# Exercise as it relates to Disease/Effect of Physical Activity on Cognitive Function in Older Adults at Risk for Alzheimer Disease
## What is the background to this research?

Alzheimers disease is the most common form of dementia it initially causes short term memory loss, confusion, indecision and gradually, recall memory. medical treatment has proved to make no change while exercise has linked with the slowing of this cognitive decline. As the worlds population ages, the prevalence of elderly adults with Alzheimer disease (AD) is going to increase dramatically "from the current 26.6 million to 106.2 million by 2050" if the onset could be delayed by a minimum of 12 months there would be a dramatic decline in future AD cases. Thus the need for identification of AD in the elderly population and strategies to delay the onset of AD are the intended targets if this study. Previous observational study's have shown that the implement of physical activity in comparison to sedentary individuals seem less inclined to experience cognitive decline later in life. This study implements physical activity in both educational and practical manner's over a 24-week period between 2004-2007.

## Where is the research from?

This research into the effects of physical activity on cognitive function in older adults was conducted in Perth, Western Australia funded by the National Health and Medical Re- search Council of Australia. Published by the American Medical Association in 2008. The author's Nicola T. Lautenschlager MD, Kay L. Cox, PhD, Leon Flicker, MBBS, PhD, Jonathan K. Foster, DPhil, Frank M. van Bockxmeer, PhD, Jianguo Xiao, MD, PhD, Kathryn R. Greenop, PhD, OAsvaldo P. Almeida, MD, PhD all collaborated to provide a cohesive study on the positive effect of exercise and its ability to delay cognitive imparement in older adults.

## What kind of research was this?

This study was a randomised trial, the volunteered participants were chosen after a pre screening tests of; cognitive function, Geriatric Depression scale test, Weekly alcohol consumption and Any risk factors that rendered them unable to participate in physical activity were all tested. The volunteers that did not reach the intended benchmark for these pre screening tests were not selected to take part in this test. Within this research there was two groups, a control and an experimental group.

## What did the research involve?

The research involved three hundred and eleven (311) individuals in which were screened for eligibility for the tests. from this initial 311 a further 141 individuals were excluded as they did not reach the requirements of the pre-screening tests. leaving 170 participants in which were split into two groups consisting of 85 individuals each for the respective control and exercise group.
| Control group | Exercise Group |
| initial pre screening as well as information on healthy lifestyles with no mention of physical activity | Initial pre screening tests with an assessment of physical activity with information about recommended steps per day |
| 6 telephone calls to record social cognitive theory within the 24 week intervention | Received newsletters in weeks 2, 8, 14, 20, 32, 40, 65 and 72 to reinforce the key messages of the program |
| Follow up visits at 6, 12 and 18 months after baseline | Recorded a simplified diary on physical activity that was submitted monthly. |
| | 6 telephone calls to record social cognitive theory within the 24 week intervention |
| | Follow up visits at 6, 12 and 18 months after baseline |

## What were the basic results?

the study showed after the 18-month period of testing that in comparison to the control group the exercise group had seen significant changes in:
* A less delayed Recall in the areas of words digits and general memory testing
* ADAS Cog scores were significantly better
* A lower clinical dementia rating
* Better overall physical activity levels

## How did the researchers interpret the results?

A vast majority of results were interpreted via the change in Alzheimer Disease Assessment Scale– Cognitive Subscale (ADAS-Cog) scores. Data from these tests were then compared between the two groups and the averages were then calculated with the final ADAS score coming form this calculation after the 24 week period of the study.

## What conclusions should be taken away from this research?

In main the conclusions that should be taken away are:
* There is no clinical cure for cognitive diseases such as AD and the onset of dementia yet physical activity has proven beneficial in slowing/delaying this process.
* A cognitive improvement was seen from the exercise group over an 18-month follow up period.
* this cognitive improvement lasted a minimum 12 months after the intervention had ceased.
* This study shows from a minimum of 142 minutes of additional exercise of low- moderate intensity showed a large improvement with subjective and objective memory impairment.

## What are the implications of this research?

This research shows the importance of how such a little addition of 142 minutes of exercise per week can positively affect and delay the onset of cognitive decline in individuals over the age of 50. Furthermore, it is recommended that proper pre- screening is done to ensure in e individual is able to participate in exercise. "An important merit of this trial was to demonstrate the benefit of a simple intervention that is almost universally available".

## References

* ↑ N.Lautenschlager, MD et,al. 'EOPAOCFIOAARFAD' 2008—Vol 300, No. 9 (1027)
* ↑ N.Lautenschlager, MD et,al. 'EOPAOCFIOAARFAD' 2008—Vol 300, No. 9
* ↑ N.Lautenschlager, MD et,al. 'EOPAOCFIOAARFAD' 2008—Vol 300, No. 9 (1036)
* ↑ http://jama.jamanetwork.com/article.aspx?articleid=182502