Alzheimer’s and Exercise

Hardly a day goes by in my office when a patient doesn’t ask me if they could be getting Alzheimer’s disease because they could not remember where they left their keys or forgot why they went into their bedroom. I am happy to say this doesn’t mean they are getting Alzheimer’s.  It is a normal part of aging. We all know someone who has Alzheimer’s disease and many of us have parents who have this which certainly causes a lot of concern. Almost everyone will have a decrease in short-term memory as they age. Sometimes it is due to just distraction, anxiety or even depression.
Over the years, advertisements for various supplements, including vitamins, entice us by claiming to improve memory or prevent the onset of dementia. Unfortunately, absolutely nothing has really been proven to help slow the progression of dementia except for exercise. Expert opinions suggest that remaining mentally active at your job, working crossword puzzles, playing Scrabble or other games requiring reasoning can possibly help delay memory loss. Neuroscientist have developed software programs to stimulate different areas of the brain which sound promising.
Nevertheless, exercise is the only thing that has a plethora of scientific data suggesting it will help slow the onset of dementia and Alzheimer’s disease.
Many studies have actually shown changes in the parts of the brain that control thinking and memory in people who exercise versus people who don’t. “Even more exciting is the finding that engaging in a program of regular exercise of moderate intensity over a year is associated with an increase in the volume of selected brain regions,” says Dr. Scott McGinnis, a neurologist at Brigham and Women’s Hospital and an instructor in neurology at Harvard Medical School.
Exercise reduces inflammation in the body as well as the brain and stimulates the release of many healthful chemicals which improve the production and survival of new brain cells. These chemicals help neutralize the harmful chemicals released by stress and anxiety which impair cognition.  Regular exercise also reduces insulin resistance and increases blood flow and oxygen to the brain.
Canadian authors Paterson and Warburton reviewed 66 prospective studies including 19,988 participants followed for an average of 7 years and concluded that exercise reduced the risk of cognitive impairment and disability by 50 percent. The exercise needs to be of moderate to high intensity which would be 30-60 minutes per day or 150 to 180 minutes per week. It is now also recommended that we lift weights targeting all 7 major muscle groups at least twice per week. This is particularly important as we age.
Studies have shown exercise training increases fitness, physical function, cognitive function, and positive behavior in people with dementia and related cognitive impairments. Even for people who have normal intellectual brain function, regular exercise will continue to improve cognition and allow access to the creative part of the brain.
I highly recommend the book Spark by John Ratey, MD. This book details the science of exercise and the brain and the lifelong benefits that exercise provides for brain function.  I encourage all my patients, young and old, to establish exercise as an enjoyable habit.  It will help you stay physically and mentally fit.
Karl Hempel, M.D.


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