"Case Report: Ketogenic Diet Acutely Improves Cognitive Function in Patient with Down Syndrome and Alzheimer's Disease" (Newell et al., 2023)

Dr. Lee "There's a particularly compelling study. I'd like to share one case report and conclude today's lesson with it. The title is "Case Report: Ketogenic Diet Acutely Improves Cognitive Function in Patient with Down Syndrome and Alzheimer's Disease" (Newell et al., 2023). Down syndrome carries a much higher risk of early-onset Alzheimer's. Among Americans in their seventies, 8% of the general population has Alzheimer's, but 77% of those in their seventies with Down syndrome do—more than nine times higher. This paper reports the case of a woman with Down syndrome, given the pseudonym Mary."

In 2014, Mary had a body mass index of 46.7—obese—but could participate in a wide range of activities on her family's hobby farm. She could care for the horses and dogs, clean the stalls, and return the animals to their pens. She could be alone for up to five hours.

In 2016, at age 41, Mary's memory began to slip gradually. She became confused when leaving the house and could not find her way back. She showed fear, anxiety, and obsessive-compulsive behaviors. She could not dress herself properly and tired easily. Being alone was no longer safe.

In 2018, Mary was first seen by an internist and, after several tests, was prescribed daily paroxetine 20 mg, memantine 28 mg, and alprazolam 0.5 mg. Between 2014 and 2020 she followed a paleo-style diet, with daily carbohydrate intake under 100 g, and her BMI fell to 27.2. But her cognition kept declining.