Wednesday, September 3, 2008

Exercise Beneficial For Individuals At Risk Of Dementia

“A study published in the September 3 issue of JAMA reports that cognitive function modestly improved in adults suffering with memory problems who participated in a home-based physical activity program compared to those who did not participate in the program. Alzheimer disease (AD) affects 26.6 million people worldwide and is expected to affect 106.2 million by 2050 as the world population increases. Nicola T. Lautenschlager, M.D. (University of Melbourne, Australia) and colleagues write that, ‘If illness onset could be delayed by 12 months, 9.2 million fewer cases of AD would occur worldwide.’ To test the impact of physical activity on the rate of cognitive decline, Lautenschlager and colleagues conducted a randomized controlled trial that consisted of 138 adults age 50 years and older who were at increased risk of dementia. Randomization created two groups of participants: one group was assigned to education and usual care and the second was assigned to a 24-week home-based program of physical activity. All participants reported memory problems but did not meet criteria for dementia. The exercise intervention encouraged patients to perform at least 150 minutes of moderate-intensity physical activity per week that were to be completed in three weekly 50-minute sessions. Walking was the activity most frequently recommended, and the intervention in general resulted in more physical activity per week than with usual care - about 142 minutes per week or 20 minutes per day. The researchers used the Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-Cog, a battery of tests) to assess cognitive function over an 18-month period. At the end of the study, participants who were randomly assigned to the exercise group were found to have better ADAS-Cog scores and delayed recall scores compared to participants who were assigned to the control (usual care) group. In addition, Clinical Dementia Rating scores were lower in the physical activity group compared to the usual care group.Lautenschlager and colleagues conclude: ‘Unlike medication, which was found to have no significant effect on mild cognitive impairment at 36 months, physical activity has the advantage of health benefits that are not confined to cognitive function alone, as suggested by findings on depression, quality of life, falls, cardiovascular function, and disability.’”

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