Fitness Improves Dementia-Related Brain Decline

August 14, 2008—Cardiorespiratory fitness may help delay brain “shrinkage” (atrophy) that occurs in people with Alzheimer’s disease, according to new research published in Neurology.

Brain atrophy happens earlier in a person with Alzheimer’s disease than in someone who is aging normally. Maintaining physical fitness may help delay changes in the brain during normal aging. Prior research has shown that healthy seniors with higher cardiorespiratory fitness have lower rates of cognitive decline compared with people with lower cardiorespiratory fitness. Little research has been conducted on the association of fitness and changes in the brain in people with Alzheimer’s disease.

This study included 64 people without dementia and 64 people with early-stage Alzheimer’s disease and compared their levels of cardiorespiratory fitness and brain size. Treadmill testing was used to measure cardiorespiratory fitness and magnetic resonance imaging was used to measure brain size. Higher fitness levels were associated with increased brain size in people with Alzheimer’s disease, but there was no relationship between fitness and brain size in people without dementia after controlling for age.

“These results demonstrate a relationship between cardiorespiratory fitness and brain atrophy in the earliest clinical stages of Alzheimer’s disease,” said Jeffrey Burns, MD, and his colleagues from the University of Kansas School of Medicine, Kansas City. “Higher fitness levels in early Alzheimer’s participants were associated with preserved brain volume (less brain atrophy) independent of age and dementia severity.”

Cardiorespiratory fitness may benefit the brain by increasing blood flow, preventing blood vessel damage, and improving the body’s metabolic activity. Further research is needed to understand the role of cardiorespiratory fitness in Alzheimer’s disease.

Staying fit

Exercise is one part of what influences a person’s level of cardiorespiratory fitness, which can be difficult for people with Alzheimer’s disease to maintain. Here are some tips for how people with dementia can continue to stay engaged in physical activity:

• People in the early stages of Alzheimer’s disease may have no trouble exercising and should be encouraged to do so (supervised if necessary).

• As the disease worsens they may not understand how to continue exercising on their own. Group exercise classes with instruction may help them continue to stay involved in physical activity.

• Choosing stimulating exercise classes may help people with Alzheimer’s disease stay more engaged. Some classes, for instance, combine gentle movements with music or dance. A person with Alzheimer’s disease may forget the names of family members but may not forget how to dance.

(Neurology 2008;71:210–16)

Jane Hart, MD, board-certified in internal medicine, serves in a variety of professional roles including consultant, journalist, and educator. Dr. Hart, a Clinical Instructor at Case Medical School in Cleveland, Ohio, writes extensively about health and wellness and a variety of other topics for nationally recognized organizations, Web sites, and print publications. Sought out for her expertise in the areas of integrative and preventive medicine, she is frequently quoted by national and local media. Dr. Hart is a professional lecturer for healthcare professionals, consumers, and youth and is a regular corporate speaker.

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