Exercise is associated with reduced risk for incident dementia among person 65 years of age and older

Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101-1448, USA.
Annals of internal medicine (Impact Factor: 17.81). 02/2006; 144(2):73-81. DOI: 10.1111/j.1600-0838.2006.00572_2.x
Source: PubMed

ABSTRACT Alzheimer disease and other dementing disorders are major sources of morbidity and mortality in aging societies. Proven strategies to delay onset or reduce risk for dementing disorders would be greatly beneficial.
To determine whether regular exercise is associated with a reduced risk for dementia and Alzheimer disease.
Prospective cohort study.
Group Health Cooperative, Seattle, Washington.
1740 persons older than age 65 years without cognitive impairment who scored above the 25th percentile on the Cognitive Ability Screening Instrument (CASI) in the Adult Changes in Thought study and who were followed biennially to identify incident dementia.
Baseline measurements, including exercise frequency, cognitive function, physical function, depression, health conditions, lifestyle characteristics, and other potential risk factors for dementia (for example, apolipoprotein E epsilon4); biennial assessment for dementia.
During a mean follow-up of 6.2 years (SD, 2.0), 158 participants developed dementia (107 developed Alzheimer disease). The incidence rate of dementia was 13.0 per 1000 person-years for participants who exercised 3 or more times per week compared with 19.7 per 1000 person-years for those who exercised fewer than 3 times per week. The age- and sex-adjusted hazard ratio of dementia was 0.62 (95% CI, 0.44 to 0.86; P = 0.004). The interaction between exercise and performance-based physical function was statistically significant (P = 0.013). The risk reduction associated with exercise was greater in those with lower performance levels. Similar results were observed in analyses restricted to participants with incident Alzheimer disease.
Exercise was measured by self-reported frequency. The study population had a relatively high proportion of regular exercisers at baseline.
These results suggest that regular exercise is associated with a delay in onset of dementia and Alzheimer disease, further supporting its value for elderly persons.

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Available from: Walter A Kukull, Sep 28, 2015
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    • "al . , 2010 ) and that its positive effects may be most beneficial for demanding cognitive behaviors that utilize specific sets of neural networks and computational processes like pattern separation . This is especially important when determining what cognitive behaviors could actually be alleviated in aging - related diseases like Alzheimer ' s ( Larson et al . , 2006 ; Lautenschlager et al . , 2008 ; García - Mesa et al . , 2011 ) . Similar to Creer et al . ( 2010 ) ; Madroñal et al . ( 2010 ) , but unlike van Praag et al . ( 2005 ) , we do not see an increase in the number of proliferating or 7 week - old cells in the DG of aged mice following voluntary exercise , supporting the view that neurogene"
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    ABSTRACT: Normal aging and exercise exert extensive, often opposing, effects on the dentate gyrus (DG) of the hippocampus altering volume, synaptic function, and behaviors. The DG is especially important for behaviors requiring pattern separation-a cognitive process that enables animals to differentiate between highly similar contextual experiences. To determine how age and exercise modulate pattern separation in an aversive setting, young, aged, and aged mice provided with a running wheel were assayed on a fear-based contextual discrimination task. Aged mice showed a profound impairment in contextual discrimination compared to young animals. Voluntary exercise rescued this deficit to such an extent that behavioral pattern separation of aged-run mice was now similar to young animals. Running also resulted in a significant increase in the number of immature neurons with tertiary dendrites in aged mice. Despite this, neurogenesis levels in aged-run mice were still considerably lower than in young animals. Thus, mechanisms other than DG neurogenesis likely play significant roles in improving behavioral pattern separation elicited by exercise in aged animals.
    Frontiers in Systems Neuroscience 08/2015; 9:114. DOI:10.3389/fnsys.2015.00114
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    • "Studies have documented the beneficial effects of PA on various conditions and diseases including stroke (Billinger et al., 2014) and dementia (Larson et al., 2006; Middleton and Yaffe, 2009), while easing the burden of chronic disease on health and social care services can save public funds (DoH, 2005). Despite such benefits, in many countries low levels of PA are common (World Health Organisation (WHO), 2010) with participation in regular PA being particularly low among older adults (Troiano et al. 2008; WHO, 2010). "
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    ABSTRACT: Inactive lifestyles have negative health consequences, while time spent sedentary (sitting and lying) is related to morbidity and premature mortality. Older adults often form the most sedentary segment of the population. Much of this behaviour may be practised at home where this group can spend extended periods. Physical activity rates among older adults are particularly low. Even household physical activities can be beneficial for this group, while they can constitute much of an older person's total activity. Despite this context, the home's role in the active and sedentary behaviours of the older population appears critically understudied. Using interview and focus group data collected from 22 older adults (healthy volunteers, stroke survivors and people with dementia), this paper begins to address this issue. Aspects of the home that aid or impede a more active, less sedentary lifestyle are identified with three presenting particular capacity in this respect discussed: steps, space within the home, and the location and form of facilities, fixtures and fittings. The crucial role health status plays in structuring this capacity is identified. Simple design recommendations, devised to support older people to lead more active lives at home, are presented.
    Building Research and Information 06/2015; 43(5):1-15. DOI:10.1080/09613218.2015.1045702 · 1.45 Impact Factor
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    • "Indeed, cognitive impairment has been identified as an independent risk factor for falls (Latt, Lord, Morris, & Fung, 2009), and a recent study found that impairments in executive function were associated with inferior performance on measures of gait and balance in PD (Xu et al., 2014). Exercise in general has been shown to improve executive function and prevent cognitive decline in healthy individuals (Larson et al., 2006; van Gelder et al., 2004). One clinical trial provides class II level of evidence that 24 months of PRET is effective in improving attention and working memory in nondemented patients with mild-to-moderate PD when evaluated off medication, but this effect was not different than an exercising control group (David et al., 2015). "
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    ABSTRACT: Objective: This paper reviews the therapeutically beneficial effects of progressive resistance exercise training (PRET) on motor and nonmotor symptoms in Parkinson’s disease (PD). Methods: First, we perform a systematic review of the literature on the effects of PRET on motor signs of PD, functional outcomes, quality of life, and patient perceived improvement, strength, and cognition in PD. Second, we perform a meta-analysis on the motor section of the UPDRS. Finally, we discuss the results of our review and we identify current knowledge gaps regarding PRET in PD. Conclusion: This systematic review synthesizes evidence that PRET can improve strength and motor signs of Parkinsonism in PD and may also be beneficial for physical function in individuals with PD. Further research is needed to explore the effects of PRET on nonmotor symptoms such as depression, cognitive impairment, autonomic nervous system dysfunction, and quality of life in individuals with PD.
    02/2015; Volume 4(Issue 1):11 – 27. DOI:10.1123/kr.2014-0074
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