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SALEM COMMUNITY HOSPITAL...Exercise may reduce risk of Alzheimer’s

April 22, 2012
Salem News

Daily physical activity may reduce the risk of Alzheimer's disease and mental decline even in people older than 80, according to a new report this week in the medical journal Neurology. And it's not just walking, running, or other exercises that count. Tasks like cooking, playing cards, and even moving a wheelchair with a person's arms count as physical activity and can help lower risk for Alzheimer's disease.

Alzheimer's disease is the most common type of dementia. The symptoms include serious memory loss, confusion, and mood changes that develop gradually and worsen with time. According to the Alzheimer's Association, risks for developing Alzheimer's disease include advanced age and family history.

In recent years, several studies have found that older people are less likely to develop Alzheimer's disease and other forms of dementia if they engage in vigorous exercise, such as jogging, swimming, or brisk walking.

However, those who are too frail or out of shape to hit the treadmill or work-out shouldn't despair. According to the new study, even mundane, low-key tasks like gardening, cooking, and washing dishes can lower the risk of Alzheimer's if they're performed often enough.

New Study Findings

The study, which was published this week in Neurology, included 716 dementia-free men and women in their 70s and 80s. Compared to the most active people, those with the lowest levels of overall physical activity had more than double the risk of going on to develop Alzheimer's disease. Greater physical activity was also associated with a slower rate of aging-related memory and cognitive decline.

"This suggests that people in their 80s who can't participate in formal exercise still get a benefit by leading a more active lifestyle," said lead author Aron S. Buchman, MD, associate professor of neurological sciences at Rush University Medical Center, in Chicago. "You don't have to get a membership in the local YMCA. If you walk up some more steps, stand up and do the dishes more, you stand to benefit because it's incremental and adds up over the course of a full day."

Most previous research on physical activity and dementia risk has relied on questionnaires that ask participants to remember how much exercise they got in recent days-a potentially iffy method with people of any age, let alone older adults whose memory may be waning. The new study, by contrast, is among the first to use an objective measure of physical activity.

All of the participants wore a motion-sensitive, wristwatch-like device 24 hours a day for up to 10 days. These devices, known as actigraphs, have been shown to provide an accurate snapshot of a person's total everyday activity, including mild activity. "It doesn't make a difference if you're chopping onions, or walking up and down stairs, or on an exercise machine," Buchman said.

Over the next four years, the participants underwent annual cognitive tests and were asked to report how often they engaged in physical activities such as gardening, walking, and swimming, as well as social and brain-stimulating activities. (The researchers took all of these activities into account, along with other variables such as age, sex, education, overall health, depression, and genetic factors.)

Roughly 10 percent of the participants received an Alzheimer's diagnosis during the follow-up period. The higher a person's activity level, the lower his or her risk of Alzheimer's tended to be. The participants who were least active at the beginning of the study-those with actigraph readings in the bottom 10th percentile-were 2.3 times more likely to receive a diagnosis than those in the 90th percentile.

The findings show only an association, and do not establish that physical activity directly prevents Alzheimer's. That said, Buchman and his colleagues assessed the participants' cognitive health and prior physical activity in detail at the start of the study, which allowed the researchers to all but rule out the possibility that undiagnosed or early-stage dementia was leading to low physical activity.

"The results are very novel and should change the way we think about recommendations that we make to older people," said Dr. Buchman. "The fact that an older person may not be able to participate in a formal exercise program is not the end of the discussion. The walk-away message is that 'active lifestyle' has a much larger definition and includes a whole range of activities. It is not just walking and running or formal exercise, but older people should be encouraged to make their lifestyle more active. If you wash dishes or walk a couple of extra stairs, it will add up over the course of a day and will benefit you over the course of time."

The physical activity in the study "was for the most part heavily weighted toward non-exercise activity," Buchman says. This non-exercise activity appears to be beneficial, but the study findings suggest that more vigorous exercise might be even better.



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