Alzheimer's, Dementia & Mental Health
First Study Using Exercise to Slow Cognitive Decline
in Older Americans Finds Success
Slowing Alzheimer’s by a year could prevent 9.2
million cases, as world prepares for 106 million victims by 2050
Sept.
2, 2008 – A study to be reported in the Journal of the American Medical
Association tomorrow says testing of older Americans with memory
problems, who participated in a home-based physical activity program,
shows they experienced modest improvement in cognitive function.
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The researchers believe this trial is the first to
demonstrate that exercise improves cognitive function in older adults
with subjective and objective mild cognitive impairment.
It will, too, almost surely attract the attention
of millions of senior citizens that are worried about memory problems,
because the exercise program that achieved the positive results was not
that stressful. Most of the participants used walking.
There is a rush by researchers to slow the advance
of Alzheimer’s disease, which is expected to increase its victims in the
world from 26.6 million today to over 106 million in 2050.
“If illness onset could be delayed by 12 months,
9.2 million fewer cases of AD would occur worldwide. For this reason,
attempts have been made to identify individuals who are at increased
risk of AD and to test interventions that might delay the progression of
prodromal symptoms (early non-specific symptom, or set of symptoms) to
full-blown dementia,” the authors write.
Nicola T. Lautenschlager, M.D., of the University
of Melbourne, Australia, and her colleagues conducted a randomized
controlled trial to test whether a physical activity intervention would
reduce the rate of cognitive decline among 138 adults age 50 years and
older at increased risk of dementia.
The participants, who reported memory problems but
did not meet criteria for dementia, were randomly allocated to an
education and usual care group or to a 24-week home-based program of
physical activity.
The aim of the intervention was to encourage
participants to perform at least 150 minutes of moderate-intensity
physical activity per week, which participants were asked to complete in
three 50-minute sessions each week.
The most frequently recommended type of activity
was walking. The intervention resulted in 142 minutes more physical
activity per week or 20 minutes per day than with usual care.
Cognitive function was assessed with the Alzheimer
Disease Assessment Scale–Cognitive Subscale (ADAS-Cog; a measuring tool
that consists of a number of cognitive tests) over 18 months.
The researchers found that by study end,
participants in the exercise group had better ADAS-Cog scores and
delayed recall than those in the usual care control group. Participants
in the physical activity group also had lower Clinical Dementia Rating
scores than those in the usual care group.
“To our knowledge, this trial is the first to
demonstrate that exercise improves cognitive function in older adults
with subjective and objective mild cognitive impairment. The benefits of
physical activity were apparent after 6 months and persisted for at
least another 12 months after the intervention had been discontinued,”
the authors write.
“The average improvement of 0.69 points on the ADAS-Cog
score compared with the usual care control group at 18 months is small
but potentially important when one considers the relatively modest
amount of physical activity undertaken by participants in the study.”
“Unlike medication, which was found to have no
significant effect on mild cognitive impairment at 36 months, physical
activity has the advantage of health benefits that are not confined to
cognitive function alone, as suggested by findings on depression,
quality of life, falls, cardiovascular function, and disability.”
Editorial:
Physical activity for older adults at risk for alzheimer disease
“Health advances of the past century have led to
more individuals surviving to extreme old age, when their risk of
Alzheimer disease and related dementias increases substantially,” writes
Eric B. Larson, M.D., of the Group Health Center for Health Studies,
Seattle, in an editorial in the magazine.
“Exercise—and possibly other lifestyle
factors—appear to affect vascular risk and late-life brain health. In
addition to traditional medical approaches to prevent this dreaded
disease, social factors such as providing universal education, general
medical care, a suitable environment, adequate nutrition, habitual
exercise, and opportunities for continued social interactions throughout
the lifespan also may contribute significantly to improve well-being in
late life.”
