Exercise can help elderly in fight against Alzheimer's

The most frail elderly people, exercising for short periods of time, registered the greatest gains in a recent cohort study.

By Susan J. Landers — Posted Feb. 13, 2006

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Washington -- Evidence of the health benefits of regular exercise keeps mounting. A study has determined that regular exercise is associated with a delay in the onset of dementia and Alzheimer's disease.

The study in the Jan. 17 issue of the Annals of Internal Medicine found that older adults who exercised three or more times a week had a 30% to 40% lower risk for developing dementia compared with those who exercised fewer than three times per week.

Because many people regard Alzheimer's as one of the most dreaded consequences of aging, the findings might provide a compelling reason to heed health advice to get up and move, researchers say.

"Even those elderly people who did modest amounts of gentle exercise, such as walking for 15 minutes three times a week, appeared to benefit," said lead author Eric B. Larson, MD, director of Group Health Cooperative's Center for Health Studies in Seattle. Group Health is a nonprofit health care system.

The study followed 1,740 Group Health members age 65 and older over a six-year period. The participants were contacted every two years to assess exercise frequency, cognitive function, physical function, symptoms of depression and lifestyle characteristics, including smoking and alcohol use.

The participants listed walking, hiking, swimming, aerobics, calisthenics and weight training among exercises they performed.

After six years, 158 participants had developed dementia, and 107 of those had been diagnosed with Alzheimer's.

The rate of dementia was 13 per 1,000 person-years for people who exercised three or more times per week, compared with 19.7 per 1,000 person-years for those who exercised fewer than three times weekly.

These findings support those of other trials, said William Thies, PhD, vice president of medical and scientific affairs at the Alzheimer's Assn. "It's important to have multiple studies, and this study is a good size and was done by good people."

The study was designed to be more definitive than previous ones. Dr. Larson tested all participants to eliminate those who might have been developing Alzheimer's but not showing signs.

Benefits for the most frail

Those participants who benefited most from exercise were those most frail at the start of the study. "So this means that older people really should 'Use it even after you start to lose it,' " Dr. Larson said. "Exercise may slow the progression of age-related problems in thinking."

Exercise might improve brain function by boosting blood flow to areas used for memory, Dr. Larson said. "Earlier research has shown that poor blood flow can damage these parts of the brain."

Animal studies also have shown that exercise can reduce the amount of amyloid in mice engineered to produce more of the protein fragments that accumulate between the nerve cells in the brains of people with Alzheimer's, Dr. Thies said. "So I think there is a possibility that there are multiple mechanisms at work: those dealing with the general good health of the brain and those dealing with some of the specific chemistry of Alzheimer's."

"We are edging closer to placing prevention of cognitive deterioration and of dementia on the long list of health benefits induced by physical activity," wrote Laura J. Podewils, PhD, epidemiologist at the Centers for Disease Control and Prevention, and Eliseo Guallar, MD, DrPH, assistant professor of epidemiology at John's Hopkins' Bloomberg School of Public Health, in an editorial that accompanied Dr. Larson's study.

While it is difficult to find a health downside for exercise, Dr. Thies said, there remains the worry that the selected population affected the study's outcome. "The piece that still remains unknown is whether the exercise is causative of less Alzheimer's, or whether it is a function of the fact that the people who exercise more are more healthy to begin with, and that is why they have less Alzheimer's."

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External links

Information from the Alzheimer's Assn. on physical exercise (link)

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