More than 5 million Americans have Alzheimer’s, which leads to deteriorating mobility. (ISTOCKPHOTO)
Exercise may help slow loss of physical abilities in people with dementia

THE QUESTION Might regular exercise have a mitigating effect on the physical decline that generally accompanies Alzheimer’s disease?

THIS STUDY involved 210 people with Alzheimer’s who were 78 years old on average, had shown a decline in mobility and were living at home with a spouse. Most had moderate or severe Alzheimer’s, and nearly all were taking medication for the disease. They were randomly assigned to one of two groups that exercised for an hour twice a week or to a third group that did no organized exercise. One group exercised at home with the help of a physiotherapist, with the exercises tailored to each person’s specific needs and abilities. The others exercised in groups of 10 at an adult rehabilitation center day-care program, with a mix of endurance, balance and strength-training exercises supervised by physiotherapists. The non-exercisers were given advice by nurses on nutrition and exercise. After a year, physical abilities had deteriorated in all groups, but the decline was slower among those who exercised, especially those who exercised at home, than it was for those who did not exercise, based on standardized scales. Also during the year, more falls were recorded for those who did not exercise than for those who did. The authors noted that less physical decline means less need for help day to day.

WHO MAY BE AFFECTED? Anyone with Alzheimer’s disease, a brain disorder that robs people of memory and mental functioning but also leads to mobility and functional deterioration as the dementia progresses. No cure has been found and no medication can slow or prevent the disease, but various drugs have been approved to treat symptoms. Today, more than 5 million Americans have Alzheimer’s, a number that is expected to reach 7 million by 2025 and nearly 14 million by 2050, unless ways are found to prevent, slow or stop the disease.

CAVEATS The study did not compare relative effectiveness of specific types of exercise. The physiotherapists who participated in the study had been trained in treating people with dementia. Those who exercised with a group may not have done quite as well, the authors surmised, because people with dementia often do not like group activities.

FIND THIS STUDY April 15 online issue of JAMA Internal Medicine.

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The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment's effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.