Aerobic Exercise and Heart-Healthy Diet May Slow Development of Memory Problems

Journal of the American Geriatrics Society Research Summary

Cognitive impairment without dementia (CIND), or mild cognitive impairment, is a condition that affects your memory and may put you at risk for Alzheimer’s disease and dementia. According to the U.S. National Library for Medicine, signs of mild cognitive impairment may include frequently losing things, forgetting to go to events and appointments, and having more trouble coming up with words than other people of your age.

Sine experts believe that risk factors for heart disease also are risk factors for dementia and late-life cognitive decline and dementia. Recently, researchers examined two potential ways to slow the development of CIND based on what we know about preventing heart disease. They published the results of their study in the Journal of the American Geriatrics Society.

The research team had a theory: That the healthy lifestyle behaviors that slow the development of heart disease could reduce heart disease risk and also slow cognitive decline in older adults with CIND. These behaviors include regular exercise and a heart-healthy diet, such as the DASH (Dietary Approaches to Stop Hypertension) diet.

In order to investigate their theory, the researchers designed a study titled “Exercise and NutritionaL Interventions for coGnitive and Cardiovascular HealTh EnhaNcement” (or ENLIGHTEN for short). The goal of the study was to examine the effects of aerobic exercise (sometimes known as “cardio” or “cardiovascular” exercise because it involves activities that increase the circulation of oxygen through the blood) and the DASH diet on cognitive functioning in older adults with CIND.

The ENLIGHTEN study examined 160 adults 55-years-old or older. The study participants were older adults who didn’t exercise and had memory problems, difficulty thinking, and making decisions. They also had at least one additional risk factor for heart disease, such as high blood pressure (also known as hypertension), high cholesterol, diabetes, or other chronic conditions.

Participants took a number of tests to measure their heart disease risk factors and cognitive ability. Researchers also assessed participants’ dietary habits and ability to perform daily activities. The participants were then randomly assigned to one of four groups: a group doing aerobic exercise alone, a group following the DASH diet alone, a group doing aerobic exercise and following the DASH diet combined, or a group receiving standard health education.

People in the exercise group did 35 minutes of moderate intensity aerobic exercise (including walking or stationary biking) three times per week for six months. They were supervised for three months and then exercised unsupervised at home for three months. Participants in the exercise group did not receive any counseling in the DASH diet and were encouraged to follow their usual diets for six months.

People in the DASH eating plan group received instruction about how to meet DASH guidelines in a series of weekly sessions for three months and then bi-weekly for the remaining three months. Participants in the DASH group were asked not to engage in regular exercise until the completion of the six-month study.

People in the exercise and DASH group followed the exercise and DASH programs for six months. The participants who were enrolled in the health education group received weekly educational phone calls for three months and then bi-weekly calls for three months. Phone calls were conducted by a health educator on health topics related to heart disease. Participants were asked to maintain their usual dietary and exercise habits for six months until they were re-evaluated.

At the conclusion of the six-month intervention and assessment, participants were free to engage in whatever activity and dietary habits they desired, with no restrictions.

The results of the research team’s study showed that exercise improved the participants’ ability to think, remember, and make decisions compared to non-exercisers, and that combining exercise with the DASH diet improved the ability to think, remember, and make decisions, compared to people who didn’t exercise or follow the diet—even though they didn’t perfectly follow the programs they were assigned to during the six-month interventions.

The researchers concluded that their findings are promising proof that improved ability to think, remember, and make decisions can last one year after completing a six-month exercise intervention. They suggested that further studies would be needed to learn more.

This summary is from “Longer Term Effects of Diet and Exercise on Neurocognition: One Year Follow-Up of the ENLIGHTEN Trial.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are: James A. Blumenthal, PhD; Patrick J. Smith, PhD; Stephanie Mabe, MS; Alan Hinderliter, MD; Kathleen Welsh-Bohmer, PhD; Jeffrey N. Browndyke, PhD; P. Murali Doraiswamy, MBBS, FRCP; Pao-Hwa Lin, PhD; William E. Kraus, MD; James R. Burke, MD; and Andrew Sherwood, PhD.

Exercise Improves Anxiety and Mood in Older Adults Undergoing Chemotherapy

Journal of the American Geriatrics Society Research Summary

Although we know that exercise improves anxiety and mood problems in younger people with cancer, few studies have looked at the effects of exercise on older adults with cancer. Since most new cancer cases occur in adults aged 60 or older, a team of researchers from the University of Rochester Medical Center and other institutions designed a study to learn more.

Their study appeared in the June issue of the Journal of the American Geriatrics Society (JAGS).

Having cancer increases the chances of people experiencing anxiety and mood issues, which can affect emotional and social well-being. In turn, this may lead people to discontinue cancer treatments—which can mean shortening their survival.

Chemotherapy can benefit older adults with cancer, even though older people receiving this type of treatment often experience higher rates of dangerous side effects than younger people do. Older adults often experience anxiety and other mood disorders during their treatment for cancer, too—and treating those problems with medications can often cause potentially dangerous side effects.

What’s more, many anti-anxiety medications such as benzodiazepines and antidepressants are listed in the American Geriatrics Society (AGS) Beers Criteria® as being potentially inappropriate for older adults. That’s why it is desirable to seek alternative treatments that are safe and effective at improving anxiety, mood disturbances, and emotional and social well-being, including treatments that don’t rely on medications. For example, several studies have been conducted to examine the relationship between exercise and mood in cancer survivors and most have shown positive results. Continue reading

How Interval Training Affects “Belly Fat” in Obese 70-Year-Olds

Journal of the American Geriatrics Society Research Summary

By today’s estimates, one-third of adults aged 65 or older are obese. This growing obesity trend, along with the decrease in our level of physical activity as we age, seriously raises our risk of diseases and death.

We know that aging leads to a gradual decrease in lean body mass (LBM). Put simply, LBM is the entire weight of your body minus the weight associated with fat tissue. As we age, fat distribution in the body can shift, and often increases in the belly region. This is a health concern for older adults, because so-called “belly fat” (also known as “central obesity”) is associated with a greater risk for heart disease than general obesity.

Now, a team of researchers have designed a study to learn more about the effects of a 10-week, easy-to-perform, personalized, progressive vigorous-intensity interval training among 70-year-olds with “belly fat.” Their study was published in the Journal of the American Geriatrics Society. Continue reading

Exercise May Lessen Risk of Falling for Older Adults who have Alzheimer’s Disease and Mental Health Challenges

Journal of the American Geriatrics Society Research Summary

Alzheimer’s disease (AD) is a brain disease that causes changes that kill brain cells. AD is a type of dementia, which causes memory loss and problems with thinking and making decisions. People with AD and other forms of dementia have difficulties performing the daily activities others might consider routine.

Dementia takes a toll on those who live with it—and it also places a burden on caregivers. Along with problems connected to memory, language, and decision-making, dementia can cause neuropsychiatric symptoms, such as depression, anxiety, changes in mood, increased irritability, and changes in personality and behavior.  People who have AD/dementia also have twice the risk for falls compared to people without dementia. About 60 percent of older adults with dementia fall each year.

Researchers suggest that having neuropsychiatric symptoms might predict whether an older person with AD/dementia is more likely to have a fall. We also know that exercise can reduce the number of falls in older adults with dementia. However, we don’t know very much about how neuropsychiatric symptoms may increase the risk of falls, and we know even less about how exercise may reduce the risk of falls for people with dementia and neuropsychiatric symptoms. A research team decided to explore whether exercise could reduce the risk of falling among community-dwelling people with AD who also had neuropsychiatric symptoms. Continue reading

Physical Activity Lowers Risk of Death from Heart Disease

Journal of the American Geriatrics Society Research Summary

Frailty is a health condition that increases risks of poor health, falls, disability, and death in older adults. Signs of frailty include weakness, weight loss, slow walking speed, exhaustion, and low levels of activity. As our population ages, scientists expect that more and more of us will need to address frailty and its associated health concerns.

Geriatrics is the branch of healthcare dedicated to working with older people. Geriatrics experts have suggested that physical activity may one of the best ways to prevent frailty.

Physical activity includes walking and other gentle forms of exercise. It is proven to improve health. Physical activity can lower the risk of many chronic diseases, including type 2 diabetes, heart disease, several cancers, and depression. Exercise also can improve your ability to perform your daily activities and can lower your risk of death from heart disease. In frail older adults, physical activity has been shown to improve strength, balance, agility (the ability to move quickly and easily), walking speed, and muscle mass (the amount of muscle you have in your body). These are all key functions tied to frailty.

Researchers recently reviewed a number of studies about exercise in frail older adults. The review found a number of studies that showed exercise helped reduce falls, improved walking ability, improved balance or increased muscle strength.  However, we still don’t know whether physical activity can reduce death among frail older adults.

Researchers recently designed a study to fill that knowledge gap by exploring whether physical activity could lower the high rate of death associated with frailty in older people. Their study was published in the Journal of the American Geriatrics Society. Continue reading