Can 150 minutes of exercise a week help prevent Alzheimer’s disease?

SALT LAKE CITY – Most mornings, Lonnie Wollin gets out of bed early and one of his first tasks is to log half an hour or so on his stationary bike, unless he has a real bike ride or planned hike early with his equally active wife and friends.

Wollin, who turns 75 this month, also does some strength training several times a week because he takes seriously the idea of ​​staying as healthy as possible from head to toe.

Especially the head. Wollin has lost eight family members to Alzheimer’s disease, including her father. He is doing his best to avoid or avoid that fate himself.

Science says it could do a lot. The effective medication to treat Alzheimer’s has proven stubbornly elusive and it has been more than a decade since any new drug received approval from the Food and Drug Administration. But the research yields tantalizing clues that increasingly convinced experts, behaviors, not a pill, may be key to ensuring additional years of quality of life, even for those at increased risk of Alzheimer’s.

Could 150 minutes of exercise a week make a difference in how long you stay healthy? That’s quite possible, experts say, based on the research. Add other healthy behaviors, and the odds go higher.

The National Institute on Aging, the Alzheimer’s Association and others are funding ongoing randomized clinical trials, the gold standard of research, to determine what role health or harm behaviors could play. The rewards could be great, adding years of quality and avoiding dementia.

The institute announced in June the results of two observational studies that followed 3,000 long-term participants. The researchers concluded that healthy lifestyle behaviors produce a “substantially lower risk” for Alzheimer’s disease. Her measurements were exercise for at least 150 minutes a week, intellectual stimulation, good nutrition, not smoking, and low to moderate alcohol consumption.

Dr. Klodian Dhana, an assistant professor at Rush University, who led the study, said that those who practiced two or three of the lifestyle options had a 37% lower risk and those with four or five had a 60 risk. % lower Alzheimer’s, compared to those with none or none of the lifestyle factors.

Research published in March had already found that higher daily step counts were associated with a lower risk of all-cause mortality.

“What’s good for the heart is good for the brain,” says Dr. Norman Foster, a neurologist and professor at the University of Utah in Alzheimer’s imaging and clinical research. “There is a lot of good, objective scientific evidence to support these kinds of changes, which also have a lot of common sense.”

That is hopeful news for people like Wollin who are disciplined in trying to keep their brains healthy.

“I don’t think lifestyle changes replace the search for a treatment or a cure,” said Wollin, a financial adviser, lawyer and lifelong advocate who helped found the Alzheimer’s Association decades ago. “But it certainly is something that people can do now.”

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Alzheimer’s is a progressive neurological disease and the most common form of dementia, affecting more than 5 million people in the United States, according to the Centers for Disease Control and Prevention, which projects that the number will nearly triple in 2060. The risk increases with advancing age. .

Experts say the disease probably begins long before symptoms appear. Lifestyle can change the “when”.

“It is more realistic to talk about delaying onset than to talk about prevention for someone who has risk factors,” Dallas Anderson, program director in the institute’s Neuroscience Division, told the Deseret News.

He recommends an “activity program and maybe other things to have more years of life without dementia.”

Exercise must be moderate to vigorous to be effective, but Foster said that even walking provides excellent health benefits. You have to do it long enough and fast enough to feel warm and make your heart beat. It should be part of the usual routine.

People can do multiple beneficial things at once, such as a walk with a friend that includes stimulating conversations. After all, Anderson said, research suggests that multiple factors contribute to disease risk.

Experts say the body needs to be fueled by high-quality nutrition, preferably similar to the Mediterranean DASH diet that focuses on plant-based foods.

“Do what’s good for your heart: diabetes control, blood pressure control, exercise, and also help the brain. They are good at trying to reduce the risk of Alzheimer’s disease, “said Foster.

Anderson said that people who have been relatively sedentary benefit the most when they move.

It’s a matter of both habit and programming, said Foster, who cautions that it’s too easy to do too much at once, causing pain, exhaustion, and quitting smoking. But she doesn’t think the activity’s dribs and drabs produce the same effect, noting that 2,000 continuous steps is different from 2,000 steps a day, 10 steps at a time.

The most important thing is to start, form a habit and choose something nice that you will continue doing.

Reaching for gold

Evidence in the United States, Canada, and Western Europe suggests that the rate, but not the amount, of Alzheimer’s specific risk for age has decreased. But there are many baby boomers who age, so the number of people with Alzheimer’s will grow, Anderson said.

The silver lining, he noted, is that boomers are more educated than previous generations and probably had better medical care to control things like diabetes and blood pressure. On the downside, the number of obese people is increasing – bad news because that increases Alzheimer’s risk.

While drug development has been painfully slow (the newest Alzheimer’s drug was approved more than a decade ago, and none prevents or cures Alzheimer’s), studies are destroying the mystery of the disease.

The institute is funding more than 230 active clinical trials on Alzheimer’s and dementia, and 100 are non-drug interventions. They join studies conducted in China on aerobics and balance training, Washington state and Cache county, Utah, among others, showing that exercise protects the brain.

Non-pharmacological randomized trials are underway, said Kristina McLinden, director of the National Institute on Aging program that oversees dementia clinical trials not focused on pharmaceutical treatments.

A study looks at the effects of aerobic exercise on increased impairment in those with mild cognitive impairment. The trial partners with the YMCA at multiple sites where people are assigned to different exercise classes to see the impact. If an exercise program works, it could quickly expand to other YMCAs across the country, she said.

Some trials look at exercise alone or in combination with medications. Social interaction and nutrition are being studied.

Building on a famous Finnish study that showed that exercise and diet improve mental processing speed and cognition, a US version funded primarily by the Alzheimer’s Association with ancillary funds from the institute will soon enroll participants to try to locate it. in United States.

Another institute study examines neuroimaging to see how exercise changes the brain.

The goal of the long list of studies is, as McLinden says, “to figure out what really has the effect.”

So why is 150 minutes of exercise a week often suggested as a fitness goal?

The number suggests suggestions for exercising 30 minutes a day, five days a week, although that’s not set in stone.

“I think a lot of that comes from cardiovascular research where we know a lot more and have handled large-scale randomized clinical trials,” said McLinden. “I think, in general, we know that what is good for the heart is good for the brain. So that really informs the choice to go after these goals. “

When the trials are over, McLinden hopes that science can tell what the drugs bring, what exercise contributes, and whether they work together.

Foster cautions that COVID-19 has complicated exercise for some and many older people suffering from isolation, which will not help their cognition.

“The damage when you don’t stay physically active and socially engaged is much more than I thought. And it has to do with many things that many of us can relate to, even without Alzheimer’s disease or without being 85 years or older, “she said.

People like Wollin are eagerly awaiting the study’s findings. But they don’t expect to take steps to protect their own brain health, but instead incorporate into their behaviors what science suggests might help.

Then he walks. And walks. And bicycles.