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Exercise Your Body and Mind: Can We Avoid a Looming Health Crisis?

While cardio respiratory fitness has not yet been proven to have a direct effect on halting the symptoms of Alzheimer's disease, if a causal connection is found it would have a huge impact on our aging population, as well as the health of our economy.
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We have heard that playing Scrabble and doing crossword puzzles may help keep our minds sharp as we age. Now, new research suggests that if we can find a way to play these games while walking on a treadmill, we may stay sharper even longer.

We are all eager to hear some good news when it comes to Alzheimer's research. Despite a great deal of public and private funds devoted to finding a cause and cure (NIH estimated $527 million was spent last year, $2 billion over the past four years) little research has resulted in significant findings that will decrease the vast numbers of people who will likely suffer the disease. Thus far, studies have primarily targeted early diagnosis and potential medications to treat Alzheimer's symptoms. But none of the drugs commonly prescribed today ( Aricept, Namenda, Exelon, Razadyne or Cognex) have been found to stop the progression of this debilitating illness.

Which is why one recent study out of the University of Texas has scientists enthusiastic. The results showed that individuals who engaged in higher levels of exercise at midlife were less likely to develop Alzheimer's than those who exercised at a lower level. While cardio respiratory fitness has not yet been proven to have a direct effect on halting the symptoms of Alzheimer's, if a causal connection is found it would have a huge impact on our aging population, as well as the health of our economy.

We know that Alzheimer's is likely caused by the accumulation of plaque that slowly disrupts the signaling between neurons in the brain, and that the risks for the disease increases with age. But very little else is known about its origins and course, nor how to slow down the damage it creates to memory and cognition. The disease progresses until people are often left unable to care for themselves. Most dementia cases are believed to be a consequence of Alzheimer's, according to the Alzheimer's Association.

The number of people who will suffer Alzheimer's disease is projected to triple by 2050 -- rising from 5 million to 13.8 million in the United States alone. According to the L.A. Times, 3.3 percent of 65- to 74-year-olds, 18.5 percent of 74- to 84-year-olds and 36.6 percent of those 85 and older are likely to suffer Alzheimer's by the midpoint of the century. These new estimates, published in the journal Neurology, make clear the need for new and better treatments for a disease that will affect 38 million people worldwide.

As the number of patients rise, so will the costs of caring for them. Medical care in this country is expected to top $1 trillion a year for Alzheimer's patients. These recent projections were based on a study of senior citizens evaluated for Alzheimer's between 1997 and 2011 by the Rush Institute for Healthy Aging in Chicago. Participants were 65 years or older, from a variety of ethnic, socioeconomic and education backgrounds. The study combined data from U.S. death rates, education and current and future population estimates from the U.S. census.

The study examining the connection between exercise and Alzheimer's out of Texas was conducted between 1971 and 2009 at an out-patient clinic. Reported in the Annals of Internal Medicine, it examined 19,458 middle-aged individuals who were given a treadmill exercise test as part of their annual preventive doctor visit. The results from these tests were compared to available Medicare data on the individuals' health claims to determine whether or not they developed dementia.

Findings showed that of the middle-aged people tested, 1,659 suffered dementia and Alzheimer's later in life. Those who performed better on the treadmill test were 40 percent less likely to develop the disease. Over the past decade, other small, short-term studies have reported a similar relationship between physical activity and brain health, but the National Institute of Health suggested that these previous studies had not provided enough evidence to promote lifestyle changes in order to improve brain health.

Laura F. DeFina, M.D., the lead author of the study out of Texas, said her findings overcame some of the problems found in other research studies by using "a large homogeneous patient population, an objective measure of fitness, and a long follow-up. We therefore believe our data give a strong message to improve fitness, which we think may be more powerful than some previous attempts at changing behavior."

"Exactly how exercise may preserve brain function is not fully understood," says Dr. DeFina, "but we know that anything we can do to keep our heart healthy is critical to keeping our brain healthy." She wrote: "Future studies should address the dose-response relationship with physical activity needed to modify fitness levels to inform public health recommendations for dementia prevention."

For now, we know that fitness does reduce the likelihood of diabetes and hypertension, two risk factors that have been identified as contributing to dementia. MedPage Today reports: "Fitness has also been linked to greater brain volume, and some evidence points to connections between physical activity and neural plasticity, neurotrophic factors, and beta-amyloid protein deposits."

Dr. DeFina added, "In addition, studies on the effect of midlife physical activity and fitness levels on brain structure and function may further elucidate the mechanism(s) of the protective effect of fitness levels."

Dr. Richard Isaacson, director of the Alzheimer's division at the University of Miami Miller School of Medicine, said:

"Based on most recent data, we know that the brain changes that lead to dementia occur 20 to 30 years before the onset of symptoms, so that is the time to make lifestyle changes. If you are worried about developing Alzheimer's or dementia, the time to make healthy lifestyle choices and changes is now."

To create a plan to deal with dementia patients in the future, the Obama administration started the National Alzheimer's Project in 2011. It's mission was to bring together public, private and nonprofit organizations to fund research aimed at understanding the disease and potentially finding solutions. More recently, the We Can't Wait initiative was announced, calling for the National Institute of Health to allocate an extra $50 million to Alzheimer's research this year -- an expenditure that Obama says will not necessarily require approval by Congress. According to the White House, it reflects this administration's ongoing commitment to fighting this disease.

No one knows for certain what people should do to prevent or delay Alzheimer's and dementia, but it's very likely there is a link between lifestyle habits and a lowered risk of these diseases. We may not know exactly how physical fitness protects the brain, nor how much exercise is enough to have any impact at all, but the "move it or lose it" message seems to be gaining scientific support as more research is done.

Meanwhile, it can't hurt to get out those Scrabble games and get on a treadmill while we still can. We owe it to ourselves -- and to our country -- to at least try to avoid the looming crises created by brain diseases that may debilitate so many of us.

What do you think can be done to help avoid the health crisis created by the increasing number of people who will suffer Alzheimer's and dementia?

Vivian Diller, Ph.D. is a psychologist in private practice in New York City. She serves as a media expert on various psychological topics and as a consultant to companies promoting health, beauty and cosmetic products. Her book, "Face It: What Women Really Feel As Their Looks Change" (2010), edited by Michele Willens, is a psychological guide to help women deal with the emotions brought on by their changing appearances.

For more information, please visit my website at; and continue the conversation on Twitter @ DrVDiller.

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