One more reason to get moving

By Rosemary Black, for MDLinx
Published February 21, 2019

Key Takeaways

You already know that exercise can reduce the risk of everything from type 2 diabetes and heart disease to depression. Now, it turns out that being more physically active may protect against dementia as well. Older adults who either engage in daily exercise or just do everyday tasks, such as housework, may maintain more of their thinking skills and memory than their less active counterparts—and that holds true even if they have the brain lesions or biomarkers that are linked to dementia, according to a recently published study in Neurology.

In the study, researchers assessed 454 older adults (191 with dementia and 263 without dementia) who underwent physical examination and cognitive testing annually for 20 years. All participants consented to brain donation upon their passing (mean age at death: 91 years). Participants’ physical activity was monitored with an accelerometer. Upon collection and analysis of individualized movement data, the researchers calculated an average daily activity score for each participant.

When scientists examined the decedents’ brains for lesions and biomarkers of dementia and Alzheimer’s disease, they found a link between a higher level of physical activity and better cognition that was independent of the presence of biomarkers of dementia, Alzheimer’s disease, or related cognitive disorders.

The study authors concluded that, “Physical activity in older adults may provide cognitive reserve to maintain function independent of the accumulation of diverse brain pathologies. Further studies are needed to identify the molecular mechanisms underlying this potential reserve and to ensure the causal effects of physical activity.”

Exercise is already touted for its beneficial effects on health.

“Prior studies have indicated that higher levels of aerobic exercise, along with a diet low in saturated fat and refined sugars, combined with increased amounts of lean proteins and healthy grains and fiber, are an important component to control blood pressure and reduce cholesterol and triglycerides,” said Robert Glatter, MD, emergency physician, Lenox Hill Hospital, New York City, NY. “Keeping yourself physically active to improve cardiac fitness translates to improved vascular health, which has clear neuroprotective effects.”

As far as which types of physical activity older Americans should try to get, Dr. Glatter recommended “practical interventions” such as taking the stairs instead of using the elevator or escalator. Also, try walking to your destination rather than driving, he added.

“Simply taking ‘standing breaks’ at work, instead of sitting, is also going to benefit your vascular health overall, by reducing stasis and improving blood flow,” Dr. Glatter noted.

The key to enticing older people—or anyone, for that matter—to exercise is to “find things they enjoy doing,” said Scott Going, PhD, exercise physiologist and professor, Department of Nutritional Sciences, The University of Arizona College of Agriculture and Life Sciences, Tucson, AZ. “Ask what do they like to do? Maybe they enjoy social dancing, or moving around the yard doing chores,” he said. It doesn’t matter what they do, as long as it’s on a regular basis, he added. Even low-intensity exercise can be beneficial.

It's key to remember that exercise needn’t take place at a gym, explained Shawn Anthony, MD, sports medicine surgeon, Mount Sinai West, New York City, NY. “Any time not spent sitting can be made part of an exercise program,” he said. “Body weight exercises are a great way to build core and muscle strength, improve balance, and gain benefits for cardiovascular health.”

Simple exercises may include heel-toe walking, one-leg balancing, and standing marches, he added.

“Exercises can be performed while waiting in line at the supermarket or during TV commercial breaks,” Dr. Anthony said. “Everyday house chores like laundry and cleaning also are efficient ways to keep moving.”

About 30 minutes a day of exercise is recommended, and it can be broken up into 5 and 10-minute increments, Dr. Going said.

Those who are wheelchair-bound can do upper body activities, he added. The American Academy of Retired Persons offers suggestions for exercise and fitness routines for older adults as well.

According to Dr. Glatter, while exercise is important, there are other factors that come into play as well when weighing risk factors for Alzheimer’s disease and dementia.

“The contributions of adequate sleep, treating depression, and reducing isolation may be equally important as we age, since they ultimately affect blood pressure and lipid profile,” he said. “Keep in mind that one of the key aspects of reducing the risk for dementia centers around vascular health. Along with aerobic exercise, your blood pressure and lipid profile are important determinants that influence the pliability and reduce stiffness in small blood vessels.”

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