By LAURAN NEERGAARD - AP Medical Writer
New research suggests that even a simple exercise routine could help older Americans with mild memory problems.
Doctors have long recommended physical activity to help maintain a healthy brain. But the government-funded study marks the longest test of whether exercise makes any difference once memory begins to fail — research done in the midst of a pandemic that added isolation to the list of brain-health risks for participants.
The researchers recruited about 300 sedentary older adults with hard-to-detect memory changes called mild cognitive impairment, or MCI, a condition that is sometimes, but not always, a precursor to Alzheimer’s Half were assigned aerobic exercises, and the rest were assigned stretching and balance moves that only modestly increased their heart rate.
Another key component: Participants in both groups received great attention from trainers who worked with them at YMCAs across the country, and when COVID-19 shut down gyms, it helped keep them moving at home via video calls.
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After a year, cognitive tests showed that, overall, neither group had worsened, said lead researcher Laura Baker, a neuroscientist at Wake Forest School of Medicine. Brain scans also didn’t show the shrinking that accompanies worsening memory problems, she said.
By comparison, similar MCI patients in another long-term brain health study, but without exercise, experienced significant cognitive decline over a year.
Those early findings are surprising, and the National Institute on Aging cautioned that following people who don’t exercise in the same study would have offered better evidence.
But the results suggest “this is doable for everyone,” not just older people healthy enough to sweat a lot, said Baker, who presented the data Tuesday at the Alzheimer’s Association International Conference. “Exercise should be part of prevention strategies” for older people at risk.
Previous research has found that regular physical activity of any kind can reduce harmful inflammation and increase blood flow to the brain, said Maria Carrillo, Alzheimer’s Association Chief Scientific Officer.
But the new study is especially intriguing because the pandemic is halfway over, leaving already vulnerable older people socially isolated, something that has long been known to increase people’s risk of memory problems, Carrillo said.
It’s a frustrating time for dementia research. Doctors are hesitant to prescribe a high-priced new drug called Aduhelm it was supposed to be the first to slow the progression of Alzheimer’s, but it’s not yet clear if it actually helps patients. Last month, researchers reported that another drug that works in a similar way, by targeting the amyloid plaques that are a hallmark of Alzheimer’s disease, failed in a key study.
While amyloid clearly plays a role, it’s important for drugmakers to increasingly focus on many other factors that can lead to dementia, Carrillo said, because effective treatment or prevention will likely require a combination of tailored strategies.
One example of a new approach: Sometimes in dementia, the brain has trouble processing sugar and fats in the blood for the energy it needs, John Didsbury of T3D Therapeutics said at the Alzheimer’s meeting. His company is testing a pill that aims to speed up that metabolism, with results expected next year.
In the meantime, there is a growing urgency to determine whether steps people might take today, such as exercise, might offer at least some protection.
How much and what kind of exercise? In Baker’s study, older people were supposed to move for 30 to 45 minutes four times a week, whether it was a vigorous spin on the treadmill or stretching exercises. That’s a great question for anyone who’s sedentary, but Baker said MCI’s effects on the brain make it even more difficult for people to plan and stick with new activity.
Hence the social stimulation, which she attributed to each participant completing more than 100 hours of exercise. Baker suspects that sheer volume could explain why even simple stretching adds up to an apparent benefit. The participants were supposed to exercise without formal support for an additional six months, data that Baker has not yet analyzed.
“We wouldn’t have done the exercise on our own,” said retired agricultural researcher Doug Maxwell of Verona, Wisconsin, who joined the study with his wife.
The duo, both 81, were assigned to stretching classes. They felt so good afterward that when the study ended, they bought electric bikes in hopes of getting even more active, efforts that Maxwell acknowledged are hard to sustain.
Next up: Baker is leading an even larger study of older adults to see if adding exercise to other steps that can’t hurt, like a heart-healthy diet, brain games and social stimulation together, can lower dementia risk.
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