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 Researchers studied 160 adults, age 65 on average, all sedentary and
all with some cognitive impairment but not dementia. Participants
were randomly assigned to one of four groups: aerobic exercise three
times a week; nutritional counseling and a heart-healthy diet; both
the exercise and nutrition counseling; or a control group that
didn't change their diet or exercise habits.
After six months, people who exercised scored higher on thinking
tests than they did at the start of the study, an improvement
equivalent to reversing nearly nine years of aging, researchers
report in Neurology.
"There are currently no proven medical therapies to stop or reverse
age-related cognitive decline, and these lifestyle changes have the
potential to delay the onset of dementia for years," said lead study
author James Blumenthal of Duke University Medical Center in Durham,
North Carolina.
In particular, exercise improved thinking skills known as executive
function, which involves a person's ability to regulate their
behavior, pay attention, organize ideas and achieve goals. Exercise
did not, however, seem to improve memory.
Participants assigned to exercise had three weekly sessions of 45
minutes, including a 10-minute warmup followed by 35 minutes of
activities like walking, jogging, or cycling. For the first three
months, they worked out at 70 percent of their maximum heart rate,
working up to 85 percent for the second three months.
People in the nutritional counseling group were taught how to follow
the Dietary Approaches to Stop Hypertension (DASH) diet, which is a
low-sodium, high-fiber diet rich in fruits and vegetables, beans,
nuts, low fat dairy products, whole grains and lean meats.
The DASH diet alone didn't appear to impact thinking skills. But
people with the greatest cognitive improvements were those in the
group assigned both to exercise and follow the DASH diet, suggesting
the diet might enhance the effects of exercise.
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People in the control group didn't start exercising or adopt a DASH
diet and were assigned only to receive health education classes. At
the end of the six months, they showed no improvements in cognitive
function. In fact, on average, their function declined slightly, by
the equivalent of six months of aging.
Beyond its small size, one limitation of the study is that it was
conducted at a single site, and results might be different
elsewhere, the authors note.
Still, the results underscore the importance of lifestyle changes
for older adults with cognitive impairment, said Sandra Bond
Chapman, founder of the BrainHealth center at the University of
Texas at Dallas.
"The pre-dementia stage of the population studied is a critical time
to be proactive about staving off brain vulnerabilities," Chapman
said by email. "Individuals can impact their brain health
significantly by exercising regularly, reducing salt and adding food
that is rich in potassium and magnesium."
Even sedentary older adults should be able to find some way to get
moving, said Scott Hayes, a psychology researcher at the Ohio State
University in Columbus.
"Although folks may have pain, physical impairments or disabilities,
there are often alternative exercises available to get people
moving," Hayes, who wasn't involved in the study, said by email.
"So, if someone has difficulty walking or running, they may be able
to use a stationary bike, swim, or do some resistance training,"
Hayes said. "I would encourage folks to avoid the notion that they
cannot exercise.
SOURCE: https://bit.ly/2CnY2nG Neurology, online December 19, 2018.
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