Exercises to combat dementia

By Alistair Gardiner
Published January 6, 2021

Key Takeaways

Physical exercise is an important part of staying healthy, regardless of age or lifestyle. Working out regularly leads to positive health outcomes—and, according to recent research, these include protection against dementia.

A 2020 report in The Lancet estimates that roughly 50 million people around the world live with dementia, and the number is projected to increase to 152 million by 2050. Research illustrates that risk factors for cardiovascular disease are also risk factors for dementia. In short: What’s good for your heart, is good for your brain.

Beyond that, those who exercise regularly are also less likely to develop high blood pressure, type 2 diabetes, obesity, heart disease, and stroke, all of which are risk factors for dementia. 

While the exact mechanisms have not been established, it’s thought that exercise improves blood flow to the brain, which may stimulate brain cell growth and survival. Alongside healthy choices like smoking cessation and eating a nutritious, balanced diet, getting regular exercise is a great strategy to avoid dementia. 

Physical fitness and mental fitness

A number of recent studies have found associations between getting more physical activity and lower risks of dementia. In a study published in 2019 in Neurology, researchers studied 454 brain autopsies, and then looked at daily physical activities, cognitive abilities, and motor performance of the deceased, using a series of regression analyses. 

Investigators found that higher levels of total daily activity and better motor abilities were independently associated with improved general cognition. The study also indicated that these associations remained significant when researchers focused specifically on those who had developed Alzheimer disease or other brain pathologies. The researchers concluded that physical activity in older adults may provide “cognitive reserve,” which could help maintain brain function, although further studies are needed to determine the molecular mechanisms responsible.

Other studies have approached the question from different angles, bolstering the association between working out and protection from dementia. One study, published in The Lancet in November 2019, sought to examine whether a change in cardiorespiratory fitness over time is associated with change in risk of incident dementia, dementia-related mortality, and the rate at which dementia develops. 

Researchers collected data from more than 30,000 people, gathered as part of a separate health study conducted in the 1980s. Participants had provided information on their cardiorespiratory fitness, and researchers then tracked rates of incident dementia and dementia-related mortality during a 20-year follow-up period. They found that not only did those who had sustained a high level of fitness have a lower risk of dementia, those who increased their cardiorespiratory fitness over time actually decreased their risks of dementia incidence and mortality, delayed onset, and increased longevity after diagnosis.

What’s the best routine?

There are three types of exercise that should be in your routine: sustained aerobic exercise, strength training, and flexibility/balance training. Let’s break them down.

Sustained aerobic exercise is physical activity performed at a moderate level of intensity over a prolonged period of time—typically at least 30 minutes. For beginners: If your heart rate is higher than when you’re stationary, you’re doing it right. Examples include brisk walking, dancing, jogging, biking, and swimming, any of which can improve general physical health and improve blood flow to the brain.

Strength training—also called weight training or resistance training—involves working your muscles. You can lift weights, use resistance bands, or squeeze rubber balls. Strength training builds or maintains muscle. Other benefits include increasing tendon/ligament strength and improved bone density, flexibility, tone, metabolic rate, and postural support.

Flexibility and balance exercises may not feel as challenging—but they’re just as important as the other types mentioned above. Examples include yoga, tai chi, and Pilates, all of which can help to strengthen the spine and supporting muscles around the body, and improve balance and coordination. Including these in your routine can prevent falls later in life, which can help you to avoid head traumas or injuries that prevent further exercise—both of which can contribute to increased risks of dementia. 

Health experts recommend a combination of all three of these exercise tactics. And recent evidence supports this. 

One study, published in Applied Physiology, Nutrition and Metabolism in 2019, examined the relationship between workout intensity and memory enhancement. Researchers worked with a cohort of 64 elderly participants and split them into three groups: one that engaged in high-intensity interval training, one that engaged in moderate continuous training, and one control group. While high-intensity interval training offered the greatest improvements to memory, researchers concluded that exercise intensity didn’t matter for executive functioning, given that positive trends were observed in both exercise groups. The study found that improvement in fitness in general correlated with improvement in memory performance.

Similarly, a study published in February 2020 in Physical Medicine and Rehabilitation reached the conclusion that strength training and aerobic exercise offer benefits for dementia patients. The study compared the benefits of the two types of exercises by monitoring the progress of 80 elderly dementia patients over 4 weeks. The researchers used the Barthel Index as a primary outcome measure, along with various cognitive and mental assessments, and the monitoring of biomarkers like plasma monocyte chemotactic protein-1 levels and serum brain-derived neurotrophic levels. The study found that both types of exercise provided significant benefits to elderly patients with dementia.

Bottom line 

Evidence shows that not only does exercise improve brain function and behavior, and decrease the burden of neuropsychiatric disease, the benefits may extend to future generations via epigenetic changes. So don’t wait. Now is the perfect time to add some exercise to your weekly schedule. Your body, your brain, and maybe even future generations, will benefit!

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