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Reduce Your Risk of Dementia with Physical Activity

Physical activity was linked to less cognitive decline among seniors in a large study. How are you staying active?

Older people who would like to stay sharp can take one simple step: keep moving! Research from Rush University Medical Center suggests that physical activity can reduce elders’ risk of dementia ( Neurology, Feb. 19, 2019). In fact, it is one of the few strategies that can reduce the risk of dementia. Keep reading to learn about the study from Rush and other studies looking at how activity–including intellectual and social engagement–helps the brain. But you do not have to run marathons to benefit. A recent study shows the benefits of practicing an ancient martial art.

Tai Ji Quan Classes Reversed Cognitive Decline:

A new study in the Annals of Internal Medicine demonstrates that practicing Tai Chi, a form of martial art that emphasizes slow movement can improve cognitive function (Annals of Internal Medicine, Oct. 31, 2023). That is in sharp contrast to the results of new anti-amyloid drugs like Leqembi and Aduhem. Those pricey Alzheimer’s medications did not help people improve their cognitive scores, but merely slowed the inevitable deterioration.

How Was the Study Structured?

The new study included roughly 300 older people who were worried about their memories. They began the trial with testing on the Montreal Cognitive Assessment, which ranges from 0 (poor) to 30 (excellent). A score of 18-25 indicates mild impairment. The average score of these participants was 25. Then the researchers assigned them to one of three groups: a control group that did stretching; a standard tai ji quan class and a cognitively enhanced tai ji quan class. Each class met twice a week for six months through video links. In the cognitively enhanced class, they got additional verbal instruction and were asked to do the moves on both sides, in differing sequences, forwards and backwards, and so forth.

The volunteers who practiced cognitively enhanced tai ji quan improved their scores 3.1 points on the Montreal Cognitive Assessment scale. In comparison, those in the standard tai ji quan practice group improved 1.7 points, whereas those in the stretching group did not improve.

The lead author told NPR that the level of improvement with Tai Chi represents three extra years of healthy functioning. Who wouldn’t be pleased with that, especially given the other benefits that tai ji practice offers?

Strength Training Protects Mice from Memory Loss:

Research in mice suggests that resistance training could be beneficial for the brain. We know–mice are different from people. We don’t grant the mouse research the same credibility as research in humans, but it is quite interesting.

Researchers in Brazil conducted an innovative study on mice to determine if exercise can reduce the risk of developing dementia (Frontiers in Neuroscience, April 6, 2023). In particular, they examined the benefits of physical activity with resistance.

In this study, scientists chose mice that were genetically modified to develop amyloid plaques in their brains. As a result, they serve as a model for people who develop Alzheimer disease. Mice trained to exercise did better on subsequent memory tests than the sedentary mice used as controls. They also had fewer amyloid plaques and reduced inflammation in the brain compared to sedentary mice.

The investigators conclude:

“Altogether, the present results suggest that RE plays a role in alleviating AD [Alzheimer disease] symptoms, and highlight the beneficial effects of RE training as a complementary treatment for AD.”

As we have already stated, results in mice may differ from those in human beings. However, adopting habits of physical activity, including strength training, is not likely to be harmful. Keep reading to learn more about the relevant research in humans.

How Was the Rush Research on Physical Activity and Cognitive Function Conducted?

The investigators examined 454 older individuals every year for as long as 20 years. The volunteers took cognitive tests and had annual physical exams. They also agreed to donate their brains for examination upon their deaths.

It is more complicated to measure physical activity, other than relying on what people say they are doing. (That doesn’t always correspond well to what they actually do.) To determine the volunteers’ activity levels, each participant wore an accelerometer for seven days during the study. This wristwatch-like device measures all movements. These may range from small actions such as walking from one room to another to much larger actions such as a vigorous exercise routine. In addition, the volunteers completed 10 supervised motor performance tests as part of the testing regimen.

What Was the Relationship Between Physical Activity and Dementia?

Some of the study subjects had dementia, while the others did not. The accelerometer picked up differences between these two groups. Those with dementia made an average of 130,000 movements daily, as counted by the accelerometer. That may sound like a lot, but the people who were in better cognitive shape made an average of 180,000 movements daily. Overall, people with better motor skills also scored better on measures of memory and thinking.

Volunteers who moved more during the day were more likely to be thinking clearly and remembering things better. Physical activity and motor skills accounted for 8 percent of the differences in cognitive test scores. Brain autopsies showed that even people with signs of Alzheimer disease did better than expected if they maintained strong physical activity to the end of their lives.

The scientists concluded:

“Physical activity in older adults may provide cognitive reserve to maintain function independent of the accumulation of diverse brain pathologies. Further studies are needed to identify the molecular mechanisms underlying this potential reserve and to ensure the causal effects of physical activity.”

This is not the first study to demonstrate the cognitive benefits of physical activity. A recent study showed that seniors in an active exercise program improved their executive function. Of course, there is also the more immediate reward: taking time to play just makes you feel good!

How Does Regular Exercise Affect the Brain?

Another study published in the journal Neurology may have uncovered a mechanism to explain how physical activity affects the brain (Neurology, April 13, 2022). The researchers recruited 134 older people without cognitive difficulties and scanned their brains. Those who reported more physical activity also had more gray matter. They also had better glucose metabolism in their brain tissue. In addition, those who exercised regularly had lower body mass indices (BMI) and insulin levels.

The lead author notes that

“Maintaining a lower BMI through physical activity could help prevent disturbed insulin metabolism that is often seen in aging, thus promoting brain health.”

Staying Active Can Help Ward Off Cognitive Decline:

You may have noted the term “cognitive reserve” in one of the quotes above. Two recent studies, both from the UK, suggest that staying engaged socially and intellectually along with moving the body can help reduce our chances of cognitive decline.

The 1946 Birth Cohort:

One of these studies focused on people born in the UK in 1946 (Neurology, August 3, 2022). The researchers had data on 1,184 participants at numerous times in their lives. First, they had cognitive tests from 1954, when the participants were eight years old. Presumably these were similar to the IQ tests that some of us took during childhood in the US.

The scientists also created a “cognitive reserve index” from three measures during adulthood: educational attainment by age 26, leisure activity participation at age 43, and occupation(s) up to 53. Two additional measures allowed them to test cognitive decline in adulthood. In one, they measured reading skill at 53. In the final tests, they assessed the volunteers’ APOE genetic status, since this is known to affect the risk of Alzheimer disease. And finally, they conducted tests called Addenbrooke’s Cognitive Examination.

What they found was interesting: people who’d had high scores in childhood also tended to do better at age 69. However,  for people who scored well on their adult reading test and their measures of cognitive reserve, the childhood intelligence scores were unrelated to the 69-year-old scores.

One of the study’s authors summarized the results:

“…taking part in an intellectually, socially and physically active lifestyle may help ward off cognitive decline and dementia.”

The UK Biobank Study:

Another recently published study recruited 501,376 participants from the UK Biobank between 2006 and 2010 (Neurology, July 27, 2022). The scientists collected data on mental and physical activity from the volunteers at that time. (Participants’ mean age then was 56.) These investigators also knew the subjects’ APOE status, because the biobank is a repository for genetic material.

After more than ten years of follow-up, just over one percent of the volunteers had developed dementia. Analysis revealed that those who frequently engaged in vigorous physical activity were 35 percent less likely to have it. Housework and visits with friends and family also reduced the risk for dementia significantly. These were independent of the role of the APOE gene.

According to one of the study authors, Dr. Huan Song:

“By engaging more frequently in healthy physical and mental activities, people may reduce their risk of dementia, irrespective of their inherited genetic susceptibility.”

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Li F et al, "Clinical effectiveness of cognitively enhanced Tai Ji Quan training on global cognition and dual-task performance during walking in older adults with mild cognitive impairment or self-reported memory concerns : A randomized controlled trial." Annals of Internal Medicine, Oct. 31, 2023. DOI: 10.7326/M23-1603
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