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Can Aerobic Exercise Improve Cognitive Function and Decrease Alzheimer’s Disease Risk?

Yes and you can find out even more in our new book, Running All Over The World, Our race against early onset Alzheimer’s 

  • Researchers are investigating ways to help improve cognitive function and potentially decrease dementia risk.
  • One in three seniors dies from Alzheimer’s disease and other forms of dementia and it kills more people than breast and prostate cancers combined.
  • Now a new study has found evidence that one year of aerobic exercise training improved cardiorespiratory fitness, cerebral blood flow regulation, and memory function in people with mild cognitive impairment.

Moderate to vigorous-intensity aerobic exercise may benefit adults with mild cognitive impairment, according to a new study by researchers at the University of Texas Southwestern Medical Center. Finding ways to help people with mild cognition is important to potentially combat rising cases of Alzheimer’s disease and other forms of dementia.

The study, published in the Journal of Applied Physiology, found evidence that one year of aerobic exercise training improved cardiorespiratory fitness, cerebral blood flow regulation, and memory function in people with mild cognitive impairment.

“Aerobic exercise is very important for improving both vascular function and brain function,” said Rong Zhang, PhD, a professor of neurology at the University of Texas Southwestern Medical Center, a research scientist at Texas Health Presbyterian Hospital in Dallas, and the study’s principal investigator. “The brain is a unique organ. It needs constant blood flow and oxygen supply.”

Few ways to fight rising cases of dementia

Alzheimer’s disease and other forms of dementia are among the nation’s biggest public health threats.

While this study didn’t look at combating Alzheimer’s disease directly, it looked at helping people with mild cognitive impairment. Mild cognitive impairment has been shown to increase the risk of developing dementia caused by Alzheimer’s disease or other neurological conditions.

Experts have been looking for ways to prevent all forms of dementia, including Alzheimer’s. Currently, there is no cure.

Research into this subject has become more pressing as America’s population is aging rapidly. More than 10,000 people turn 65 years old each day.

One in three seniors dies from Alzheimer’s disease or other forms of dementia, and it kills more people than breast and prostate cancers combined. More than 6 million people over the age of 65 in the United States live with Alzheimer’s disease, a figure that is expected to balloon to almost 13 million by 2050, according to the Alzheimer’s Association.

During the pandemic, Alzheimer’s disease and other dementia-related deaths rose 16 percent.

What the study found

For this study, researchers observed 37 people ages 55 to 80 with mild cognitive impairment. These adults were observed over a 12-month period.

For the first 10 weeks of the study, these subjects participated in three exercise sessions a week that included brisk walking for 25 to 30 minutes, according to Tsubasa Tomoto, PhD, the paper’s lead author and a post-doctoral fellow at the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian and the University of Texas Southwestern.

At the beginning of the study, the subjects participated in three brisk walking exercise sessions each week for 25 to 30 minutes. Beginning in week 11, they exercised 4 times a week, walking briskly uphill for 30 to 35 minutes per session. After week 26, exercise sessions increased to 4 to 5 times a week for 30 to 40 minutes.

Researchers found that vigorous exercise was associated with a host of benefits for people with mild cognitive impairment. They not only improved their cerebral blood flow regulation and cardiorespiratory fitness, but they also their memory and executive function.

Exercise and dementia risk

“While we don’t have any effective treatment yet for Alzheimer’s yet, prevention is the most important key” at this time, said Tomoto. “We are focused on mild cognitive dysfunction. There is some research that suggests that if you do intervention, you could have some hope in reducing Alzheimer’s. That’s why we focused on this population. If you could exercise, it could improve vascular function and may lead to cognitive improvement.”

Dr. Santosh Kesari, PhD, a neurologist, neuroscientist, and neuro-oncologist, said there has been some evidence suggesting a connection between exercise and reducing the risk of Alzheimer’s.

“It’s an interesting study,” said Kesari, director of neuro-oncology at Providence Saint John’s Health Center in Santa Monica, California. “It validates the fact that exercise can improve cardiovascular and brain function in a fairly short period of time. It’s not revolutionary, but this is a good study in the sense that it documents this in a different way.”

Benjamin Bikman, PhD, an associate professor of cell biology and physiology at Brigham Young University, added that research around Alzheimer’s disease is changing, even examining if Alzheimer’s disease is a metabolic disorder affected by insulin.

“The brain is an energy hog, with among the highest metabolic demands of any tissue in the body,” Bikman explained. “In order for the brain to get all the energy it needs, the hormone insulin must be able to do its job. Insulin, among many roles, opens glucose doors into parts of the brain involved in memory and learning, helping those brain cells get all the glucose they need to function.”

He noted that exercise helps regulate insulin.

“Exercise has many beneficial effects, but among the most relevant with Alzheimer’s disease is that it drastically improves insulin sensitivity, allowing insulin to work better in the body and allow more glucose to feed the hungry brain,” Bikman explained. “While we should certainly [do] mental exercises to keep our brain sharp, such as studying a new language and learning a new instrument, this shouldn’t replace whole-body exercise, which helps the myriad metabolic functions in the body, including the brain, run optimally.”

Kesari said the potential implications of this study and others like it are massive.

“Simply exercising could improve your brain function in the long run, and it’s good for you at the end of the day. The health economic implications are huge. It could reduce severe dementia in the long run and reduce healthcare costs

How to Prevent Dementia: Is It Possible?

A slightly fading memory is not unusual as you grow older, but dementia is so much more than that. It’s not a normal part of aging.

There are some things you can do to lower your risk of developing dementia, or at least slow it down. But because some causes are outside your control, you can’t totally prevent it.

Let’s take a closer look at some causes of dementia and what you can do right now to start reducing your risk.

What is dementia?

Dementia is a blanket term for chronic, progressive loss of mental function. It’s not a disease, but a group of symptoms with various causes. There are two main categories for dementia, Alzheimer and non-Alzheimer.

Alzheimer’s disease is the most common cause of dementia. Dementia of Alzheimer’s disease involves memory loss, plus impairment of other functions of the brain such as:

  • language
  • speech
  • perception

Non-Alzheimer dementias have to do with frontotemporal lobar degenerations, with two main types. One type mostly affects speech. The other type involves:

  • behavioral changes
  • personality changes
  • lack of emotion
  • loss of social filter
  • apathy
  • trouble with organization and planning

In these non-Alzheimer’s dementias, memory loss appears later in disease progression. The second most common cause is vascular dementia. Some other non-Alzheimer’s dementias are:

Mixed dementia is when there are multiple causes. For example, a person with Alzheimer’s disease who also has vascular dementia has mixed dementia.

Can you prevent dementia?

Some types of dementia are due to things beyond your control. But there are some things you can do to lower your risk of developing dementia and maintaining overall good health.


Regular physical activity can help reduce the risk of dementia. A 2019 studyTrusted Source showed that aerobic exercise may slow atrophy in the hippocampus, the part of the brain that controls memory.

Another 2019 study revealed that active older adults tend to hold on to cognitive abilities better than those who are less active. This was the case even for participants who had brain lesions or biomarkers linked to dementia.

Regular exercise is also good for weight control, circulation, heart health, and mood, all of which could affect your dementia risk.

If you have a serious health condition, talk to your doctor before starting a new exercise regimen. And if you haven’t exercised in a while, start small, maybe just 15 minutes a day. Choose easy exercises and build up from there. Work your way up to:

  • 150 minutes a week of moderate aerobics, such as brisk walking, or
  • 75 minutes a week of more intense activity, such as jogging

Twice a week, add some resistance activities to work your muscles, such as push-ups, sit-ups, or lifting weights.

Some sports, like tennis, can provide resistance training and aerobics at the same time. Find something you enjoy and have fun with it.

Try not to spend too much time sitting or lying down during the day. Make movement a priority every day.

Eat well

A diet that’s good for the heart is good for the brain and overall health. A healthy diet may reduce your risk of conditions that can lead to dementia. According to the World Health Organization (WHO)Trusted Source, a balanced diet consists of:

  • fruit and vegetables
  • lentils and beans
  • grains, tubers, or roots
  • eggs, milk, fish, lean meat

Things to avoid or keep to a minimum are:

  • saturated fats
  • animal fats
  • sugars
  • salt

Your diet should center around nutrient-rich, whole foods. Avoid high-calorie, processed foods that provide little to no nutritional value.

Don’t smoke

ResearchTrusted Source shows that smoking can increase the risk of dementia, especially if you’re 65 years old or more. Smoking affects blood circulation all around your body, including the blood vessels in your brain.

If you smoke, but find it hard to quit, talk to your doctor about smoking cessation programs.

Go easy on alcohol

ResearchTrusted Source shows that excessive alcohol consumption may be a major risk factor for all types of dementia, including early-onset dementia. The current Dietary Guidelines for AmericansTrusted Sourcedefines moderate drinking as up to one drink per day for women and up to two for men.

One drink is equal to .6 ounces of pure alcohol. That translates into:

  • 12 ounces of beer with 5 percent alcohol
  • 5 ounces of wine with 12 percent alcohol
  • 1.5 ounces of 80 proof distilled spirits with 40 percent alcohol

Keep your mind active

An active mind may help lower the risk of dementia, so keep challenging yourself. Some examples would be:

  • study something new, like a new language
  • do puzzles and play games
  • read challenging books
  • learn to read music, take up an instrument, or start writing
  • stay socially engaged: keep in touch with others or join group activities
  • volunteer

Manage overall health

Staying in good shape can help lower risk of dementia, so get a yearly physical. See your doctor if you have symptoms of:

  • depression
  • hearing loss
  • sleep problems

Manage existing health conditions such as:

  • diabetes
  • heart disease
  • high blood pressure
  • high cholesterol
What are common risk factors for dementia?

The risk of developing dementia rises with age. About 5 to 8 percentTrusted Source of people over age 60 have a form of dementia, says the WHO.

Conditions that can increase the risk of dementia include:

Contributing factors may include:

  • long-term alcohol or drug use
  • obesity
  • poor diet
  • repeated blows to the head
  • sedentary lifestyle
  • smoking
What are the symptoms of dementia?

Dementia is a group of symptoms involving memory, reasoning, thinking, mood, personality, and behavior. Some early signs are:

  • forgetfulness
  • repeating things
  • misplacing things
  • confusion about dates and times
  • trouble finding the right words
  • changes in mood or behavior
  • changes in interests

Later signs may include:

  • worsening memory problems
  • trouble carrying on a conversation
  • trouble completing simple tasks such as paying bills or working a phone
  • neglecting personal hygiene
  • poor balance, falling
  • inability to problem solve
  • changes in sleeping patterns
  • frustration, agitation, confusion, disorientation
  • anxiety, sadness, depression
  • hallucinations
How is dementia diagnosed?

Memory loss doesn’t always mean dementia. What initially looks like dementia could turn out to be a symptom of a treatable condition, such as:

  • vitamin deficiency
  • medication side effects
  • abnormal thyroid function
  • normal pressure hydrocephalus

Diagnosing dementia and its cause is difficult. There’s no single test to diagnose it. Some types of dementia can’t be confirmed until after death.

If you have signs and symptoms of dementia, your doctor will probably start with your medical history, including:

  • family history of dementia
  • specific symptoms and when they started
  • other diagnosed conditions
  • medications

Your physical exam will likely include checking:

  • blood pressure
  • hormone, vitamin, and other blood tests
  • reflexes
  • balance assessment
  • sensory response

Depending on results, your primary care doctor may refer you to a neurologist for further evaluation. Cognitive and neuropsychological tests may be used to assess:

  • memory
  • problem solving
  • language skills
  • math skills

Your doctor may also order:

  • brain imaging tests
  • genetic tests
  • psychiatric evaluation

A decline in mental functioning that interferes with everyday tasks may be diagnosed as dementia. Lab tests and brain imaging can help exclude or confirm certain diseases as the cause.

FINDING HELP FOR DEMENTIAIf you, or someone you care about has dementia, the following organizations can help or refer you to services.

How is dementia treated?

Medicines for Alzheimer’s disease include:

  • cholinesterase inhibitors: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne)
  • NMDA receptor antagonist: memantine (Namenda)

These drugs can help improve memory function. They may slow progression of Alzheimer’s disease, but they don’t stop it. These drugs can also be prescribed for other dementias, such as Parkinson’s disease, Lewy body dementia, and vascular dementia.

Your doctor can also prescribe medications for other symptoms, such as:

  • depression
  • sleep disturbances
  • hallucinations
  • agitation

Occupational therapy can help with such things as:

  • coping mechanisms
  • safer behaviors
  • behavior management
  • breaking tasks into easier steps
What’s the outlook for people with dementia?

Some types of dementia can be effectively treated and reversed, particularly those caused by:

  • B-12 deficiency and other metabolic disorders
  • buildup of cerebral spinal fluid in the brain (normal pressure hydrocephalus)
  • depression
  • drug or alcohol use
  • hypoglycemia
  • hypothyroidism
  • subdural hematoma following a head injury
  • tumors that can be surgically removed

Most types of dementia are not reversible or curable, but they’re still treatable. These include those caused by:

  • AIDS dementia complex
  • Alzheimer’s disease
  • Creutzfeldt-Jakob disease
  • Parkinson’s disease
  • vascular dementia

Your prognosis depends on many factors, such as:

  • cause of dementia
  • response to treatment
  • age and overall health

Your doctor can help you understand more about your individual outlook.

The bottom line

Dementia is a group of symptoms affecting memory and other cognitive functions. The top cause of dementia is Alzheimer’s disease, followed by vascular dementia.

Some types of dementia are due to things you can’t change. But lifestyle choices that include regular exercise, a balanced diet, and mental engagement can help lower your risk of developing dementia.

Alzheimer’s Disease Symptoms

Alzheimer’s disease

Alzheimer’s disease (AD) is a type of dementia where brain cells die. The condition affects memory, thinking, and behavior. According to the Alzheimer’s Association, this disease accounts for 60 to 80 percent of dementia cases. Alzheimer’s disease is more common in people over the age of 65, but some people have early onset AD and show symptoms as early as their 40s or 50s.

This is a progressive disease that worsens over time. It’s the sixth leading cause of death in the United States. After a diagnosis, people with the condition can live an average of four to 20 years.

Recognizing early symptoms of AD and intervening early helps prolong and improve your quality of life.

Early symptoms of AD

Early symptoms of AD can be mild and subtle — so subtle that you may not notice a change in your thinking or behavior. In the early stage of the disease, you’ll likely have trouble remembering new information. This is because the disease often begins to impact areas of the brain responsible for learning new information. You may repeat questions over and over, forget conversations or important appointments, or misplace objects such as your car keys.

Occasional memory loss can be a normal part of aging, so forgetfulness isn’t necessarily a sign of AD. However, you should speak with your doctor if the problem worsens.

The top 10 warning signs include:

  • misplacing objects and being unable to retrace steps
  • memory loss that affects everyday life (unable to budget, drive to a location)
  • difficulty planning or problem solving
  • taking longer to accomplish normal daily tasks
  • losing track of time
  • having trouble determining distance and distinguishing colors
  • difficulty following a conversation
  • poor judgment leading to bad decisions
  • withdrawal from social activities
  • mood and personality changes and increased anxiety
Moderate symptoms of AD

Eventually, AD spreads to more regions of the brain. Family and friends may recognize changes in your thinking and behavior before you do. Sometimes, it’s hard to identify memory problems in ourselves. But as the disease progresses, you may recognize telltale symptoms in yourself, such as confusion and a shorter attention span. As more of your brain cells die, you’ll begin to show signs of moderate AD, which include:

  • problems recognizing friends and family members
  • difficulty with language and problems with reading, writing, or working with numbers
  • difficulty organizing thoughts and thinking logically
  • inability to learn new tasks or to cope with new or unexpected situations
  • inappropriate outbursts of anger
  • perceptual-motor problems, such as trouble getting out of a chair or setting the table
  • repetitive statements or movement, and occasional muscle twitches
  • hallucinations, delusions, suspiciousness or paranoia, and irritability
  • loss of impulse control, such as undressing at inappropriate times or places or using vulgar language
  • exacerbation of behavioral symptoms, such as restlessness, agitation, anxiety, tearfulness, and wandering — especially in the late afternoon or evening — called, “sundowning”
Severe AD symptoms

At this point in the disease, brain plaques (clusters of protein that destroy brain cells) and tangles (dying nerve cells that twist around one another), may appear on imaging tests of the brain. Both are hallmarks of AD. This is the final stage of AD. People at this stage lose control of physical functions and depend on others for care. They sleep more often and are unable to communicate or recognize loved ones.

Other symptoms of severe AD include:

  • lack of bladder and bowel control
  • weight loss
  • seizures
  • skin infections
  • groaning, moaning, or grunting
  • difficulty swallowing

Due to the loss of physical function, people with late-stage AD may deal with complications. Difficulty swallowing can result in inhaling liquids into the lungs, which increases the risk of pneumonia. They may also suffer from malnutrition and dehydration. Limited mobility also increases the risk of bedsores.

Conditions with similar symptoms

There are other causes of dementia with symptoms similar to AD. A doctor conducts physical and neurological examinations and uses brain imaging technology to diagnose or rule out AD. The following list of neurodegenerative diseases can mimic AD:

  • Parkinson’s disease with dementia leads to shaking and difficulty with walking, movement, and coordination.
  • Vascular dementia occurs from impaired blood flow to the brain and leads to problems with reasoning, planning, judgment, and memory.
  • Frontotemporal lobar degeneration affects the frontal and temporal lobes of the brain, which are associated with personality, behavior, and language.
  • Frontotemporal dementia affects the temporal and frontal lobes that influence decision-making, behavioral control, emotion, and language.
  • Pick’s disease is a rare and permanent form of dementia similar to AD except it often affects only certain brain areas.
  • Supranuclear palsy is a rare brain disorder that causes serious and progressive problems with control of gait and balance, complex eye movement, and thinking problems.
  • Corticobasal degeneration occurs when areas of your brain shrink and nerve cells die over time. The result is growing difficulty moving on one or both sides of your body.

Other possible causes of dementia include:

  • medication side effects
  • depression
  • vitamin B-12 deficiency
  • chronic alcoholism
  • certain tumors or infections of the brain
  • blood clots in or on the brain
  • metabolic imbalances, including thyroid, kidney, and liver disorders

Talk to a doctor if you or a loved one is experiencing symptoms of AD. Because symptoms worsen over time, it’s important to recognize the possibility of AD. Your doctor can make a diagnosis and assess whether symptoms are mild, moderate, or severe.

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