Can Exercise Help Prevent Alzheimer’s Disease?

Brain X-ray

A report published this week in the Annals of Internal Medicinesuggests that moderate levels of exercise may delay the onset of dementia. The study, which spanned 11 1/2 years, showed a remarkable 38% reduction in the chance of getting dementia for people who exercised three or more times a week, in comparison with those who exercised less than three times a week.

The study was extensive, involving 1,740 participants. To ensure that none of the participants showed any signs of dementia going into the study, they were given cognitive screening tests, and only the top 25 percent were accepted. Each participant was followed up every two years for an average of 6.2 years over the course of the study. By the end of the study, 158 people developed some form of dementia (107 of those developed Alzheimer’s Disease) and 1,185 remained dementia-free. Others either withdrew from the study or died during that period.

The findings support recent studies that suggest physical exercise can enhance cognitive function. Of those who exercised three or more times per week, an average of 13 people out of 1000 developed dementia in each year of the study. For those who exercised less, this ‘incident rate’ was 19.7 people out of 1000. Physical exercise was defined as lasting at least 15 minutes at a time and included such things as walking, hiking, bicycling, aerobics, swimming, weight training, and stretching.

Other factors were considered as well, such as smoking, drinking, using dietary supplements, as well as health conditions such as coronary heart disease, cerebral-vascular disease, hypertension, and diabetes. Surprisingly, these factors, along with gender and age differences were fairly consistent across the two groups: those with dementia and those without. In other words, the single most important difference was the frequency of exercise.

The researchers did not set out to determine a dose-response, that is, the amount of exercise needed to have a beneficial effect. But they did determine that the greatest reduction was in those who scored lower on fitness tests, as long as they exercised at least three times a week. Another study done a year earlier showed that moderate levels of physical activity (3-5 times per week) were associated with a greater delay in the onset of dementia than high exercise levels (more than 7 times per week)– a 45% reduction compared with a 28% reduction . This may mean that one only needs to do moderate amounts of exercise to realize these benefits, and that the frailest people are the most likely to see the benefits. The chief author of the article suggests that senior citizens may have even more reason to “use it even after (they) are losing it”

The researchers note that they did not take into consideration non-leisure and work activities of the participants, which may affect the results. But the results of the study are consistent with earlier ones which showed less tissue loss in the hippocampus in persons at higher levels of physical functioning than frailer older adults. The hippocampus is an area of the brain involved in cognitive functions and is damaged in Alzheimer’s patients.

The researchers concluded the study by suggesting that “physicians and health promotion programs might find this information valuable as our society works to find truly effective ways to promote physical activity for all its well-known benefits”. It would do society well to look into preventative measures such as exercise to help decrease the incidence of Alzheimer’s and other forms of dementia. This would allow seniors to live out their final years as independently as possible and curb what is often referred to as the greatest fear of aging.

To your health,
Chris

References

Larson, E.B., Wang, L., Bowen, J.D. et al (2006). Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older. Annals of Internal Medicine,144, 1-20.

Brown, D.W., Brown, D.R., Heath, G.W. et al (2004). Associations between physical activity dose and health-related quality of life. Medicine & Science in Sports & Exercise,36:890-896.

Colcombe, S.J. Erickson, K.I., Raz, N. et al (2003). Aerobic fitness reduces brain tissue loss in aging humans. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences58:M176-M180.

Sticking With It

List of New Year's ResolutionsHappy New Year!

Many of us make New Year’s resolutions and many of those resolutions are health and fitness related. Resolutions such as “I will give up coffee” (or alcohol, or cigarettes) are common. So are the resolutions to eat better, lose weight, join a gym, or go to the gym we joined last New Year!

Regardless of how they’re phrased, people often find it hard to stick to their New Year’s resolutions. Notice how many flyers you receive in your mailbox in late December for discounts on gym memberships or weight loss programs. Fitness centres, weight loss clinics, and alternative health practitioners expect to get new customers in the New Year as people resolve to be fit, healthy, or live a more balanced life.

While it is good to see people thinking of positive things they can do for themselves, how many actually do the things they plan to do or stick with them long enough to turn their resolutions into healthy lifestyles? Just go into your neighbourhood fitness centre in January and see how crowded it is. However, by February, the numbers start to dwindle and by March, the numbers are back to where they were before the holiday season.

Why is it that people have such a hard time sticking with resolutions that are good for them?

There are many reasons. Poor planning is a big one. People say they’re going to do something without planning on how they’ll actually carry it out. Without a game plan, there can be no winning the game. Habits take time to form, whether they’re good ones or bad ones.

You need to exercise regularly for at least 1 or 2 months before it becomes a habit. This, of course, will depend on how frequently you exercise. I tell my clients to incorporate exercise into their lives at least three days a week, but also recommend that they be physically active every day if possible. Being physically active means doing things like taking your dog for a walk, taking the stairs instead of the escalator or elevator whenever possible, getting off the bus one stop early and walking the rest of the way home, doing household chores, etc.

Exercise, however, is structured physical activity. Adding structure to an already busy schedule can be tricky, but not impossible. I often hear older adults who are retired say that they can’t imagine how they ever worked full-time because they lead such busy lives. I also know that we can make ourselves too busy — too busy to see friends and family, too busy to take a vacation, too busy to finish that novel we were reading and too busy to exercise.

How can we put exercise into our busy lives so that it starts becoming habit?

The first thing we need to do before adding exercise to our lives is some homework.

Start by talking with your doctor or health care professional to determine if there are precautions you must take. If you are taking certain medications or have particular health conditions, you may need clearance from your doctor on such things as your target exercise heart rate, intensity level, certain exercises to avoid, or modifications to exercises.

Next, think about what activities you are interested in doing and try to match your fitness goals to your interests and lifestyle.

If possible, have a consultation with a personal trainer or fitness consultant. Even if you are unsure or unwilling to begin training sessions, you can still benefit from speaking with someone trained in the field of fitness counseling about identifying and setting goals. One consultation session can go a long way to helping you develop a program you can stick with whether you choose to do the program on your own, in a class, or with a trainer.

Consider your lifestyle needs and activity preferences. Is it important for you to be in a group, be independent, meet new people, be a leader, learn something every day, or to be alone? Do you like being physically active or does it feel like a chore? Do you feel the need to release frustration, energy, or to be relaxed? Do you prefer to be outdoors? Do you like to try something new? Do you have family, job, or other commitments that require large blocks of time?

Once you have identified these and other lifestyle needs that are important to you, prioritize them and for the top three, identify activities which will help you satisfy those needs.

Next, plan your first steps. How are you going to be more active or incorporate an exercise program into your schedule? What days of the week work best for you? What works best with your schedule: morning, afternoon, or evening? Remember that if you are planning on doing muscle conditioning you should leave at least 48 hours in between sessions.

You may want to formalize your plan by creating a self-contract where you list your goals, what you need to do to realize those goals, and what you can do to help you stay on track. Remember: old habits die hard and new ones are hard to pick up. You may have “fallen off the wagon” in the past. Ask yourself what made you lose your resolve. Be honest. Identify the event or pattern you followed and write it down. This will help you to seal your contract so that you can prevent that from happening again. Sign your contract and on separate piece of paper, identify the areas you think you may be at risk of in terms of cheating or breaking your contract. If weight loss is your goal, identify your weak areas. Don’t be too hard on yourself. If you can have the occasional chocolate chip cookie and but stay committed to losing weight, then don’t sweat it. However, if that one cookie always seems to take you down a slippery slope to throwing in the towel, then it’s best to identify it and develop a strategy to avoid the temptation.

Finally, don’t get paralyzed by failure. A failure is not a failure if you learn something from it. If you find that you really dislike attending the abs and back class at your gym after a month, then do something else. Just don’t beat yourself up over it or stop being active. Maybe you should try a different class or work with a trainer. There is no right or wrong way, only the way that works best for you.

Remember the slogan from Canada’s Physical Activity Guide: “Make physical activity a part of your life every day”.

Don’t dwell on past mistakes, move forward, and make this your year to get fit and stay strong!

To your health,
Chris