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Physical Activity May Slow Alzheimer's Disease

Staying active may preserve the brain volume in patients who are in the early stages of Alzheimer's disease, new study findings suggest.

Monday, July 14, 2008

Reuters Health - Maintaining a higher level of physical fitness may preserve the brain volume in patients who are in the early stages of Alzheimer's disease, new study findings suggest.

"In normal aging, physical fitness appears to mitigate functional and structural age-related brain changes," Dr. Jeffrey M. Burns and colleagues write in the current issue of the journal Neurology.

To see if this also occurs in patients with Alzheimer's disease, Burns at the University of Kansas School of Medicine, Kansas City, and his associates evaluated the level of cardiorespiratory fitness in a group of 57 patients with early-stage Alzheimer's disease and in 64 "control" subjects without dementia. The subjects' brain volumes were determined by magnetic resonance imaging.

The fitness levels were "modestly" higher in the control group, their report indicates.

In the Alzheimer's group, fitness levels were significantly associated with whole brain volume. The association remained after accounting for the potential influence of age, sex, severity of dementia, physical activity, and physical frailty.

Although whole brain volume was associated with cognitive performance and level of dementia, the investigators observed no significant association between dementia severity and physical fitness.

There were no significant associations between physical fitness and brain volume or cognitive performance in the control group.

"Our data are consistent with, but do not establish, cardiorespiratory fitness as a moderating factor in neurodegeneration," the investigators conclude. It's also possible, they say, that that a common underlying disease-related process may impact both the brain atrophy and cardiorespiratory fitness in subjects with early Alzheimer's disease.

Even though they could not determine the cause, Burns told Reuters Health that he "definitely" would encourage physicians to recommend appropriate physical exercise to patients with Alzheimer's disease.

"I recommend that all my Alzheimer's patients stay both physically and mentally active, even though proof is lacking that these activities clearly influence disease progression," he said. "There are exercise benefits for general health as well as for depressive symptoms that can be achieved with physical exercise in people with dementia."

"There are two important points that motivate research like ours," he explained. "First, we need proof that exercise and physical fitness cause a modification of the disease process and then determine what mechanism is mediating that effect."

"Second, if exercise is a disease-modifying therapy for Alzheimer's disease, we are doing a very poor job of fully utilizing it as a therapy. Thus, more evidence is necessary to demonstrate this, which in turn will stimulate the development of programs and delivery systems that will encourage people with dementia to exercise and, more importantly, sustain that behavior."

With those goals in mind, Burns' group plans to continue to follow these same patients over 2 years to see if physical fitness levels correlate with changes in cognition and brain structure over time.

They are also planning a large study of various types of exercise in Alzheimer's disease patients to assess the cause-and-effect relationship of exercise and enhanced cardiorespiratory fitness on disease progression, Burns said.

SOURCE: Neurology, July 15, 2008.

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