The Impact of Exercise In Alzheimer’s Disease
Alzheimer’s Disease is a non-reversible, progressive deterioration of brain cell function leading to loss of cognitive and physical function that impacts approximately 6 million Americans and their families. Alzheimer’s accounts for 60-80% of all Dementia related cases and is the 5th leading cause of death amongst elderly related individuals, 65+ and 7th leading cause of death amongst adults.
The complex series of brain related changes that can occur over decades lead to predictable changes in symptomatology. Individuals are initially asymptomatic, then begin to showcase difficulty remembering newly learned information, difficulty with familiar tasks and increased confusion. Signs of memory concerns progress from Mild Cognitive Impairment to Mild Dementia and eventually to Advanced/Severe Dementia causing behavioral and mood changes, difficulty swallowing, speaking and walking, disorientation, confusion amongst many other signs and symptoms.
Risk Factors
Aging
Family History of Dementia
Diabetes
Physical Inactivity
High Blood Pressure
Dietary Issues/Obesity
Poor Sleeping Habits/Sleeping Disorders
Traumatic Brain Injury
Excessive Alcohol
Hall Mark Brain Related Changes
Individuals with Alzheimer’s Disease have an increase in plaque deposits, protein fragments called beta-amyloid plaques, between the nerve cells and twisted fibers of protein called Tau inside the nerve cells.
Delay Onset & Slowing Progression…
Reducing modifiable risk factors and consult a physician to determine if prescription medications and other healthcare professional assistance would benefit the patient, caregivers, and family members.
How Exercise Impacts Alzheimer’s Disease
Alzheimer’s Disease has no cure, however physical activity and exercise has a protective effect against developing the condition and slows the rate of progression once diagnosed. Active individual’s in their 70’s and 80’s have approximately 40% reduced risk of developing Mild Cognitive Impairment and Dementia compared to inactive peers.
Exercise is an anti-inflammatory, improves redox status in brain tissue and thus ameliorates hallmarks signs of Alzheimer’s, including increased clearance of Tau and Amyloid Plaques from the brain. It improves the release of brain derived neurotrophic factor (BDNF), that significantly improves cognitive function and brain function through improve support of brain tissue, new neuron formation, new formation of synapses and new dendrite formation allowing improved neural adaptations. Additionally, exercise counteracts modifiable risk factors: Diabetes, excessive weight, hypertension.
Ortiz et al. performed a systematic review and meta-analysis to determine the correct FITT: Frequency, Intensity, Time & Type of exercise to improve the following categories: Strength training, Aerobic training, Balance, Multi-sensory training, Stretching/warm-up and mobilization (Multi-modal intervention) versus typical a control group with typical care and the impact it has on: Cognitive function, Functional independence, Physical function, & Neuropsychiatric symptoms.
Cognitive Function
Trend towards significant improvement with exercise
Significant improvement in cognition (MMSE scores) in strictly Aerobic training
Functional Independence
Significant improvement in Barthel Index (functional independence scores) following exercise protocol
Physical Function
Significant improvement in physical function in 6 Minute-Walk Test, Balance Tests (BBS, Functional reach), following exercise protocol
Neuropsychiatric Symptoms
Significant improvement in neuropsychiatric symptoms in NPI scores following exercise protocol
Exercise had a significant positive impact attenuating cognitive decline in patients with Alzheimer’s Disease.
An exercise protocol had significant positive impact on executive function, working memory, cognitive flexibility, performance with Activities of Daily Living (ADLs) and physical function with reduced risk of falls.
Exercise Guidance
Higher intensity exercise had a greater impact, especially higher intensity cardiovascular activity, related to increasing BDNF (production of neurotrophic factors) versus lower intensity exercise
Lower glycogen stores and increased ketones demonstrated increase in neurotropic factors
Resistance training could induce improve functional independence, neuropsychiatric symptoms and verbal fluency
Progressively improve exercise time from 60 to 300 minutes/week with a multi-modal routine (stretching, aerobic, resistance training, balance training) to vastly improve aforementioned limitations. See the following article for additional tips!
More Information & Additional Resources
NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
800-438-4380
adear@nia.nih.gov
www.nia.nih.gov/alzheimers
Alzheimers.gov
www.alzheimers.gov
Alzheimer's Association
800-272-3900
866-403-3073 (TTY)
info@alz.org
www.alz.org
Alzheimer’s Foundation of America
866-232-8484
info@alzfdn.org
www.alzfdn.org
References
Alzheimer's disease. Centers for Disease Control and Prevention. https://www.cdc.gov/dotw/alzheimers/index.html. Published September 27, 2022. Accessed April 3, 2023.
Alzheimer's disease fact sheet. National Institute on Aging. https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet#diagnose. Accessed April 3, 2023.
López-Ortiz S, Valenzuela PL, Seisdedos MM, et al. Exercise interventions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev. 2021;72:101479. doi:10.1016/j.arr.2021.101479
What is alzheimer's? Alzheimer's Disease and Dementia. https://www.alz.org/alzheimers-dementia/what-is-alzheimers. Accessed April 3, 2023.
