Dementia: exercise slows cognitive decline, but is unable to delay need for nursing-home placement

Exercise can halt the progress of dementia to some extent: in the early stages of the disease physical activity promotes cognitive and functional ability as well as sense of wellbeing among sufferers. However, experts at the Congress of the European Academy of Neurology confirmed that exercise is ultimately unable to reduce the risk of early nursing home placement or premature mortality.

Berlin, 23 June 2015 – Exercise appears to be a major factor in slowing cognitive and functional decline in dementia patients. Physical activity is also known to help improve patient wellbeing, as shown in a series of current studies presented at the 1st Congress of the European Academy of Neurology (EAN) in Berlin. More than 6,500 experts from around the world are discussing the newest developments in their field in the German capital city from 20 to 23 June.

“Physical exercise can be an effective treatment option for people suffering from mild to moderate dementia and who are already on medication,” explained Dr Ana Capisizu of the University of Bucharest. “Regular physical activity helps to improve patients’ cognitive and functional performance. It also has a favourable bearing on mental wellbeing and can reduce depression.” The expert’s claims are underlined by the results of a recent study by her team which monitored 40 patients. In the study, a group of subjects suffering from mild to moderate dementia participated in various tests at regular intervals. Some of the group took part in an exercise programme. After 12 weeks, the physically active patients performed significantly better in tests designed to monitor problem-solving, quality of life and functional ability.

Physically active patients performed better in four out of five tests

A recent Danish study delivered similar results: more than 300 people suffering from early-stage Alzheimer’s dementia underwent a series of tests at the start of the study, which were repeated a year later. The study showed that the patients who engaged in physical activity for more than four hours a week performed significantly better in four out of five tests. Study author Dr Kristian Steen Frederiksen of the Danish Dementia Research Centre, Rigshospitalet, Copenhagen confirmed: “There is a clear association between exercise and quality of life. Physically active patients were also less likely to suffer from neuropsychiatric symptoms which may include apathy and anxiety, which frequently manifest themselves in people suffering from Alzheimer’s dementia. They also better performed better in activities of daily living (ADL).”

No increase in life expectancy

Although exercise had a positive effect on symptoms in the early stage of the disease, a follow-up over three years involving the same group showed that physical activity had no influence on two major points, as Dr Frederiksen reported: “Patients with Alzheimer’s disease require nursing-home care placement and institutionalised care at an earlier stage than non-dementia sufferers of the same age. Although we did find a small difference with regard to nursing-home placement, our data does not confirm that physical activity influence these developments. Physically active Alzheimer patients require nursing-home placement at the same stage as inactive sufferers and there is no indication that exercise extends life expectancy.”

Source: EAN Abstracts Frederiksen et al, Physical activity as a predictor of clinical course in mild AD: the Danish Alzheimer´s Intervention Study; Frederiksen et al, Impact of physical activity on nursing home placement and mortality in mild Alzheimer´s Disease: the Danish Alzheimer´s disease Intervention StudY (DAISY); Capisizu et al, Effectiveness of Physical Exercise Training in Elderly with Mild to Moderate Dementia.

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