July 16, 2012 -- I have been working with Mr. and Mrs. Smith for the past six months.
Mr. Smith is 80 years old and in generally good physical health, but was brought by his wife for consultation, as his short term memory had been in decline for two years. After an extensive evaluation, we determined that Mr. Smith had probable Alzheimer's disease and started him on memory medication.
At her husband's most recent follow-up visit, Mrs. Smith, a spry 79-year-old woman, was grateful that her husband had been diagnosed and was being treated. But, she asked, "What about me and my adult children, what can we do to delay or decrease OUR risk of Alzheimer's disease?"
The results of four clinical trials presented at the Alzheimer's Disease International Conference (AAIC) in Vancouver, Canada, may give Mrs. Smith and her adult children hope and a possible tool to delay or decrease their risk of Alzheimer's.
The four clinical trials looked at exercise, to see if various types could improve memory and brain functions in older adults. They looked at people without memory problems as well as those with mild memory complaints (sometimes termed "senior moments").
The first study, led by Dr. Kirk Erickson of the University of Pittsburgh, followed 120 sedentary or inactive older adults (over age 65) for 12 months as they began one of two programs prescribed by the researchers: either a moderate-intensity walking regimen or a stretching/toning program.
Only those in the walking program showed improved memory and an increase in the size of the hippocampus, the part of the brain that controls memory and other intellectual functions.
This study shows that the brain, even in the later years, can grow and develop, and function better if stimulated by exercise.
Two studies, one from the National Center for Gerontology and Geriatrics in Japan and one from the University of British Columbia in Vancouver, Canada, looked at older adults who already had mild memory problems, known as mild cognitive impairment, but no Alzheimer's disease.
The Japanese study, led by Dr. Hiroyuki Shimada, followed older adults between 65 and 93 years of age for 12 months. They were assigned to either a supervised multicomponent exercise program for 90 minutes, twice weekly, or no exercise. The exercise program consisted of aerobic exercise and muscle strength training and postural balance training.
At the end of the year, the exercise group showed improved memory and ability to use language.
The Canadian study looked at women between the ages of 60 and 70 with mild memory problems who were assigned to either resistance training like weight lifting, aerobic training like walking, or balance and tone exercises, twice weekly for six months.
Resistance training significantly improved attention, memory and some other higher brain functions. In addition, three brain regions involved in memory showed increased activity on brain scanning.
Aerobic training also resulted in improvement on a memory task.
The final study was also from the University of British Columbia. It was conducted by Dr. Nader Fallah, who randomly assigned 155 healthy women between the ages of 65 and 75 to either resistance training exercises or balance and tone training exercises for one year.
Exercise May Help Stave off Alzheimer's
He found two things. First, both exercise groups saw improvements in memory and some other brain functions at the end of one year. However, those with higher levels of intellect at the beginning of the study did best with resistance training.
Back to our patient and caregiver, Mr. and Mrs. Smith.
Both were recommended a supervised exercise regimen consisting of daily walking, twice-weekly resistance training, and balance exercises -- the latter to decrease the risk of dangerous falls.
There is growing evidence that what is good for the heart is good for the brain. This would include controlling high blood pressure, diabetes, obesity, high cholesterol, smoking and lack of exercise, all risk factors for strokes and heart attacks.
Regular exercise is a tool that Alzheimer's patients and their at-risk family members can use to improve memory and brain functions and possibly to delay or decrease the risk of Alzheimer's disease.
Dr. George Grossberg is the Samuel A. Fordyce Professor of neurology and psychiatry at the Saint Louis University School of Medicine and past president of the American Association of Geriatric Psychiatry and of the International Psychogeriatric Association (IPA).