Exercise to battle cognitive decline
Marcus Dobson first recognized the cognitive decline brought on by Parkinson's disease when he realized he no longer wanted to play with his grandchildren or even be in the same room with them.
Bunny Fontrier wasn't having any cognition problems, but after caring for her mother with dementia she thought she should look at herself, too.
Dobson, 60, and Fontrier, 63, are currently participating in a cognition-related exercise study at Wake Forest Baptist Medical Center in Winston-Salem, NC.
"I thought I'd find out how my mind is, and if my memory and thinking skills are going to be improved by this," Fontrier said.
The study got under way in March and will continue through late 2014. It is designed to show whether high- or low-intensity exercising, or both, can help people with early cognition problems.
"There are no FDA-approved medications for mild cognitive impairment," said Valerie Wilson, M.D., geriatrics clinic director at Wake Forest Baptist's Sticht Center on Aging. "We encourage people to stay physically and mentally active. It's one of those things that just makes sense."
"What used to be referred to as senility or just 'old age' is now much more understood, recognized and talked about," said Richard Gottlieb, president and CEO of Senior Services Inc., a nonprofit agency that conducts a variety of programs for older adults in the Winston-Salem area. "I think early intervention is a plus, but there is still a lot of anxiety and fear about dementia. And it's critical that we find some answers in terms of prevention and cures."
The brain, just like other parts of the body, changes as it ages. That process can affect the functioning of neurons, the cells in the brain responsible for the way people think.
"It's a complicated metabolic pathway we still do not yet fully understand," Wilson said.
Although the percentages have held steady, the number of dementia cases is up because of the rising number of elderly in the United States. It's estimated that 5 percent of the population will have dementia by age 65. By age 80, the figure jumps to 30 percent.
Memory declines with aging, even in healthy people, for a variety of reasons. Dementia is a general term for a significant decline in cognitive function that interferes with daily life. Alzheimer's disease is the most common form of dementia, accounting for 60 to 80 percent of dementia cases, according to the Alzheimer's Association.
One of the toughest things for individuals and family members is to recognize the first signs of a cognitive problem.
Kathy Long, director of Senior Services' Elizabeth and Tab Williams Day Center in Winston-Salem, said it is important to understand that "confusion is never normal."
People who are older shouldn't fear disclosing a problem because confusion does not necessarily mean dementia, Long said. Urinary tract infection, pneumonia and reaction to medication are just three common issues that can cause cognitive problems, and they can be easily treated.
For more than a decade, Laura Baker, a cognitive neuroscientist and associate professor of geriatrics and gerontology at Wake Forest Baptist, has been studying the benefits of aerobic exercise in slowing cognitive decline and Alzheimer's disease.
Next year, Baker will work with the Alzheimer's Disease Cooperative Study consortium at the University of California, San Diego, in a $5.5 million effort funded by the National Institute on Aging. She also directs other exercise and memory studies at Wake Forest Baptist, such as the program in which Fontrier and Dobson are participating.
One goal behind the various studies is to show that exercise helps. Another, Baker said, is to have exercise become a Medicare-approved treatment in the battle against Alzheimer's and cognitive decline.
For people in the national exercise study, Baker said, "We hope to change their sedentary ways within 12 months. We're going to give them the needed tools and confidence to exercise on their own. One day, adults with mild cognitive impairment who are at high risk for dementia may be able to get a prescription for a specific exercise program at their local YMCA."
Baker is one of many scientists nationwide working to prove the benefits of aerobic exercise for cognition and brain health. For example, a recent observational study published online by the Cooper Institute in Dallas showed that higher levels of cardiorespiratory fitness during middle age made people less likely to develop dementia in their senior years.
At Wake Forest Baptist, each exercise study participant is given about 90 minutes of memory and thinking tests upon signing up. The tests provide a snapshot of the participant's "baseline" cognitive abilities. At the end of each individual's participation, the tests are administered again to provide a comparison.
Just weeks into their exercise programs, Fontrier and Dobson already like where they stand.
Fontrier said she has been able to do better at her job, which involves reviewing numbers, since beginning her exercise program.
Dobson, a gemologist and jewelry appraiser, said that exercising has helped him recapture the desire to play with his grandchildren and helped him to maintain focus.
"I can look you in the eye and have a valid conversation," he said. "That was something that my fellow employees said they hadn't seen in a long time."
By Les Gura
Wake Forest Baptist HealthWire