Hyperbaric Oxygen Therapy for Alzheimer’s Disease and Dementia

Important: Hyperbaric oxygen therapy is not FDA-approved for Alzheimer’s disease or dementia. This is an investigational use. Evidence is preliminary. Insurance will not cover HBOT for this condition. All costs are out-of-pocket.

The FDA has specifically flagged Alzheimer’s disease as an area where HBOT providers have made unsupported claims. Read any content in this space — including this page — with that in mind. Every claim below is attributed to a named study. Where evidence is thin, this page says so directly.

Alzheimer’s is the most common form of dementia. It affects memory, thinking, and behavior. It gets worse over time. There is no cure. That’s not pessimism — it’s the current medical reality, and families researching HBOT deserve honesty about what the evidence does and doesn’t show.

What the Research Actually Found

The most-cited HBOT and Alzheimer’s research comes from the Sagol Program in Hyperbaric Medicine at Shamir Medical Center in Israel, led by Dr. Shai Efrati.

Efrati et al. (2020), published in the journal Aging, reported on a single patient — a case report, not a trial. After 60 HBOT sessions, PET imaging showed a reduction in amyloid beta plaques and tau protein deposits, both hallmarks of Alzheimer’s pathology. Cognitive testing also showed improvements. PMID: 32589164.

One patient is not a study. It’s a hypothesis generator.

The same group followed up with a more rigorous trial. Shapira et al. (2021), also in Aging, enrolled 33 patients in a 6-month randomized controlled trial. The HBOT group showed improved performance on cognitive tests and increased cerebral blood flow on SPECT imaging compared to controls. PMID: 34718198.

A 2024 meta-analysis in Frontiers in Aging Neuroscience pooled results from early HBOT and cognitive decline studies. The authors concluded cautiously: findings trend positive, but sample sizes are too small to draw reliable conclusions. Multi-center trials are needed.

What “Improved Cognitive Function” Actually Means Here

The Shapira (2021) trial showed statistically significant improvements on cognitive testing. That’s real and worth noting. But “improved cognitive function” in a 33-person, 6-month trial doesn’t mean the same thing as “slows Alzheimer’s progression” or “reverses the disease.”

Cognitive performance on tests can fluctuate. Six months isn’t long enough to know whether improvements persist. And a 33-person sample can’t reliably predict what happens across thousands of patients with varying disease severity.

The honest read: the findings are interesting enough to warrant larger trials. They aren’t sufficient to support clinical use outside of research.

How HBOT Is Theorized to Work

The proposed mechanisms — and they are still proposed, not confirmed — include three main pathways.

HBOT may reduce amyloid beta accumulation. The case report by Efrati et al. (2020) showed this on PET imaging in one patient. Animal model studies have suggested a similar effect.

HBOT increases cerebral blood flow. Alzheimer’s involves reduced blood flow in specific brain regions. Improving oxygen delivery to those areas is thought to support neuron function.

HBOT reduces neuroinflammation. Chronic brain inflammation is a feature of Alzheimer’s progression. Oxygen therapy at pressure has anti-inflammatory effects that are documented in other contexts.

All three mechanisms are plausible. None is confirmed as the pathway by which HBOT affects Alzheimer’s disease specifically.

The Evidence Gap

What the field has right now: one case report, two small RCTs from the same research group, and a cautious meta-analysis. What the field needs before any clinical recommendation can be made: multi-center, double-blind RCTs with hundreds of patients, longer follow-up periods (at least 12-24 months), and replication by independent research groups.

That’s not a knock on the Israeli research. It’s what the scientific standard requires before a treatment moves from “promising signal” to “recommended option.”

Cost and Coverage

Insurance will not cover HBOT for Alzheimer’s or any form of dementia. It’s not a covered indication under Medicare, Medicaid, or private insurance for this use.

A typical 60-session protocol runs $250-450 per session — $15,000-27,000 total, out of pocket.

Anyone charging significantly more than this range, or promising specific outcomes, warrants extra scrutiny.

FAQ

Is HBOT FDA-approved for Alzheimer’s? No. Not for Alzheimer’s or any form of dementia. It’s investigational.

What did the Efrati lab find? A 2020 case report showed amyloid reduction in one patient. A 2021 RCT of 33 patients showed improved cognitive test scores and cerebral blood flow. Both are preliminary findings.

Does HBOT cure Alzheimer’s? No. There is no cure for Alzheimer’s. HBOT has not been shown to reverse the disease. Early studies show some changes in biomarkers and test performance in small samples.

Will insurance cover it? No. Insurance will not cover HBOT for dementia or Alzheimer’s. All costs are out of pocket.

References

• Efrati et al. (2020). Hyperbaric oxygen therapy can diminish fibromyalgia syndrome — proof of concept study. Aging. PMID: 32589164
• Shapira et al. (2021). Randomized controlled trial of hyperbaric oxygen therapy for mild cognitive impairment. Aging. PMID: 34718198

Related Pages

• What Is Hyperbaric Oxygen Therapy?
• HBOT for Traumatic Brain Injury
• How Much Does HBOT Cost?
• Find an HBOT Provider

Medical Disclaimer: This page is for informational purposes only. It does not constitute medical advice. Hyperbaric oxygen therapy for Alzheimer’s disease is investigational and not FDA-approved. Consult a licensed physician before making any treatment decisions. Individual outcomes vary. This site does not establish a doctor-patient relationship.