Age Matters Clinic


Toronto Geriatric Assessment and Memory Clinic

Exercise May Help Patients With Dementia

Elderly Woman Stretching

So far there are no effective medications to treat or prevent dementia. The few medications available only work in mild cases of dementia and even when they work, they generate adverse effects which are not well tolerated by patients. Over the years, researchers have been trying to discover non-drugs methods to treat or prevent dementia. One such method is exercise.

A few years ago anecdotal reports about the benefits of exercise in people with dementia were published but no one paid attention. Now researchers believe that exercise may be helpful for many patients with dementia. Several large scale studies have been done on dementia patients and the results suggest that the brain can remain healthy and productive as long as the exercise is maintained. In fact some experts believe that exercise started at a younger age may even prevent the onset of Alzheimer disease.

It is believed that regular exercise started at a younger age has not only physical benefits to the body but also to the brain. The type of exercise is not relevant as long as it is performed for at least an hour once or twice a week. Unlike medications, it has been shown that regular exercise improves cognition, lowers the risk of dementia and perhaps even prevents progression of the disease. Several large scale imaging studies have been done in people who are exercising and in most individuals MRI studies revealed better brain perfusion and better nerve connectivity- which equated to improve mental functioning. These findings were not seen in people who were sedentary.

How exercise improves brain health is not well understood but many believe that it is physical modulation of the blood vessels that play a critical role. Exercise improves blood flow to the brain and allows for better perfusion. This may help prevent damage to the nerves that are regularly deprived of oxygen as we get older.

Experts in dementia suggest that people who want to prevent dementia do some type of aerobic exercise that can include walking, gym exercise, playing basketball (even in the driveway is adequate) or perform some type of home chore like raking leaves, shoveling snow or other yard work. All these physical activities are beneficial to the brain. For those who have impaired ambulation, recommended exercises include rowing machines static bicycles or some type of sitting exercise with weights. Individuals with arthritis may perform on exercise machines while in the sitting position.

There is no good or bad exercise as long as it is performed on a regular basis. Studies show that the benefits of exercise are long lasting. However, if exercise is stopped then the benefits slowly disappear. The added benefit of exercise for prevention of dementia is that several studies now show that there is lower risk of death compared to people who do not exercise.

People who are inclined to start exercises to prevent dementia should be guided by their healthcare providers. Elderly people are often frail and are at a risk for falls; hence the type of exercise should be guided by the capability of the individual.