Physical Fitness Leads to Reduced Falls in Alzheimer’s Patients

By Kim Deng

Physical fitness can help the mind, body, and quality of life for people with early Alzheimer’s Disease and dementia, according to two new studies presented at the Alzheimer’s Association International Conference on Alzheimer’s Disease held on July 27, 2008. Alzheimer's Affects the Hippocampus

In the first study, Robyn A. Honea, PhD, and colleagues from the University of Kansas Medical Center investigated the relationship between cardiorespiratory fitness and regional brain volume. They studied healthy older adults and those with early Alzheimer’s Disease using MRI tests and a new analysis technique called voxel-based morphometry.

This is the first time that MRI brain imaging has been used to demonstrate the connection between cardiorespiratory fitness and Alzheimer’s-related brain changes in the hippocampus, an area of the brain important for memory and spatial navigation. In Alzheimer’s Disease, the hippocampus is one of the first regions of the brain to suffer damage.

In the study, older adults ages 60 and over (including 63 with early-stage Alzheimer’s Disease and 56 without) had MRI scans and fitness assessments based on peak oxygen consumption during a treadmill test. The researchers found that study participants with early Alzheimer’s Disease, and not healthy elderly, had a significant relationship between the size of key brain areas associated with memory (hippocampal and parahippocampal volume) and cardiorespiratory fitness. For example, those with better fitness ratings had less atrophy and those with worse fitness ratings had more atrophy. These findings clearly suggest that maintaining cardiorespiratory fitness may positively modify Alzheimer’s-related brain atrophy.

In the second study, researchers from Western Medicine in Australia showed that a caregiver-driven, home-based exercise program could reduce falls, improve balance, and maintain the quality of life in people with dementia over a 12-month period.

One-third of older people living in these communities fall each year, and people with dementia fall up to three times more than those who have no cognitive impairment. The researchers found that people in the exercise group fell significantly less often than people in the control group within the first six months. In the second six months of the study, there was no difference between the groups.

The investigators concluded that the home visits in the first six months were important in keeping people motivated to do the exercises and may have had an impact on how often they fell. The study also showed that people in the exercise group improved their balance over 12 months while the usual care group showed some deterioration in their balance over time. "The results of this study were encouraging," said Wraith. "Falls have a negative impact on a person’s quality of life, often resulting in nursing home placement, increased mortality, and significant costs to the community. Targeting this high risk group may be a relatively cost effective way of having a significant impact on the overall rate of falling in the elderly."

A significant problem with increasing frailty and balance impairment is that the person with Alzheimer’s Disease becomes less independent due to the fear of falling. People in the exercise group showed no significant increase in fear of falling over 12 months, while the usual care group became more fearful. In addition, the study showed that the quality of life was maintained for both the caregiver and the person with dementia in the exercise group, but that it deteriorated for participants in the usual care group.

“These studies reinforce the need for increased awareness and education about the importance of living a brain-healthy lifestyle, including staying physically active,” said William Thies, PhD, vice president of Medical and Scientific Relations for the Alzheimer’s Association. “Growing evidence shows that physical exercise does not have to be strenuous or require a major time commitment. It is most effective when done regularly, and in combination with a brain-healthy diet, mental activity, and social interaction.”

Source: Alzheimer’s Association International Conference on Alzheimer’s Disease on July 27, 2008.

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