# Exercise as it relates to Disease/The Effects of Resistance Training on Cognitive Decline in Seniors with Mild Cognitive Impairment

Cognitive decline is a pressing health care issue. Worldwide, 1 new case of dementia is detected every 7 seconds.
Dementia:
Dementia is a descriptive term derived from the Latin root de mens, indicating an observable decline in mental abilities. It is an acquired clinical syndrome characterised by deterioration of mental functioning in its cognitive, emotional and conative aspects
Mild Cognitive Impairment:
Mild cognitive impairment (MCI) describes a state of cognitive functioning that is below defined norms, yet falls short of dementia in severity.
Mild cognitive impairment is a well-recognized risk factor for dementia and represents a critical window of opportunity for intervening and altering the trajectory of cognitive decline in seniors.
Rehabilitation Methods
Cognative Rehabilitation: Cognative rehabilitation aims to intervene during early stages of dementia to maintain memory and higher cognitive function. This is also an effective way to devise strategies to compensate for declining function. A 2012 systematic review concluded that studies to date provide evidence that cognitive stimulation programs benefit cognition, however studies were of variable quality and further research is needed.
Exercise Programs: Several studies have demonstrated that formal exercise programs may improve physical functioning or at least slow the progression of functional decline for adults with Alzheimer disease; however, the literature reported that exercise programs do not appear to improve cognitive functioning in adults with dementia.
Occupational Therapy: Motor skills and activities of daily living can be significantly improved through individualized therapy sessions. This is also cost-effective and has advantages in having none of the side effects that drug treatments present.
Risk Factor Control: Identification and treatment of risk factors may represent an important strategy for decreasing the incidence of dementia and for slowing the progression of cognitive decline.

## Where Is The Research From?

This study was conducted via the Department of Physical Therapy, University of British Columbia, Vancouver, Canada

## What Type Of Research Was This?

This study was conducted using a proof-of-concept, single-blinded, randomized controlled trial designed to provide preliminary evidence of efficacy of both resistance training and aerobic training to improve executive cognitive functions.

## What Did The Research Involve?

The Exercise for Cognition and Everyday Living study was a 6-month randomized trial. Women (n=86) 70–80 years old were randomly allocated to twice-weekly resistance training (n=28), twice-weekly aerobic training (n=30), or twice-weekly balance and tone training (n=28) which was the control group.
Tests were carried out to identify resolution, cognitive functions, and working memory. Broader effects of exercise training on cognitive function were examined by assessing associative memory. Regional patterns of functional brain plasticity were assessed along with general balance and mobility and general cardiavascular capacity.
All resistance training exercise classes were led by certified fitness instructors. The aerobic training program consisted of outdoor walking at 40-80% of heart rate reserve. The balance and tone training consistend of stretching, range of motion, and balance exercises.

## What Were The Basic Results?

The results showed that around 90% of the participants completed the 26-week trial.
Resistance Training Results:
* Significantly improved performance on resolution and cognitive functions (P=.04)
* Significantly improved performance on the associative memory task (P=.03)
* Led to functional changes in 3 regions of the cortex:
** Right lingual (P=.03)
** Occipital-fusiform (P=.02)
** Gyri and the right frontal pole (P=.03)
* Significant positive correlation between change in hemodynamic activity in the right lingual gyrus and change in behavioral associative memory performance (r=0.51; P=.02)
Aerobic Training Results:
* Significantly improved general balance and mobility (P=.03)
* Significantly improved cardiovascular capacity (P=.04)

## What Conclusions Can We Take From This Research?

In senior women with subjective memory complaints, resistance training improved selective attention/conflict resolution, associative memory, and regional patterns of functional brain plasticity. In contrast, aerobic training improved physical function. Indicating resistance training can benefit multiple domains in those at risk for dementia.
Resistance training also significantly improved associative memory performance, co-occurring with positive functional changes in hemodynamic activity in regions involved in the memorization of associations. Impaired associative memory is a hallmark of early stages of Alzheimer disease.
To conclude, this study suggests that twice-weekly resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with mild cognitive impairment. Appropriate resistance training can therefore be used as a positive preventative strategy regarding dementia.

## Practical Advice

Based on the results shown in this study, a focus on resistance training will generate the biggest benefit for preventing dementia, however there are still some positive results from aerobic training. People with Mild Cognitive Impairment, and people who want to prevent this should see an exercise professional to help them coordinate appropriate resistance and aerobic training programs to help them with this goal.

## Further Information / Resources

For further information on Mild Cognitive Impairment and the benefits of exercise follow the links bellow:
Signs and Symptoms of Mild Cognitive Impairment:
* https://www.fightdementia.org.au/about-dementia-and-memory-loss/about-dementia/memory-loss/mild-cognitive-impairment
* https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=120
Exercise for Mild Cognitive Impairment:
* http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919839/

## References

* 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Nagamatsu, Lindsay S. "Resistance Training Promotes Cognitive And Functional Brain Plasticity In Seniors With Probable Mild Cognitive Impairment". Arch Intern Med 172.8 (2012): 666. Web.
* ↑ Gustafson, L. "What Is Dementia?". Acta Neurologica Scandinavica 94 (1996): 22-24. Web.
* ↑ Feldman, Howard H. and Claudia Jacova. "Mild Cognitive Impairment". The American Journal of Geriatric Psychiatry 13.8 (2005): 645-655. Web.
* ↑ Orrell, M., B. Woods, and A. Spector. "Should We Use Individual Cognitive Stimulation Therapy To Improve Cognitive Function In People With Dementia?". BMJ 344.feb15 1 (2012): e633-e633. Web.
* ↑ Teri, Linda et al. "Exercise Plus Behavioral Management In Patients With Alzheimer Disease". JAMA 290.15 (2003): 2015. Web.
* ↑ Rolland, Yves et al. "Exercise Program For Nursing Home Residents With Alzheimer's Disease: A 1-Year Randomized, Controlled Trial". Journal of the American Geriatrics Society 55.2 (2007): 158-165. Web.
* ↑ Pitkälä, Kaisu H. et al. "Effects Of The Finnish Alzheimer Disease Exercise Trial (FINALEX)". JAMA Internal Medicine 173.10 (2013): 894. Web.
* ↑ Öhman, Hannareeta et al. "Effects Of Exercise On Cognition: The Finnish Alzheimer Disease Exercise Trial: A Randomized, Controlled Trial". Journal of the American Geriatrics Society 64.4 (2016): 731-738. Web.
* ↑ Graff, M. J L et al. "Community Based Occupational Therapy For Patients With Dementia And Their Care Givers: Randomised Controlled Trial". BMJ 333.7580 (2006): 1196-1196. Web.
* ↑ Graff, M. J L et al. "Community Occupational Therapy For Older Patients With Dementia And Their Care Givers: Cost Effectiveness Study". BMJ 336.7636 (2008): 134-138. Web.
* ↑ Snyder, Heather M. et al. "Vascular Contributions To Cognitive Impairment And Dementia Including Alzheimer's Disease". Alzheimer's & Dementia 11.6 (2015): 710-717. Web.