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Review:
Exercise not proven as Dementia Treatment
Newswise — Physical activity is a good thing
for nearly everybody and clearly boosts
alertness and a sense of well-being.
So can we use it as a treatment for elderly
patients with dementia?
That’s a good question, but existing
research doesn’t provide an answer,
according to a new Cochrane Library review.
“Physical activity may be beneficial for
persons with dementia. But due to the small
number of studies we have not been able to
demonstrate this,” said review lead author
Dorothy Forbes, an associate professor with
the faculty of health sciences at the
University of Western Ontario, in Canada.
On the other hand, there is no evidence that
physical activity is harmful either, she
said.
Estimates indicate that dementia — known in
the past as senility — affects about 14
percent of Americans ages 71 and older.
More than one-third of Americans over 90
likely suffer from the condition, which
causes forgetfulness, confusion and muddled
thinking. A variety of medical conditions
causes dementia, including Alzheimer’s
disease and stroke.
Physicians are unlikely to prescribe
physical activity as a treatment for
dementia patients because there is little
evidence to support its value, Forbes said.
Nevertheless, exercise is not impossible for
many dementia patients, who might be able to
walk, swim and exercise in groups with
assistance, she said.
Researchers have shown that exercise can
improve cognition and mental health in older
adults, and some studies suggest that it
could delay dementia from three to six years
or reduce the risk that patients will
develop cognitive problems, Forbes said.
“It is less clear if physical activity
manages or improves other symptoms among
persons with a diagnosis of dementia,” she
said.
In the new review, Forbes and colleagues
sought to shed some light on that issue.
The review appears in the latest issue of
The Cochrane Library, a publication of The
Cochrane Collaboration, an international
organization that evaluates medical
research. Systematic reviews draw
evidence-based conclusions about medical
practice after considering both the content
and quality of existing medical trials on a
topic.
While evidence from animal research
indicates that physical activity could be a
useful treatment for dementia, the review
authors only found four studies that
examined the effects of exercise in humans.
Two of the studies were not included in the
analysis because the reviewers could not get
details from the original study authors.
Both of the remaining studies were small and
only included Alzheimer disease patients.
One looked at just 11 patients; the other
examined 134, but many of those did not
complete their exercise regimens.
Still, the researchers in the latter study
found that those who did exercise seemed to
do better at handling the tasks of daily
living.
None of the studies looked at the effects on
caregivers or on overall health-care costs.
Why have there been so few high-quality
studies? Research into dementia is in its
early stages, and largely has focused on
diagnosis, assessment of severity and drug
treatments, Forbes said.
To make things more challenging, funding is
limited and it can be difficult to study
people who might not be able to give consent
or comply easily with the requirements of a
study.
While there is little research supporting
physical activity as a helpful treatment for
elderly people with dementia, there is no
evidence that it is harmful, Forbes said.
“Indeed, there is some suggestion that
physical activity manages or improves
function in persons with dementia,” she
said. “Further well-designed trials are
necessary to demonstrate the effects of
physical activity.”
Dr. William Thies, vice president of medical
and scientific relations for the Alzheimer’s
Association, agreed that the studies
reviewed are not conclusive.
“It’s true that the studies had a trend
toward benefits, but that’s not enough to
say that physical exercise ought to be a
necessary element of everyone’s dementia
care.”
Still, the review findings do not change the
fact that exercise remains crucial to
long-term health, he said. “The person who
has built physical activity into their
lifestyle is going to be in better health,
more functional and probably happier over
the long run,” he said.
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