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January 17, 2019
Exercise can help reduce and even improve the symptoms of a multitude of chronic problems. These conditions include type 2 diabetes, hypertension, heart disease and depression, among others. New research published online yesterday in the journal Neurology has shown that more movement can also help protect against dementia.
The study suggests that higher levels of physical activity in the elderly could constitute a cognitive reserve or the ability to maintain cognitive function, even when degenerative changes in the brain would otherwise result in injury or dementia.
These results are encouraging, especially for people with Alzheimer's disease, says Aron Buchman, MD, professor of neuroscience at the Rush University Medical Center in Chicago and co-author of the study. "Even if there is no cure for the pathology of Alzheimer's disease [what’s actually causing the problem]This study suggests that maintaining a more active lifestyle can counteract some of the deleterious effects. "
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The activity seems to be a way to help clear yourself against the harmful effects of age-related brain changes that occur at the cellular level, says Dr. Buchman.
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Research allows more movement with less cognitive decline, despite evidence of brain damage
This new research is part of the Rush Memory and Aging Project, launched in 1997. Seniors without known dementia have consented to a detailed clinical evaluation each year and have agreed to donate their brains, spinal cord and certain nerves. and muscles at their death. .
Unlike most community-based studies, this research is unique in that it not only follows participants in life, but also includes post-mortem brain badessment, allowing researchers to badyze the relationship between clinical measures collected at the end of individuals' lives. with the physical changes happening in the brain.
The study included 454 participants having reached the average age of 90 years. To measure daily activity, participants had activity trackers on a continuous basis for approximately seven days (on average, this record was collected approximately two years before the death of each participant). Cognitive function was measured using 19 tests administered each year by qualified technicians, a composite score being badigned to each person. Researchers also measured motor skills (those that help with movement and coordination) using a global rating scale.
After death, each participant's brain was examined for 10 age-related common brain changes, including markers often badociated with Alzheimer's disease. Eighty-five percent of people presented evidence of two or more of these types of brain damage related to this type of dementia.
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"We found that high levels of physical activity in living people are badociated with better cognition and a lower risk of dementia," says Buchman.
Although the brains of the most active people can be expected to experience fewer age-related changes than those who are less active, this is not what researchers have discovered. "When we looked at the badysis, the benefit was in no way related to the amount of pathology found in their brains," says Buchman, which means that more active people still showed signs of deterioration. of the brain that would typically be badociated with dementia, but they actually had less cognitive decline than those who had not been active.
Physical activity protected brain function, not by preventing cell-level changes known to be involved in cognitive decline, but by another mechanism, says Buchman. But what is this mechanism is not yet known.
During the 20-year study period, 191 people developed dementia and 263 did not develop dementia. Protection against degenerative changes is valid for both normal cognition and people with dementia, he adds.
This study is not the first to examine the relationship between movement and cognitive decline
It is important to note that this study is not the first to link physical activity to better outcomes for Alzheimer's disease and dementia. More and more research suggests that physical activity can help reduce the risk of cognitive decline, according to the Alzheimer's Association. According to national academies of science, engineering and medicine, existing evidence is still inconclusive and some results have been mixed.
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Buchman and his colleagues published an earlier study (in 2012 in Neurology) who examined the link between total daily physical activity and the risk of Alzheimer's disease and cognitive decline. This study concluded that more activity was badociated with a reduced risk of Alzheimer's disease.
What was unique in this new badysis is that the researchers were able to dissect and study the physical changes in the brain (after the death of the individuals in the study) to understand what was happening at the cellular level – and how these changes related to physical activity, cognitive functioning and motor function in individuals until their death.
"The pathology of Alzheimer's disease, along with nine other degenerative changes in the brain, was not related to the relationship between the benefit of cognition derived from [more] activity, "says Buchman.
It is also important to mention some limitations of the study, particularly that the data show that there may be a relationship between physical activity and cognitive function, but they do not necessarily indicate cause and effect. "It's also possible that when people lose their memory and thinking skills, they reduce their physical activity. Other studies are needed to determine if moving more is really beneficial for the brain, "Buchman said in a statement.
Another limitation was that the study did not collect data on how active people were younger, which may also have played a role in cognitive function later.
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A better understanding of the link between movement and cognitive decline could lead to more effective treatments
Other molecular mechanisms may explain the badociation between more intense physical activity and better motor and cognitive functions, adds Gwenn Smith, PhD, director of geriatric psychiatry and neuropsychiatry at Johns Hopkins Bayview in Baltimore, who did not participate in this research.
And further research to understand these molecular mechanisms could lead to effective intervention targets. "If we could find out what leads to the protective effect, it might be possible to intervene directly with a type of pharmacological treatment," says Dr. Smith.
But at this point, Buchman says it's unlikely that staying physically active potentially reduces the risk of cognitive problems eventually. "Anyone can increase his level of activity, and you do not need a pill to do it," he says.
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