Should you exercise to prevent or reverse dementia?

Should we exercise to prevent dementia?

The answer to the latest meta analysis is showing that the data is inconclusive!

Does that mean we shouldn’t bother to exercise? No!  There are a lot benefits to exercise.

What are the benefits of exercise to the brain?

1.) Vascular benefits
This means it increased blood flow to the brain, which helps those neurons fire together and wire together. In other words you build new connections when you have more blood flow.

2.) Reduces insulin resistance 
With diabetes is our cells become resistant to insulin and thus our blood sugars can’t be controlled. If our blood glucose is too high, it can have long term vascular damage to the brain.

3.) Increases neurotrophic factors
BDNF (brain derived neurotrophic factor) is increased with aerobic exercise. This helps strengthen the synapses, and we want the stronger connections in order to help keep us resilient against the onset of the disease.

4.) Increases the size of the hippocampus.
The hippocampus is that area in the brain involved in memory and the first to decline in Alzheimer’s disease.

5. ) It increases synaptoplasticity
And thus strengthens those connections to help keep us resilient against the disease.

6.) It helps reduce stress
The more stress we have, the harder it is to recover from any sort of onslaught we get from living in this world. Getting rid of that stress allows our brain to better renew and clean up cellular debris.

7.) It improves our sleep
Sleep is vital for cleaning up cellular debris. At night, our Glymphatic nervous system becomes activated. It is like this big plumbing system in our brain where it flushes out beta amyloid and deposits in our brain that are unhealthy for us. So good sleep is vital for reducing your risk of cognitive decline and dementia.

8.) It improves mood
We know depression is a risk factor for dementia and Alzheimer’s disease and cognitive decline. So we certainly want to do anything we can to reduce our risk of depression.

So should we exercise to prevent dementia?

I believe we should, even though the studies are inconclusive.

Why? Let me tell you a little bit why reasons why I believe that they’re inconclusive based on what I know about research. One important concern is that when you combine all those studies together you often miss the individual effects of each study.

For example, there is a lot of variability between studies in how much exercise intervention was given. The time between the intervention and the measurement of cognitive decline could be years away, and that variability between intervention and measurement could wash out effects measured at the optimal interval.

Maybe the benefits only happen in combination with a good diet. What if that is not being controlled for in a study?  Then any benefits could be washed out.

Maybe exercise is stressful in one group, but in another study, they have found a way to make it fun.  What if the exercise had to be fun to have more benefits?

All these different variables cannot be sufficiently be taken into consideration in large scale studies. There are so many variables involved not only in the population, their cognitive status, but also in the exercise interventions. And because they can’t all be accounted for because of the variability between studies, they can get can get washed out in the final analysis, which makes the study inconclusive.

So what would I recommend then for exercise to prevent dementia?

I would stay in line with recommendations from the World Health Organization.

Interestingly, it is almost the same recommendations I get from the subconscious!

The World Health Organization recommends that individuals 65 and over get 150 minutes of moderate aerobics or 75 minutes of vigorous aerobic exercise a week. They should also get two muscle conditioning workouts a week that involve working all the major muscle groups. They have also found is that there’s increased benefit associated with more aerobic activity. They recommend doubling up the aerobic activity for greater benefits. So the recommendation for additional benefits would be 300 min of moderate exercise, or 150 min of vigorous exercise. You can also substitute aerobic exercise with an alternative practice that that involves more interval training. For example, combining aerobic activity with muscle conditioning. There are workouts called HIIT or Tabata that have even more cardiovascular benefits than aerobics alone.

One more recommendation from the subconscious:

So those are options recommended by the WHO for your exercise program. Now I’ll tell you what else I get when I ask questions of the subconscious. The subconscious knows what is good and bad for you, and it knows the ideal amount and type of exercise you need.
What I find when I get recommendations from the subconscious about exercise is definitely in line with the recommendations from the World Health Organization. But I also find that most people who come to me often need to lower their levels of stress. We live in a harsh world, and alleviating that stress is really important. So I get recommendations that include either stretching or yoga once or twice a week depending on the amount of stress. So I would definitely recommend that as well.

The importance of cognitive complexity:

Several studies have shown that cognitive complexity of the types of exercise you’re doing matters. So what does that mean? It means to try a variety of workouts. Also dance has been shown to be the most beneficial because it has three benefits that prevent cognitive decline. You get exercise, intellectual stimulation and social benefits, plus it is fun!

If you want to keep challenging yourself with new workouts, one way to do this is to join Classpass. With a membership you can take a huge variety of classes all over your city!

Recommendations for people with dementia:

Panza et al. compared studies in a metanalysis where groups were given just cardiovascular exercise or cardiovascular exercise plus muscle conditioning.  He concluded that the groups that did only cardiovascular activity had more improvement than those who had a combination of aerobics and muscle conditioning.

Why?

Well, we do know that cardiovascular activity increased vascular benefits, that it increase the neurotrophic factor BDNF, and that aerobic exercise helps clear out beta amyloid in transgenic mouse models of Alzheimer’s. Because those with dementia are more likely to have beta amyloid, there are greater benefits with cardiovascular exercise.

Despite the findings of the study (and the authors did conclude that more research needs to be done), I believe that muscle conditioning is still important to do when you have dementia.

Most studies examined in the metaanalysis had either 5 sessions of aerobic activity a week vs. 3 sessions of aerobics plus 2 sessions of muscle conditioning. I personally think that the amount of aerobics activity was the determining factor regardless of whether weight training was done. In other words my guess if the study was done long enough, that 5 days of cardiovascular exercise plus 2 days of muscle conditioning would have greater benefits than just 5 days of cardiovascular activitiy. However, more research needs to be done to test my hypothesis.

Those are my current recommendations. Please know that research is always being updated, and that the variability in findings between studies makes it very hard to always be right when it comes to recommendations. Your job is just do the best you can with the information you have. It is much better than just sitting on the couch.

What is your favorite type of exercise?  Please comment below.

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