Worldwide, over 35 million people currently live with Alzheimer’s disease and this number is expected to double by 2030, according to the World Alzheimer Report 2013. One of the areas researchers are focusing on is the role of exercise for people with dementia, including Alzheimer’s disease.

According to researchers from the University of Alberta in Edmonton, Canada, people with dementia benefit greatly from regular exercise. This is indicated by better attention and memory (collectively known as “cognitive functioning”) and their ability to perform daily activities.

Their review, which re-examined the results of 16 previous study trials, was aimed at testing the theory that exercise might benefit dementia patients by either slowing the progression of the illness or helping to treat it.

The researchers argue that improving a patient’s ability to carry out everyday tasks (e.g. walking a short distance or getting up from a chair) will result in positive changes in mental processes related to cognitive functioning.

They conclude that there is promising evidence that exercise programmes improve cognition and the ability to carry out daily activities.

Previous research has also shown that people who exercise during middle age have a significantly lower risk of developing dementia later in life.

In another recent study – to be published in the February 2014 issue of the Journal of Alzheimer’s Disease – researchers led by the University of Arizona’s Department of Surgery say dementia patients that receive better rehabilitation care will improve their basic motor functions. Improvements were seen in postural balance, the ability to move from one position to another and muscle strength in the lower sections of the body.

While most people take these basic motor functions for granted, they’re very important for the independence of older people with advanced forms of dementia, including Alzheimer’s disease.

The study’s lead author Dr Michael Schwenk stresses the value of rehabilitating basic functional tasks. He says tasks such as the ability to walk or rise from a chair are of utmost importance to reduce fall risk, prevent loss of independence and increase mobility-related quality of life in patients with dementia.

As a specialist researcher in motor-performance healthcare, Dr Schwenk says the study suggests that conventional obstacles to more intensive rehabilitation – based on opinions that dementia patients have diminished mental abilities – are unfounded.

He is urging other researchers to develop better exercise training programmes specifically designed for patients with dementia. Therapists and doctors that specialise in caring for the elderly (geriatricians) are not always sure about the types of exercise and appropriate levels of intensity, as little guidance is available.

So the good news is that exercise is beneficial for physical and mental health and can significantly improve your quality of life if you have Alzheimer’s disease.

How to start exercising
Here are some important guidelines on how to start exercising and what type of exercise to consider. The most important is that you should choose an exercise activity you enjoy. Then start slowly and stick to it!

According to the Mayo Clinic, moderate, regular exercise typically refers to about 150 minutes of exercise a week – or 30 minutes a day, five days a week. Ideally, you should look at exercise that increases your heart rate to roughly the level of a brisk walk.

Exercise has many health benefits, as it:
– Prevents muscle weakness.
– Can significantly reduce the risk of heart attack, stroke and diabetes.
– Improves general cardiovascular health.
– Improves physical function, e.g. maintains flexible joints, strength and balance to reduce the risk of falls and to help you remain independent for longer.
– Helps to keep bones strong and reduces the risk of osteoporosis.
– Improves mood and sleep.
– Promotes a normal daily routine.
– Boosts confidence and enhances body image.
– Provides opportunities to interact socially with others.

Before you start
Consider your abilities, preferences and needs before you start an exercise programme. If you’ve taken part in regular exercise over the years, this will be relatively easy for you.

On the other hand, if you haven’t exercised much or have certain health issues (including heart problems, hypertension, or problems with breathing, balance or your joints), it’s very important to first consult your doctor, physiotherapist or other health professional before you start any new physical activity.

Once you’ve got the thumbs up from your doctor of physiotherapist, these tips will help you start exercising:
– If you’re not currently active, aim to do about 30 minutes of activity at least five days a week.
– You can break this up into shorter sessions throughout the day, for example, a 15-minute walk to the local shops, and then a 15-minute dancing session in the afternoon.
– If you experience pain while exercising, or after increasing activity levels, stop the exercise and seek medical advice.
– Listen to your body, and don’t exercise if you feel unwell or very tired.
– Remember that physical exercise doesn’t have to be strenuous. Take things slowly at first, but try to exercise regularly for maximum benefit.

What type of exercise is best?
Depending on your overall health and fitness level, you can opt to exercise alone or in a small group. Maybe you’d first like to try different exercises to find the one that’s most suitable and enjoyable? The important thing is to start and continue being physically active for as long as possible.

Find out from your local fitness or community centre about organised exercise and sessions such as swimming, indoor bowls, dance, tai chi and seated exercises.

Here are some types of exercise you can consider:
– Walking is suitable for people with different fitness levels. You can walk alone outdoors in your neighbourhood or walk with a friend to enjoy some fresh air and a change of scenery. Alternatively, the social activity of a group walk, offered by local leisure centres may be more to your liking.
– Dancing is an enjoyable way to de-stress and take part in exercise. It is good for increasing flexibility and strength, agility and balance. If you prefer to take a group dance class, it’s a fun sociable way to interact with others.
– You can also try doing some exercises to music. Ask a physiotherapist to create a suitable exercise programme for you. If you are wheelchair-bound, you can still do adapted forms of exercise.
– Swimming or water aerobics is a safe way to exercise as it requires less balance and is gentle on the joints. It’s best to do this under supervision.
– Seated exercise sessions can be done at home or in a group. They focus on building or maintaining balance and muscle strength and are less strenuous than exercises in a standing position.
– Tai chi is a gentle Chinese martial art form aimed at improving balance, stability and overall health. Combining meditation with a series of simple integrated movements, Tai chi is a wonderfully relaxing exercise.

Sources:
1. “An intensive exercise program improves motor performances in patients with dementia: translational model of geriatric rehabilitation.” Schwenk M, Dutzi I, Englert S, and others, Journal of Alzheimer’s Disease, 2014 article in press (DOI: 10.3233/JAD-130470; abstract).
2. Exercise programs for people with dementia; Forbes D., Thiessen E.J., Blake C.M., Forbes S.C., Forbes S., Cochrane Database of Systematic Reviews 2013, Issue 11. Art. No.: CD006489. DOI: 10.1002/14651858.CD006489.pub3. Abstract.
3. Alzheimer’s South Africa Website: www.alzheimers.org.za
4. http://www.alz.org/we_can_help_stay_physically_active.asp
5. www.alzheimers.org.uk

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