Alzheimer's Disease
Abstract & Commentary
Exercise and the Elderly: You are Never Too Old to Pump it Up!
By Martin S. Lipsky, MD
Adjunct Professor, Institute on Aging, School of Community Health, Portland State University; Dean Emeritus, University of Illinois College of Medicine, Rockford
Dr. Lipsky is a retained consultant for Health Solutions & Strategies.
This article originally appeared in the Jan. 15, 2014 issue of Internal Medicine Alert.
Synopsis: Poor fitness in the elderly can lead to serious consequences. This study showed that resistance training improved agility, lower limb strength, balance, and flexibility in a group of Alzheimer's disease patients.
Source:Garuffi M, et al. Effects of resistance training on the performance of activities of daily living in patients with
Alzheimer's disease. Geriatr Gerontol Int 2013;13:322-328.
Summary Points
- Resistance training improves agility, lower limb strength, balance, and flexibility in Alzheimer's disease patients.
- With the help of one or two sessions with a physical therapist, resistance training could be implemented and supervised at home and offers the potential for a relatively low-cost, non-pharmaceutical alternative to improve the care and outcomes of patients with Alzheimer's disease.
Throughout the world, the population is aging. In 2008, about 13% of the U.S. population was older than age 65, and by 2030 more that 20% of the U.S. population is expected to be older than age 65.1 Similar increases in the percentage of elderly individuals are expected worldwide, and by the year 2050, about 16% of the world's population will be older than age 65.2 As people age, there is an increased risk of dementia suggesting a concomitant increase in the number of individuals with Alzheimer's disease (AD). The anticipated increase in prevalence of AD makes it critically important to find ways to reduce the burden of this devastating disease. Maintaining a healthy lifestyle and regular exercise might be ways of doing this. However, while there is evidence that exercise benefits individuals with AD and might improve both brain health and physical fitness, no consensus exists about what is the best type of physical activity or how to prescribe the right intensity and frequency of exercise.
Resistance training improves muscle strength. A review of strength training and chronic diseases reported an association between muscular strength and the risk for AD. However, this review did not report on the impact of resistance training on the functionality of this population.
In this study, Garuffi and colleagues explored the impact of resistance training on patients with mild-to-moderate AD. They took 34 patients with mild-to-moderate AD and divided them into two groups. Both groups had preintervention testing using a battery of tests to assess their performance in common activities of daily living. One group participated in a resistance training program consisting of three sets of 20 repetitions of five exercises. The second group was a social gathering group that participated in a variety of unstructured activities such as writing and reading. The social gathering group was designed to minimize biases associated with socialization that might cause benefits in patients who participated in the exercise intervention.
After 16 weeks, both groups were retested to see if there was improvement in their ability to perform common activities of daily living. The researchers noted significant differences between the two groups with the individuals who participated in resistance training showing significant improvement in moving around the house, climbing stairs, standing up from the floor, and putting on socks. They concluded that resistance training improves agility, lower limb strength, balance, and flexibility in AD patients. Both protocols appeared to be effective in improving agility as measured by a moving around the house test.
COMMENTARY
While this study is small and should be verified with larger numbers of patients, it adds to a body of knowledge that fitness and exercise benefit AD patients. Resistance training, which can be done at home with little cost, demonstrated significant improvement in tasks that can help maintain a higher degree of autonomy and, perhaps, improve quality of life. It was also exciting to see that improvement occurred in only 16 weeks. While the researchers did not study institutionalization as an endpoint, the improvements seen suggest that for some individuals, an exercise program, including resistance training, might be the difference between maintaining a patient with AD at home rather than the patient being transferred to a long-term care facility. The findings suggest that with the help of one or two sessions with a physical therapist, resistance training could be implemented and supervised at home and offers the potential for a relatively low-cost, non-pharmaceutical alternative to improve the care and outcomes of patients with AD.
References
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AgingStats.gov. http://www.agingstats.gov/Main_Site/Data/2010_Documents/Population.aspx. Accessed December 18, 2013.
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World Population Prospects. The 2008 Revision [database on the Internet]. Department of Economic and Social Affairs, Population Division. 2009.
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Hurley BF, et al. Strength training as a countermeasure to aging muscle and chronic disease. Sports Med 2011;41:289-306.
