Decreasing the Risk of Cognitive Decline through Exercise
- Tue, 12/21/10 - 1:45pm
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With the prevalence of dementia expected to increase significantly as the population ages, it is imperative to identify factors that protect against cognitive impairment. A significant body of research suggests that physical activity can lower the risk of cognitive decline, and a study published in the July issue of the Journal of the American Geriatrics Society (JAGS) (www.ncbi.nlm.nih.gov/sites/entrez /20609030) underscores the importance of encouraging exercise among older adults who have never been physically active. In long-term care facilities, engaging such residents in exercise programs may make a significant difference in reducing their risk of cognitive impairment or further cognitive decline.
The JAGS study, which was led by Laura E. Middleton, PhD, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada, is the first to examine how physical activity levels at various points over the course of life may affect the risk of cognitive decline in late life. Middleton and colleagues’ study enrolled 9344 women who were 65 years or older (mean age, 71.6 years). All participants completed both the modified Mini-Mental State Examination and self-reported their physical activity levels during their teen years, at age 30 and age 50, and at the time of the study.
One of the study’s important findings is that exercise during adolescence appears to be especially important in lowering the risk of late-life cognitive impairment. While women who reported being physically active at any age were less likely to have cognitive impairment in late life than those who were always sedentary, exercise during the teen years was most strongly linked to reduced odds of cognitive decline. However, there was also good news for older women who began exercising only in late life, with women who became active in their 60s or later having half the risk of late-life cognitive impairment compared with those who remained sedentary throughout their lives.
While Middleton and colleagues call for the promotion of “physical activity early in life and throughout the life course,” they also highlight the importance of encouraging exercise among older adults who have always been sedentary. “Physical activity should be promoted particularly to those who were sedentary in early life to prevent cognitive impairment,” they report.
Long-term care facilities should both encourage residents who have never exercised to begin doing so and support those who have been active to continue with their physical activities. There are many options facilities can choose from, including the Functional Fitness for Long-Term Care (FFLTC) program. In a study of 68 long-term care residents with a mean age of 80 years, participation in the FFLTC program—which is designed so that facility staff and volunteers can conduct the classes—led to significant improvement in many patients in mobility, strength, flexibility, and physical functioning after just 4 months (www.ncbi.nlm.nih.gov/sites/entrez/10647968). Even older adults who were frail, incontinent, and had mild dementia were able to participate in and benefit from the program.
To help older adults understand the potential benefits of exercise on cognitive function, the American Geriatrics Society has published an easy-to-understand summary of the July JAGS study, which is available at http://bit.ly/AGSexercise. Feel free to print it and share it with your patients and colleagues.