the pharmacist the full list, and change prescriptions only with the prescribing doctor.
What to expect at the doctor
- Sign up. Through Apollo you sign a one-year contract before meeting the doctor, so ask them for the doctor's first-visit fee first.
- A long first visit, two to three hours: history, every medicine and supplement, sleep, food, exercise, stress, and an exam.
- The blood panel: $945 through Apollo, or "patient pay" at LabCorp or Quest. Results in 10 to 15 business days.
- The plan: a report ranks the likely causes, with what to do about each.
- Follow-ups every one to three months. Labs again about every six months.
- Every medicine and supplement, in their bottles.
- Past lab results and scans.
- A short list of changes and when they started: thinking, mood, sleep, walking, daily tasks.
- Insurance and Medicare cards, and a second person to take notes.
- What will six months cost, all in, in writing?
- Which labs will my insurance cover?
- Do I have to buy supplements from you?
- Will you send results to our regular doctor?
- What would tell us it is working, and when do we review it?
Your next steps
- Book the regular doctor for a treatable-causes check: thyroid, B12, sleep apnea, hearing, and a medicine review.
- Start the free parts: a daily walk, morning light, a set bedtime, a Mediterranean-style plate, blood pressure handled, time with people. Why these work.
- Read The End of Alzheimer's (most libraries have it), or watch the videos above.
- Set a budget you can keep for six months without touching money needed for care.
- If you go ahead, pick a doctor (near Phoenix, below, or Apollo's locator) and bring the list above.
- Track changes in the tracker, and review at three and six months.
Sleep: the brain's overnight repair
- Deep sleep is when the brain cleans house. (Fluid flushes waste, including amyloid, out of the brain faster during sleep.)
- One bad night shows up. (After a single night without sleep, 20 healthy adults had more amyloid in memory areas of the brain.)
- Years of short sleep add risk. (Six hours or less a night in your 50s and 60s was linked to about a 30% higher dementia risk over 25 years.)
- Nightly sleeping pills are a poor trade. (Over 60, they add about 25 minutes of sleep but make memory and confusion problems nearly five times as common. In mice, zolpidem (Ambien) slowed the brain's overnight cleaning.)
- What helps instead: morning light, a daily walk, the same bedtime, no long late nap, a cool dark room, and treating sleep apnea. The sleep page has the steps.
Already on a sleep medicine? Do not stop it suddenly. Some cause serious withdrawal. Ask the prescribing doctor for a plan.
How the brain cleans itself while you sleep
A neuroscientist explains how sleep flushes waste out of the brain, and why that matters for dementia.
Jeff Iliff · TED, 2014ReCODE and functional-medicine doctors near Phoenix
Checked October 2026: licence, board record, drug-company payments and Medicare.
What: ReCODE certified, and certified in functional medicine (per her site). Board-certified emergency physician.
Pros: one of four ReCODE doctors in Arizona. Licence active, no disciplinary orders. Visits from home.
Cons: private pay. She has opted out of Medicare, so Medicare pays nothing, and insurance usually doesn't cover her programmes. No prices published.
What: functional medicine, including dementia and early Alzheimer's. Three doctors, functional-medicine certified (per their site): Danielle Bechert, MD (family medicine), Emily Parke, DO and Betsy Kantor, MD.
Pros: licences active, no disciplinary orders. A family doctor on the team. Works alongside your regular doctor. Phone or video follow-ups.
Cons: first visit in person. They don't bill insurance; you send in their invoice. Medicare can't pay for Dr Bechert's visits, but labs she orders can be covered. No prices published.
What: integrative medicine, not functional medicine or ReCODE. A doctor builds a plan with you: massage, acupuncture, yoga or tai chi, nutrition, stress help. A pharmacist can check supplements against medicines.
Pros: most people can book without a referral. Original Medicare is accepted. Acupuncture is by licensed acupuncturists.
Cons: no memory programme of its own, and Mayo's Alzheimer's drug clinic is not open in Arizona yet. Medicare Advantage plans are taken only if they contract with Mayo: call your plan first. Massage and yoga are paid by card. Medicare pays for acupuncture only for long-term low back pain.
480-301-8484 (weekdays, 8 to 5) · mayoclinic.org
Our biases, out loud
- We lean on big randomized trials. Personal, many-part care rarely fits that test, so we can undervalue clinical reasoning and what is helping people now.
- We lean on mainstream US sources (the Alzheimer's Association, NIA, FDA). They have their own pulls: drug-trial funding, legal caution, and a system that pays for prescriptions more than for lifestyle care.
- This page was researched with an AI assistant. Its training leans the same way, toward establishment sources and cautious wording.
Sources for every figure: the sources page.