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  • Andrea Cziprusz

Dementia Management: The Power of Exercise

Regular exercise can help individuals with dementia or Alzheimer’s disease maintain their physical health and emotional well-being. There is a proven dose-dependent relationship between physical activity and the risk of cognitive decline, suggesting that exercise can delay the onset of Alzheimer’s Disease, cognitive decline, and mortality. At this stage, specific parameters to thwart disease progression have not been defined; however, there is sufficient data to support a multifaceted approach. Let’s take a look at the benefits of exercise for individuals with dementia, review exercise recommendations, and then explore some practical strategies to help individuals with dementia stay active.



Benefits of Exercise for Individuals with Dementia:


Physical Health: Exercise helps improve strength, endurance, flexibility, and balance, which decreases fall risk and improves mobility for activities of daily living. Physical activity also helps reduce health complications related to inactivity.


Cognition: Regular exercise has been shown to improve executive function, attention, processing speed, and memory.


Mental Health: Exercise can improve mood and reduce stress, positively impacting symptoms of anxiety, depression, agitation, and sun-downing commonly associated with dementia. Opportunities for regular social interaction and engagement can also help alleviate feelings of isolation.



Exercise Recommendations for Individuals with Dementia:


Aerobic Exercise: Target 150 minutes per week of moderate intensity aerobic exercise. This translates to about 30 minutes per day, most days of the week. Prioritize activities that increase heart rate and breathing rate, like a brisk walk, dance class, or water aerobics. If needed, start small and break active periods up into shorter time frames.


Strength Training: Strive for at least two days per week of moderate to high intensity strength training to positively impact brain health. Target large muscle groups in the upper and lower body using resistance bands, dumbbells, machines, or body weight. Start with 2 sets of 8-12 repetitions. Muscle fatigue or tiredness should be felt nearing the end of each set. If fatigue is not met, consider increasing the weight or resistance. Don’t forget to progress resistance over time to maintain an adequate level of challenge.


Balance: Cognitive impairment is an independent risk factor for falls. Improving balance at early stages of Dementia or Alzheimer’s disease may reduce fall risk at later stages. Practice a few balance positions standing at the countertop each day (tandem stance, standing on one foot) or join a weekly Tai Chi class.


As always, exercise should be modified to best suit an individual’s health, activity level, and safety. When starting a new exercise program, consult a doctor or physical therapist to ensure the chosen exercises are appropriate and safe.



Practical Strategies to Help Individuals with Dementia Stay Active:


Exercise together. A walking or gym buddy increases safety and also provides social engagement. Walking with a friend, family member, or caregiver can also be critical for individuals at risk of wandering or getting lost.


Choose activities that are enjoyable. If an individual doesn’t like the idea of exercising, activities like walking the dog, gardening, or running errands at the mall may not feel like exercise, but have the same positive impact.


Prioritize simple and easy-to-follow exercises. It may help to mirror the target exercise and/or do it together.


Make sure exercise space is safe and modify activities as needed if an individual is at risk for falling. Exercise can be done standing at the kitchen counter for additional support or seated in a sturdy chair.


Establish a regular schedule for exercise to create a sense of familiarity and routine. Put the exercise class (whether in person or on YouTube) on the calendar and keep up with it each week. Consistency is key.


Start small and progress gradually. Any amount of movement is beneficial!


Incorporating regular physical activity into everyday life during the early stages of dementia or Alzheimer’s disease increases the likelihood of maintaining an active lifestyle with disease progression. Support and encouragement from family members and caregivers is critical in maintaining a consistent and safe program. Exercise has a neuroprotective effect and is a powerful tool for individuals with dementia. A multi-tiered approach to exercise can help slow disease progression and improve quality of life.


 

Resources:

Chen WW, Zhang X, Huang WJ. Role of physical exercise in Alzheimer's disease. Biomed Rep. 2016 Apr;4(4):403-407. doi: 10.3892/br.2016.607. Epub 2016 Feb 22. PMID: 27073621; PMCID: PMC4812200.


Hill KD, LoGiudice D, Lautenschlager NT, Said CM, Dodd KJ, Suttanon P. Effectiveness of balance training exercise in people with mild to moderate severity Alzheimer's disease: protocol for a randomised trial. BMC Geriatr. 2009 Jul 16;9:29. doi: 10.1186/1471-2318-9-29. PMID: 19607686; PMCID: PMC2722658.


Morris JK, Vidoni ED, Johnson DK, Van Sciver A, Mahnken JD, Honea RA, Wilkins HM, Brooks WM, Billinger SA, Swerdlow RH, Burns JM. Aerobic exercise for Alzheimer's disease: A randomized controlled pilot trial. PLoS One. 2017 Feb 10;12(2):e0170547. doi: 10.1371/journal.pone.0170547. PMID: 28187125; PMCID: PMC5302785.


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