Alzheimer’s disease is more than losing your memory. Eventually, it affects your ability to function day to day. Can exercise – that’s physical, not just mental – be an antidote to cognitive decline?
Do you remember someone’s name after you’ve been introduced? Was it Janet or Julie; Sipho or S’bu? Most people forget, so it seems pretty normal. We also tend to accept, as a natural part of ageing, that names of people we know become increasingly elusive, though they usually pop into our heads a little later.
But when there’s no recall – when the name simply doesn’t come back, when a person can’t remember where they keep their coffee mugs, can’t visualise their normal route to the supermarket, or recall the friend who’s invited them to dinner – that is not the norm. Most of us would conclude that the person has Alzheimer’s disease. It’s a common label applied to memory loss, but there’s much more to it than that.
Alzheimer’s usually starts with short-term memory loss, but includes difficulties with reasoning, planning, making decisions and the ability to communicate. It is the most common type of dementia (there are more than 100 different types). The symptoms usually creep up slowly and often go unnoticed until they interfere with the ability to perform normal daily tasks.
While an estimated two-million people in South Africa have Alzheimer’s disease, and 46.8 million worldwide, it’s not inevitable that you won’t remember your daughter once you’re over 65. One of the best things you can do to protect your brain cells, especially those that store memory, is to get moving. And the earlier the better. That’s because, according to the Gauteng regional director of Alzheimer’s South Africa, Debbie Beech, Alzheimer’s starts about 10 years before diagnosis, though symptoms only present typically about two years before diagnosis.
Various studies have shown that the best form of exercise to delay the onset of cognitive decline is aerobic – movement that increases the heart rate and blood circulation. You could take up dancing, swimming, cycling or walking. Even gardening is good.
Hannah Raath, a Johannesburg-based biokineticist with a special interest in exercise for older adults, says, “Your brain is no different from the muscles in your body – use it or lose it.” She says we should all aim to do at least 150 minutes of moderate exercise a week. “We can apply this to reducing the risk of various conditions, including heart attack, stroke and diabetes, which are all risk factors for Alzheimer’s,” she adds.
Several scientific studies have proved that exercise reduces the incidence of dementia and improves function in Alzheimer’s patients, says Dr Susan Coetzer, a geriatrician based at Wits University Donald Gordon Medical Centre. A University of Maryland study, for example, claims that moderate physical activity may preserve the volume of the hippocampus – or hippocampi (you have two). These thumb-sized seahorse-shaped regions of your brain are responsible for short-term memory and consolidating it for longer-term storage. They determine the strength of your memory now and your dementia risk in future. The volume of the hippocampi shrink as you age – about 0.5% a year, beginning sometime after 50. But, significantly, this is also the part of the brain that is attacked first by Alzheimer’s. In a study conducted at the NeurExpand Brain Centre in Washington DC, those who increased their three walks a week from 10 to 40 minutes not just preserved, but had expanded the volume of their hippocampi by 2% after a year – the equivalent of a facelift for the brain.
While physical exercise can pump up the hippocampus, puzzling over crosswords or Sudoku, playing Bridge, reading and keeping up to date with current affairs, as well as stimulating conversation and staying socially engaged, are all fantastic exercise for the brain, says Beech.
Raath adds there’s plenty of research being done on dual task training – exercising at the same time as doing memory- or brain-stimulating activities – as an effective way of activating cognitive function. Attending classes such as Ageless Grace (www.agelessgrace.com), which challenge your brain while you exercise, are a great option. And for those already diagnosed or showing signs of Alzheimer’s, exercise can provide some benefit.
Lily Fisher, an accredited exercise instructor for seniors who also offers classes for people with Alzheimer’s, says, “Exercise jogs the memory of happy childhood times and reduces anxiety and restlessness. It also improves balance and coordination, and helps prevent muscles from atrophying, which would cause further complications.” The people in Lily’s class usually don’t remember why she’s there, but the “twinkle in their eyes” when they see her shows there’s a positive association.
Get moving now and you, aged 75, could be running a class instead of wondering why you’re there.
By Gillian Warren-Brown