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Alzheimer’s Disease: Effects of Exercise at the Cognitive Level

https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet


Pathology 

Dementia is a growing disease as the world population, especially older adults, continues to increase. According to the World Health Organization (WHO) dementia is “an umbrella term for several diseases that are mostly progressive, affecting memory, other cognitive abilities and behaviour, and that interfere significantly with a person’s ability to maintain the activities of daily living.” Alzheimer’s Disease (AD) is the most common type of dementia which accounts for 60% to 70% of all cases according to the World Health Organization (WHO, 2017). It is predicted that the population of patients with dementia will increase to 75 million people by 2031, and considering the high percentage, more people will suffer from AD (WHO, 2017).

AD is a neurodegenerative disease that is irreversible and mostly happens in individuals aged 65 and above. Degradation of neurons is a combination of accumulation of Amyloid beta (Aβ) proteins and microtubule protein Tau. The degeneration of neurons is apparent in brain imaging as a cerebral atrophy. As a result of these negative cellular changes, people with AD suffer from cognitive impairment and executive dysfunctions that affect different aspects of their life such as social, behavioral, physical, and psychological aspects.

It is important to note that AD is a progressive disease and appearance of symptoms depends on the lifestyle of the individual and the rate of molecular changes, such as Aβ and Tau, in the brain.

Types: other types of dementia are:

·           Vascular dementia

·           Frontotemporal dementia

·           Dementia with Lewy bodies

According to published data by WHO, global monetary impact of AD was US$818 billion in 2015 which is predicted to increase to US$2 trillion by 2030. This fact makes early interventions such as exercise important. 

Research

A large amount of research has been conducted on the effects of exercise on neurological conditions such as Alzheimer’s. A study investigating the effects of high intensity aerobic exercise (at 70-80% maximal heart rate completed for 16 weeks) on elderly with a mean age of 70 years old recorded significant reductions in neuropsychiatric symptoms. A similar study involving 200 participants with a mean age of 71 years old (completing an exercise program for 1 hour 3 times a week over 16 weeks) recorded improvements in dual tasks and postponing decline in dual tasks which results in more independency for individuals with AD. However, an additional study following similar parameters (78-year-olds with mild to moderate AD completing 65-75% HR aerobic exercise 3 times a week over 6 months), recorded no improvements in cognitive ability, but saw a reduction in cognitive decline and activities of daily living. Therefore, it appears as if the effects of the benefits of these programs are not universal. Yet, it seems that even less structured exercise programs are also helpful. A study which placed 40 participants with a mean age of 74 who had mild to moderate AD through 4 months of exercise recorded improvements not only in physical function (like balance and mobility), but also in cognitive function. This study also recorded increases in independence score for activities of daily living in AD patients as well. Therefore, physical activity and exercise is able to improve the quality of life for an elderly individual with AD.

Exercise

Although there seems to be a fairly beneficial effect of exercise on elderly with Alzheimer’s or Dementia, the exercises in the studies investigating the effect vary. A majority of the research looks into the effect of aerobic exercise (conducted at moderate or high intensity) on these neurological conditions. However, regardless of the exercise completed, the exercise program must be conducted over a fairly substantial amount of time with most studies placing participants through programs that are around 16 weeks long. Therefore, it is important to pick an exercise program that you or your family member enjoy so that they will be willing to continue and stick with this program consistently over many weeks.


Exercise intervention: Multimodal aerobic exercise More than 4 months in length More than 150 minutes/week Supervised. Positive effects : Reduce cognitive decline Improve functional capacity Improve strength Increase independency time Increase irisin level Neuroprotective Increase vascular health.

      

**If you believe that exercise will help you or someone you know, please contact a registered healthcare professional for more information.

**For more detail on this topic or to recommend future content, please email.


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