Keeping Alzheimer’s Disease from worsening


Exercising several times a week for 30 to 60 minutes may: Keep thinking, reasoning and learning skills sharp for healthy individuals. Improve memory, reasoning, judgment and thinking skills (cognitive function) for people with mild Alzheimer’s disease or mild cognitive impairment.


Their Alzheimer’s Disease Didn’t Worsen. Why?

— Case reports find one healthy habit in common

by Judy George, Deputy Managing Editor, MedPage Today February 3, 2023

Sustained vigorous exercise might have slowed disease progression in two patients with positive Alzheimer’s biomarkers and mild cognitive impairment, two case reports suggested.

At age 64, patient 1 was diagnosed with amnestic mild cognitive impairment. More than 15 years later, at age 80, he had minimal cognitive and functional decline and was diagnosed with mild Alzheimer’s disease.

Patient 2 was diagnosed with amnestic mild cognitive impairment at age 72. At age 80, he showed no clinical progression.

Mini-Mental State Examination (MMSE) declines averaged 0.3 points per year for patient 1 and 0.125 points per year for patient 2, compared with the average 2-point MMSE annual decline in patients with mild to moderate Alzheimer’s disease.Why the “strikingly benign, atypical clinical course”?Of all the possible contributors, intense physical activity was the likely disease-modifying factor, Davangere Devanand, MD, of Columbia University Irving Medical Center in New York City, and co-authors wrote in Alzheimer’s & Dementiaopens in a new tab or window.Both patients regularly exercised vigorously for hours a day and increased their participation after they either retired or reduced their work hours.”We know that mild to moderate exercise is associated with a lower risk of developing dementia, including Alzheimer’s disease, but the effects of vigorous, regular exercise have been poorly studied,” Devanand told MedPage Today.”The two patients in this report had Alzheimer’s brain pathology based on established biomarkers and clinical features but showed little cognitive decline for 16 years and 8 years, respectively,” he said. “Vigorous, regular exercise was the most likely explanation for their lack of deterioration, because they had multiple medical problems and did not focus on diet or cognitively-stimulating activities beyond what they did earlier in life.”

Physical exercise has been linked with a reduced risk of cognitive decline, and daily movement including step countsopens in a new tab or window have been tied to lower dementia risk. In the EXERT trialopens in a new tab or window, moderate-intensity aerobic training for 12 months did not differ from stretching and balance exercises in cognitive outcomes among people with mild cognitive impairment. Meta-analyses also have found some evidence of a beneficial effect of physical exerciseopens in a new tab or window for Alzheimer’s cognitive symptoms.

“Nearly all published studies have evaluated mild to moderate exercise for a few months to 2 years without regular exercise being required during the entire follow-up period,” Devanand and colleagues observed.

Diet was unremarkable in both patients and unlikely to have contributed to slow disease progression, they added.

“If this initial report leads to future prospective, controlled studies that confirm that vigorous, sustained exercise can slow disease progression, widespread adoption of this approach is likely with major public health implications,” Devanand and colleagues suggested. “Delaying Alzheimer’s disease progression by even a few years will lead to enormous health care and societal cost savings.”

  • Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow,they%20did%20earlier%20in%20life.%22


Mayo Clinic

Alzheimer’s disease: Can exercise prevent memory loss?

Can exercise prevent memory loss and improve cognitive function?

Answer From Jonathan Graff-Radford, M.D.

Possibly. Exercise has many known benefits for both physical and mental health, including reducing the risk of cardiovascular disease and diabetes, strengthening the bones and muscles, and reducing stress.

It also appears that regular physical activity benefits the brain. Studies show that people who are physically active are less likely to experience a decline in their mental function and have a lowered risk of developing Alzheimer’s disease. Physical activity is one of the known modifiable risk factors for dementia. Plus, regular exercise helps combat other Alzheimer’s disease risk factors, such as depression and obesity.

Exercising several times a week for 30 to 60 minutes may:

  • Keep thinking, reasoning and learning skills sharp for healthy individuals
  • Improve memory, reasoning, judgment and thinking skills (cognitive function) for people with mild Alzheimer’s disease or mild cognitive impairment
  • Delay the start of Alzheimer’s for people at risk of developing the disease or slow the progress of the disease
  • Increase the size of the part of the brain that’s associated with memory formation (hippocampus)

Physical activity seems to help your brain not only by keeping the blood flowing but also by increasing chemicals that protect the brain. Physical activity also tends to counter some of the natural reduction in brain connections that occurs with aging.

More research is needed to know how — and how much — adding physical activity may improve memory or slow the progression of cognitive decline. Nonetheless, regular exercise is important to stay physically and mentally fit. And for older adults, even leisurely physical activity offers health benefits.


Jonathan Graff-Radford, M.D.


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