Exercise in Dementia

Aerobic exercise supervised by experienced physiotherapists may act to improve mood, increase function and maintain independence in individuals with dementia.

We have known for a while that regular physical activity can reduce the risk of cognitive decline and may protect against Alzheimer’s and other dementias. But now evidence is growing that exercise may also help individuals with dementia prolong their independence and improve their quality of life.

Three new randomized controlled trials of aerobic exercise in dementia have confirmed what we have already observed in our patients. Exercise not only improves general health but also a positive impact on cognitive function, emotional wellbeing and the ability to perform activities of daily living.

Exercise Intensity

There is a tendency to choose low intensity stretching programs for individuals with dementia. Many facilities worry about potential health risks and accidents that could be caused by a more rigorous regime. Gentle stretches can be useful as a way of improving flexibility and balance, however research suggests that we may achieve even better results if we up the intensity.

A program of aerobic exercise aiming for a heart rate of 70-80% of maximum heart rate appears to provide significant benefit to people with dementia. A Danish trial demonstrated that people who participated in a sixteen week program of regular exercise at this level, supervised by experienced physiotherapists, suffered less anxiety, irritability, and depression than those who had standard care. Enthusiastic participators, who attended more often and exercised more vigorously (raising their heart rate to more than 70% of their maximal rate) also showed improved mental speed and attention.

In Alzheimer’s Disease

The clinical improvement provided by exercise appears to mirror changes in the brain. More intense aerobic programs, again aiming at 70-80% of maximum heart rate, were associated with a decrease in the number of characteristic Alzheimer’s tangles in the brain, increased blood flow in the memory and processing centres and a corresponding improvement in attention, planning, and organizational ability

In Vascular Dementia

Supervised aerobic exercise three times per week for 60 minutes with experienced supervision, significantly improved their cognitive function, including memory and selective attention, compared to the people receiving usual care. In addition, functional scans showed that the brains of study participants became more efficient with aerobic exercise training.

In Early Onset Dementia

The frontal and parietal regions of the brain, are particularly affected in Early Onset Dementia. Disease in these areas can lead to problems with planning, loss of initiative, and personality changes. This can profoundly affect quality of life and independence. Brain scans have shown that these areas in particular respond positively to exercise with potential reversal of disease and better cognitive function.

Physical activity can definitely improve the general health and wellbeing of younger individuals with dementia. But experts believe that it’s impact on these key areas in the brain, suggests that it may also help to stop the neurological damage and so help fight the distressing symptoms associated with Early Onset Dementia.

We truly believe, and evidence backs us up, that exercise is not just a way of keeping residents occupied; it really does make a significant difference to function, wellbeing and disease progression.

 

Sheryl Aldcroft

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