Physical Activity and Mild Cognitive Impairment and Alzheimer’s Disease

Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, St. George's Hospital, The University of Melbourne, 283 Cotham Road, Kew, 3103, Victoria, Australia.
Current Neurology and Neuroscience Reports (Impact Factor: 3.06). 09/2010; 10(5):352-8. DOI: 10.1007/s11910-010-0121-7
Source: PubMed


Regular physical activity undoubtedly has many health benefits for all age groups. In the past decade, researchers and clinicians have begun to focus their attention on whether physical activity also can improve health outcomes of older adults who experience mild cognitive impairment (MCI) or dementia. This ongoing question is gaining relevance in light of the aging of the world population and with it the rise of age-related conditions, such as cognitive impairment. Not surprisingly, physical activity is among the potential protective lifestyle factors mentioned when strategies to delay or prevent dementia are discussed. The first large-scale multidomain intervention trials are under way to put this to the test. This review aims to give an overview of recent trials of physical activity in patients with MCI or dementia.

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    • "Because of the absence of disease-modifying treatments, numerous studies have sought to identify potentially modifiable risk factors for AD (Barnes and Yaffe, 2011). In particular, physical inactivity has been recognized as a significant risk factor for cognitive decline (Sofi et al., 2011) and cognitive impairments, including AD and mild cognitive impairment (MCI) (Barnes and Yaffe, 2011; Lautenschlager et al., 2010), MCI is considered to be a clinical feature that typifies the prodromal phase of AD and most types of dementia (Petersen, 2004). MCI is associated with a relatively high rate of conversion to dementia, but may also revert to a healthy cognitive state (Brodaty et al., 2013). "
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    ABSTRACT: Physical activity may help to prevent or delay brain atrophy. Numerous studies have shown associations between physical activity and age-related changes in the brain. However, most of these studies involved self-reported physical activity, not objectively measured physical activity. Therefore, the aim of this study was to examine the association between objectively measured physical activity, as determined using accelerometers, and brain magnetic resonance imaging (MRI) measures in older adults with mild cognitive impairment (MCI). We analyzed 323 older subjects with MCI (mean age 71.4years) who were recruited from the participants of the Obu Study of Health Promotion for the Elderly. We recorded demographic data and measured physical activity using a tri-axial accelerometer. Physical activity was classified as light-intensity physical activity (LPA) or moderate-to-vigorous physical activity (MVPA). Brain atrophy and the severity of white matter lesions (WML) were determined by MRI. Low levels of LPA and MVPA were associated with severe WML. Subjects with severe WML were older, had lower mobility, and had greater brain atrophy than subjects with mild WML (all P<0.05). Multivariate analysis revealed that more MVPA was associated with less brain atrophy, even after adjustment for WML (β=-0.126, P=0.015), but LPA was not (β=-0.102, P=0.136). Our study revealed that objectively measured physical activity, especially MVPA, was associated with brain atrophy in MCI subjects, even after adjusting for WML. These findings support the hypothesis that physical activity plays a crucial role in maintaining brain health. Copyright © 2014 Elsevier Inc. All rights reserved.
    Full-text · Article · Dec 2014 · Experimental Gerontology
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    • "A recent meta-analysis (Sofi et al., 2011) showed that physical activity was protective against cognitive decline and Barnes and Yaffe (2011) suggest that public health campaigns targeting physical activity at a societal level could have a profound effect on future AD prevalence. Likewise, a recent review concluded that there is support for a positive association between physical activity and reduced risk of cognitive impairment , although this has not yet translated consistently into clinical trials (Lautenschlager et al., 2010). One such clinical trial with positive findings is FABS (Fitness for the Ageing Brain Study), which found that a 6-month physical activity program was of benefit for cognitive performance in people with subjective memory impairment or MCI over an 18-month follow-up period compared to a control group. "
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    ABSTRACT: IntroductionThere is increasing evidence to support the benefits of physical activity on cognition in older adults. This paper describes (i) the attitudes, beliefs and barriers towards physical activity of older adults with and without cognitive impairment and (ii) their opinion of the attributes of the ideal physical activity program.Methods Thematic analysis of focus groups and individual interviews with 50 older adults with no cognitive impairment, subjective memory complaints, mild cognitive impairment and Alzheimer's disease was performed.ResultsConsistent with previous research in cognitively intact older adults, most participants, irrespective of cognitive status, had a positive attitude towards physical activity and believed it was beneficial both generally and for cognition. There was a preference for physical activity programs to be suggested by advertising and general practitioners (GPs), undertaken in a group setting, and beliefs that they should be tailored to individual's needs and preferences, and should be affordable according to their income. Participants with cognitive impairment cited specific barriers including “memory” and “lack of companion” as well as preferring “accessible” settings and “simple/light/safe” activities.DiscussionThese findings provide useful data, particularly from participants with cognitive impairment, with whom there has been little research to date. This could contribute to efforts to translate the growing research evidence of the benefits of physical activity for brain health into effective community programs.
    Full-text · Article · Jun 2014 · Asia-Pacific Psychiatry
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    • "CVD and dementia are closely related—whether in the form of Alzheimer’s disease (AD) or CVD—and they share very similar risk factors [3,23-25]. It’s possible that there are many mediation mechanisms that improve the CVDin relation to PA, by improving brain vascular function, cerebral perfusion, and the stimulation of synaptogenesis [16]. Reinforcing data from recent years suggests that modifiable behavior can have an impact on brain plasticity in human beings and animals [26]. "
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    ABSTRACT: The aging of the population has led to the increase of chronic diseases, especially dementia and cardiovascular diseases, and it has become necessary for their relatives to dedicate more time in caregiving.The objective in the first phase of this study is to evaluate the effectiveness of a Primary Health Care procedure to increase the physical activity of people with dementia and their relative caregivers. Also the effect on the cognitive state and cardiovascular risk will be assessed. Design: Clinical, multicentric and randomized trial. A simple random sampling to select 134 patients diagnosed with dementia will be carried out. After contacting their relatives, his/her participation in the trial will be requested. A basal assessment will be made and the participants will be asigned to control or intervention group (1:1). Variables: The main measure will be the assessment of physical activity (podometer and 7-PAR) in patients and caregivers. In patients with dementia: ADAS-cog, functional degree and cardiovascular risk. In caregivers: cardiovascular risk, general health and quality of life. Intervention: For 3 months, participants will receive instructions to do physical activity with an adapted program. This program will be designed and applied by Primary Health Care professionals in patients with dementia and their caregivers. The control group will receive regular care. Analysis: An intention-to-treat analysis will be carried out by comparing the observed differences between basal, 6 and 12 months measures. Change in the mean of daily steps assessed with the podometer and 7-PAR will be the main result. If the main hypothesis is confirmed, it could be useful to improve the cognitive state of patients with dementia, as well as the cardiovascular risk of all of them. The results can be good to improve technical features of the devices that register the physical activity in the patients with dementia, and it could facilitate its commercialization.Trial registration: Clinical Identifier: NCT02044887.
    Full-text · Article · Apr 2014 · BMC Neurology
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