Four new studies presented on Sunday at the Alzheimer’s Association International Conference taking place in Vancouver, Canada, have clarified the key role that different types of exercises can play in improving mental functioning in older adults and staving off Alzheimer’s Disease.
The studies found that strength (or resistance) training – such as weight lifting or using resistance bands – can be particularly helpful in improving cognitive abilities of older adults, and could possibly help to stave off Alzheimer’s Disease. Aerobic exercise (moderate walking) was linked to growth in the region of the brain associated with memory, suggesting it too may improve memory.
As described in a detailed news release issued by the Alzheimer’s Association, the four new studies have shown, respectively, that:
- Resistance training may improve thinking and memory in older adults with Mild Cognitive Impairment (MCI);
- Moderate walking may grow the brain region related to memory, and increase a nerve growth factor;
- Higher functioning older adults may be more likely to show cognitive benefits from resistance training; and
- Combination training (aerobic + strength + balance) may improve memory in people with MCI
According to the Alzheimer’s Association, 5.4 million Americans are living with Alzheimer’s Disease today. By 2050, the number of people with Alzheimer’s in the United States is expected to nearly triple to 16 million.
“By midcentury, care for people with Alzheimer’s will cost the U.S. over $1 trillion,” said William Thies, PhD, Alzheimer’s Association® Chief Medical and Scientific Officer. “This will be an enormous and unsustainable strain on the healthcare system, families, and federal and state budgets.”
According to statistics released earlier by the Alzheimer’s Association, nearly 15 million Americans are now caring for a loved one with Alzheimer’s Disease or another form of dementia, and every 69 seconds someone in the U.S. now develops Alzheimer’s, which is the 6th leading cause of death in the U.S., and the only one among the top 10 causes of death that cannot yet be prevented or cured.
These are among the reasons why it is so crucial to find ways to slow the development of mental decline in older adults.
According to Dr. Teresa Liu Ambrose, the lead author of one of the new studies, many previous studies have established that exercise helps maintain not only a healthy heart but also a healthy mind. The new studies have gone further toward establishing which types of exercise are most helpful.
Dr. Ambrose, who is the director of the Aging, Mobility, and Cognitive Neuroscience lab at the University of British Columbia, told CNN, “We accept that exercise is the golden bullet – but we need to identify who might benefit the most from what exercise.” The new studies have helped do so.
A key finding of the studies presented on Sunday at the Alzheimer’s Association International Conference was that resistance training – such as weight lifting or using resistance bands – was particularly beneficial in improving cognitive functioning of older adults, and could possibly help to stave off dementia, of which Alzheimer’s is the principal kind.
“Currently, the strongest data for lifestyle-based Alzheimer’s risk reduction is for physical activity,” said Dr. Thies, the Chief Medical and Scientific Officer of the Alzheimer’s Association®, “yet this data is generally observational and considered preliminary.”
“These new intervention studies are taking place over longer periods of time to begin to clarify exactly which types of physical activity are most effective, how much needs to be done, and for how long,” he said. “In particular, where previously we had seen positive associations between aerobic activity, particularly walking, and cognitive health, these latest studies show that resistance training is emerging as particularly valuable for older adults,” Dr. Thies explained.
Summaries of the Four New Studies & Their Findings
Following are summaries of the four new studies and their findings, as provided by the Alzheimer’s Association in its news release issued on Sunday, July 15, 2012 from the International Alzheimer’s Conference:
“Resistance training may improve thinking and memory in older adults with MCI
Exercise and regular physical activity may prove to be promising intervention strategies to postpone or prevent Alzheimer’s dementia, but perhaps not all types of training are equally effective.
PhD student Lindsay Nagamatsu, of University of British Columbia, Vancouver, Canada, and colleagues with the EXCEL (Exercise for Cognition and Everyday Living) study compared the effects of both twice-weekly resistance training (weight lifting) (n=28) and twice-weekly aerobic training (walking) (n=30) with twice-weekly balance and tone exercises (n=28) on executive cognitive function in women aged 70-80 with probable MCI in a 6-month randomized controlled trial. Teresa Liu-Ambrose, PhD, PT, of the University of British Columbia and Vancouver Coastal Health Research Institute, was the principal investigator of EXCEL and supervises Nagamatsu.
Compared with the balance and tone group, the resistance training group significantly improved performance on the Stroop Test, which measures selective attention and conflict resolution, and a memory task. Resistance training also led to functional changes in three brain regions involved in memory. In contrast, the aerobic training group did not show similar improvements.
“MCI is a critical window to intervene against dementia,” Liu-Ambrose said. “We found that twice-weekly resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.”
“Furthermore, we found that the aerobic training group had improved performance on a different memory task called the Rey Auditory Visual Learning Test. So both exercise groups improved their memory scores, but on different types of memory. More research is needed to determine the differential effects of these two types of exercise training,” Nagamatsu added.”
. . .
“Moderate walking may grow brain region related to memory; increase nerve growth factor
According to Kirk Erickson, PhD, of the University of Pittsburgh, “There is growing interest in lifestyle factors and interventions that enhance the cognitive vitality of older adults and reduce the risk for cognitive impairment. However, very little is understood regarding the molecular processes that contribute to enhanced brain health with exercise, or the impact that greater brain volume has on cognitive function.”
Erickson and colleagues randomized 120 older adults without dementia who have been sedentary for the previous six months to a moderate intensity walking group or a stretching-toning group for one year. MRI was used to measure the size of a brain region associated with memory, known as the hippocampus, both before and after the exercise intervention. Blood was drawn to measure concentrations of brain-derived neurotrophic factor (BDNF), and a cognitive testing battery was conducted before and after the intervention.
The researchers found that, in this study group, one year of exercise training increased the size of the hippocampus by two percent (2%) in the walking group compared to the stretching-toning group. (Significant shrinking of the hippocampus is characteristic of Alzheimer’s disease.) The increase in hippocampal volume was correlated with similar changes in BDNF.
“Our findings suggest that the aging brain remains modifiable, and that sedentary older adults can benefit from starting a moderate walking regimen,” Erickson said.”
“Higher functioning older adults may be more likely to show cognitive benefits from resistance training
Nader Fallah, PhD, and colleagues at the University of British Columbia, Vancouver used multi-state modeling to investigate: 1) the simultaneous effect of exercise training and baseline factors on changes in executive cognitive function, and 2) the effect of exercise training on an individual’s probability for cognitive improvement, maintenance, or decline.
. . .
Specifically, they performed a secondary analysis of a 12-month randomized, controlled clinical trial conducted in Vancouver of 155 community-dwelling women aged 65 to 75 years old who were randomly assigned to either resistance training or balance and tone training. The primary outcome measure was performance on the Stroop Test, an executive cognitive test of selective attention and conflict resolution. Teresa Liu-Ambrose, PhD, PT, of the University of British Columbia and Vancouver Coastal Health Research Institute, was the principal investigator of this study and supervises Fallah.
The scientists found that:
- The probability of improving or maintaining results of the test were higher with resistance training among the study participants with higher function at beginning of the study.
- Resistance training and balance and tone exercises had similar effect among those with lower function at baseline.
- Overall, those in the balance and tone group demonstrated a significantly lower probability for improved performance on the Stroop Test, and a significantly higher probability of decline.
“To our knowledge, this is the first study to demonstrate that an individual’s baseline self-regulatory capacity impacts the amount of cognitive benefit the person will reap from targeted exercise training,” Fallah said.
“Before our study, we had no appreciation of the simultaneous impact of targeted exercise training and other factors, such as baseline cognitive status, on cognitive change in older adults. By using a multi-state transition model, we demonstrated that the probability of improving selective attention and conflict resolution in older adults is most evident among those with higher baseline cognitive status – which is different from the current general opinion,” Liu-Ambrose said.”
“Combination training (aerobic + strength + balance) may improve memory in people with MCI
Hiroyuki Shimada, PhD, and colleagues at the National Center for Geriatrics and Gerontology, Obu, Aichi, Japan, conducted a randomized trial to test the impact of a 12-month, supervised, multicomponent exercise on cognitive function among older adults with amnestic (memory-related) MCI. The exercise program included aerobic exercise, muscle strength training, and postural balance retraining.
“Previous reviews suggested that combined aerobic exercise and strength training improved cognitive and physical functions more than aerobic exercise alone,” Shimada said.
The final study population consisted of 47 older adults with amnestic MCI, 65 to 93 years old. Participants were randomized either to multicomponent exercise (n = 25) or an education control group (n = 25). People in the multicomponent exercise group exercised under the supervision of physiotherapists for 90 minutes/day, 2 days/week, 80 times for 12 months. People in the control group attended three education classes about health during the 12-month period. Measurements of cognitive function (Logical Memory II subtest of the Wechsler memory scale-revised, letter and category fluency, digit symbol coding, and Stroop color word test) were administered after 6 and 12 months.
The scientists found that the multicomponent exercise and educational program improved performance on Logical Memory II subtest of the Wechsler memory scale-revised. Additionally, there was a significant interaction effect for letter fluency test between groups.
“In other words, the ability to use language of the multicomponent exercise group improved significantly compared with the educational program group,” Shimada said. “Our findings suggest that an exercise intervention can, at least partly, improve or maintain cognitive performance in older adults with amnestic MCI.”
“It is very important to learn more about factors that actually raise and lower risk for cognitive decline and Alzheimer’s,” Dr. Thies, the Alzheimer’s Association® Chief Medical and Scientific Officer, said in the Association’s press release about the new studies. “To do that, we need long-term studies in large, diverse populations, and we need the research funding to conduct those trials,” he continued. “For example, we have learned very practical lifestyle risk factors for heart disease from long-term research like the Framingham Study. Alzheimer’s now needs its version of that research,” Thies added.
“The first-ever U.S. National Plan to Address Alzheimer’s was unveiled in May, and now this plan must be speedily and effectively implemented,” Dr. Thies said. “An additional $100 million is needed now for Alzheimer’s research, education, outreach and community support,” Dr. Thies urged.
About the Alzheimer’s Association and its International Conference
The Alzheimer’s Association is a nonprofit association which indicates that it is the world’s leading voluntary health organization in Alzheimer’s care, support and research. Its stated mission is “to eliminate Alzheimer’s through the advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health.” Its stated vision is “a world without Alzheimer’s.”
According to the Alzheimer’s Association, “the Alzheimer’s Association International Conference® (AAIC) is the world’s largest conference of its kind, bringing together researchers from around the world to report and discuss groundbreaking research and information on the cause, diagnosis, treatment and prevention of Alzheimer’s disease and related disorders.” “As a part of the Alzheimer’s Association’s research program, AAIC serves as a catalyst for generating new knowledge about dementia and fostering a vital, collegial research community,” the Association states.
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