# Exercise as it relates to Disease/Aerobic exercise for treating Alzheimers disease
## What is the background to this research?

Using exercise to treat symptoms of Alzheimer’s Disease. This research was brought about because aerobic exercise has been related to increased brain volume, less brain atrophy, slower dementia progression and lower risk of dementia. With other factors such as cardiovascular fitness levels also have been thought to impact brain health along with its functions, such as memory and behavioral cognitive processes in a positive way. With other studies showing that aerobic exercise can improve the cognitive function of individuals with a mild cognitive impairment(MCI)

## Where is the research from?

University of Kansas: Alzheimer’s Disease Center

## What kind of research was this?

A randomized controlled pilot trial. The participants were volunteers and were screened. The inclusion criteria included cognitive impairments such as a mild cognitive impairment and Alzheimer's disease, mild dementia, at least 55 years old with a sedentary or underactive lifestyle. The exclusion criteria included any significant psychiatric disorder, any illness or infection that was likely to affect the safety of the participant, medical history of stroke, myocardial infarction or coronary heart disease within the last 2 years, substance abuse, Type 1 diabetes or musculo-skeletal problems causing pain that would prevent aerobic exercise.

## What did the research involve?

A 26-week trial that had to the goal of comparing 150 minutes a week of aerobic exercise with non-aerobic stretching activities. 68 participants finished the study. Each participant had their exercise monitored by an exercise specialist. 3 periods of testing were implemented at the time periods of 0 weeks, 13 weeks and 26 weeks. Neuropsychological tests were performed at these times. The tests aimed to assess the participants' memory, executive composite scores, dementia, and depression symptoms. Other tests were conducted at baseline and 26 weeks. These tests were a cardiorespiratory test and a brain MRI scan. The participants' memory was tested using a variety of tests. The testing was looking for changes in Logical memory, name memory, and verbal memory. The specific tests used for were: Wechsler Memory Scale-Revised( WMS-R) subtests Logical Memory 1a and 2a, Digit Span forward and backward and the Boston Naming test. The Boston naming test was later removed Executive function was tested using the Category fluency, D-KEFS confirmed correct and free card sorting, letter-number sequencing and Stroop color-word interference. Executive function refers to the cognitive processes that are needed for controlling behavior. Depression was tested against the Cornell Scale of Depression, assessed by the caregiver. The test parameters were obtained through this article. Peak Vo2 was measured as part of the Cardiorespiratory test and a DEXA scan was performed on the participant for body composition for use in determining VO2 against muscle mass. The MRI scan was analyzed for the volume of the hippocampus and total grey matter volume, to measure and gauge brain health. The secondary goal of this research was also to test the effects of aerobic exercise on depression and generate data for use in future trials.

## What were the basic results?

The results showed that moderate aerobic exercise at 150mins a week can have a positive impact in reducing memory related and executive function suppression symptoms of the early stages of Alzheimer's disease. It also showed that aerobic exercise can improve memory retention.

## What conclusions can we take from this research?

That aerobic exercise can positively benefit and counter some of the symptoms of the early stages of Alzheimer’s disease. Aerobic Exercise could help in maintaining healthy brain function in a normal person and possibly improve memory. Cardiovascular fitness levels(Peak VO2) may have an effect on memory in normal people.

## Practical advice

In the early stages of Alzheimer’s disease, 150 mins of moderate aerobic exercise can help symptoms. This exercise should be done under the guidance and supervision of a trained exercise professional

## Further information/resources

Main Article can be found here
The outline of the testing parameters can be found here

## References

Morris, J. and Vidoni, E. (2017). Aerobic exercise for Alzheimer's disease: A randomized controlled pilot trial. [online] [Accessed 19 Sep. 2018].
Practitioners, T. (2018). RACGP -. [online] Racgp.org.au. [Accessed 19 Sep. 2018].
Shirk, S., Mitchell, M., Shaughnessy, L., Sherman, J., Locascio, J., Weintraub, S. and Atri, A. (2011). A web-based normative calculator for the uniform data set (UDS) neuropsychological test battery. Alzheimer's Research & Therapy, 3(6), p.32.
Baker, L., Frank, L., Foster-Schubert, K., Green, P., Wilkinson, C., McTiernan, A., Plymate, S., Fishel, M., Watson, G., Cholerton, B., Duncan, G., Mehta, P. and Craft, S. (2010). Effects of Aerobic Exercise on Mild Cognitive Impairment. Archives of Neurology, 67(1).