An extensive review of more than 100 randomized controlled trials (RCTs) strongly supports exercise interventions as a way to reduce both the risk of falls among adults 65 and older and the actual number of those who experience a fall. What’s less clear are some of the nuances of that finding—such as the effectiveness of resistance training or walking programs, and the differences between interventions provided by “health professionals” versus “trained providers who were not health professionals.”
The recently published Cochrane systematic review focused on 108 RCTs involving 23,407 community-dwelling adults in 25 countries. Participants were an average age of 76, and 77% were women. The majority of participants lived in the community, and RCTs that focused on participants with conditions that increased the risk of falls—Parkinson disease, stroke, multiple sclerosis, dementia, hip fracture, and severe visual impairment—were excluded.
The Cochrane reviewers analyzed various categories of exercise interventions versus control, which consisted of either no change in usual activities or an intervention not anticipated to reduce falls, such as health education, social visits, “gentle” exercises, or sham exercises. The exercise interventions were categorized as balance and functional; resistance; flexibility training; “3D” exercise including Tai Chi and Qigong; “3D” dance-based exercise; walking programs; endurance; “other”; and exercise interventions that included more than 1 of the studied categories.
Researchers at Dalhousie University have found that frailty, more so than amyloid plaques and tangles in the brain, is a key risk factor for developing Alzheimer’s disease and other forms of dementia.
PhD candidate Lindsay Wallace, lead author, and her supervisor Dr. Kenneth Rockwood, are optimistic their findings will be influential, as they were published this week in Lancet Neurology — one of the highest-impact journals in the field.
This study is the first to examine amyloid plaques and tangles in post-mortem brain tissues, in relation to both the subjects’ frailty index and the severity of their dementia symptoms when they were alive. The frailty index is a score of relative frailty based on the accumulation of deficits in physical health and ability to function.
People who move around more have sharper brains than couch potatoes, even well into old age and even if they already have some brain deterioration, researchers reported Wednesday.
The research helps answer a big question of whether exercise prevents dementia, or whether people with dementia-related damage to their brains move less because of that damage.
The new findings indicate that exercise and other activity helps preserve memory and brain function despite the various damage that leads to dementia, including hardened arteries and the brain-clogging plaques that are the hallmark of Alzheimer’s.
Moderate to high intensity exercise does not slow cognitive (mental) impairment in older people with dementia, according to new research.
The research team found that although exercise improved physical fitness, it cannot be recommended as a treatment option for cognitive impairment in dementia.
Nearly 47.5 million people worldwide have dementia and the view that exercise might slow cognitive decline has widespread popularity.
But recent reviews of trials of exercise training in people with dementia show conflicting results. To try and resolve the uncertainty, researchers decided to estimate the effect of a moderate to high intensity aerobic and strength exercise training program on cognitive impairment and other outcomes in people with dementia.
A simple, office-based screening tool scale can rapidly and accurately assess dementia risk in patients with Parkinson’s disease (PD), according to a 4-year, prospective, multi-center study.
The Montreal Parkinson Risk of Dementia Scale (MoPaRDS) identified elements specific to PD and demonstrated predictive validity equal to or greater than other cognitive impairment algorithms, reported Ronald Postuma, MD, MSc, of Montreal General Hospital in Canada and colleagues in JAMA Neurology.
“With this clinical prediction tool, dementia risk in Parkinson’s patients can be calculated in a single office visit without any statistical software,” the study’s first author, Benjamin Dawson of the University of Ottawa, told MedPage Today.
Scientists have more evidence that exercise improves brain health and could be a lifesaving ingredient that prevents Alzheimer’s disease.
In particular, a new study from UT Southwestern’s O’Donnell Brain Institute suggests that the lower the fitness level, the faster the deterioration of vital nerve fibers in the brain. This deterioration results in cognitive decline, including memory issues characteristic of dementia patients.
“This research supports the hypothesis that improving people’s fitness may improve their brain health and slow down the aging process,” said Dr. Kan Ding, a neurologist from the Peter O’Donnell Jr. Brain Institute who authored the study.
In nursing homes and residential facilities around the world, health care workers are increasingly asking dementia patients questions: What are your interests? How do you want to address us? What should we do to celebrate the life of a friend who has passed away?
The questions are part of an approach to care aimed at giving people with memory loss and other cognitive problems a greater sense of control and independence. At its core is the idea that an individual with dementia should be treated as a whole person and not “just” a patient.
The Patient Centered Outcomes Research Institute (PCORI) plans to invest $142.5 million to expand its clinical research network—another facet of a broad initiative that includes major grants supporting physical therapy research.
According to a PCORI news release, the money will be used to establish a second-phase expansion of the National Patient Centered Clinical Research Network(PCORnet), a project that links various health data research networks. The funding will be used in part to expand the number of PCORnet participants from 27 to 34, and will include both clinical data and patient-powered research networks.
The 34 PCORnet partner networks encompass more than 150 conditions, including Alzheimer’s disease and dementia, autism spectrum disorders, heart disease, obesity, Parkinson disease, behavioral health disparities among low-income populations, and health disparities among sexual and gender minorities, all drawn from a wide variety of population groups.
Christmas can be a stressful time for hosts and guests alike, and it’s more so for carers of people living with dementia.
It’s difficult to give general advice about how to get through the holiday season with as little fuss as possible because everyone is unique, and the various types and stages of dementia affect behaviour in different ways.
So I’m going to tell you a story of how one couple is getting through. Hopefully, their strategies will suggest things other families can do for a better Christmas.
Tom and Nola are not real people. Their portraits below are based on my experience working with people with dementia, and on conversations I’ve had with these people, their carers and service providers about how to cope at Christmas time.
Tom was diagnosed with dementia about three years ago.
“My memory is not so good now,” he says. But Nola, his wife and carer, says that he’s still sociable and enjoys food and company.
This has been a month of good news for two of my annoying habits.
The first is my penchant to watch sappy films from Indonesia. I lived in the country after college, and the films help me keep up my Indonesian language skills. A recent review of hundreds of dementia sufferers in India finds that dementia among speakers of multiple languages comes, on average, four years later than it does to people with dementia who are monolingual. Prior studies had found a similar phenomenon, but the new study shows that multilingualism likely postpones dementia regardless of a person’s class or formal education.
My next habit, forgive me, is singing along to musicals. A paper read this month at the Society for Neuroscience meeting in San Diego finds that when nursing home patients with Alzheimer’s disease sing along to The Sound of Music and The Wizard of Oz, they score better on measures of their cognitive abilities.
Monetary, emotional toll
The good news on dementia is a welcome tonic against some overwhelmingly frightening facts. Because we are adding, on average, at least two years to our lifespan every decade, we are all more prone to dementia. One’s chances of dementia double every five years after age 65; one of every two Americans older than 85 is afflicted with Alzheimer’s.