# Exercise as it relates to Disease/Is exercise an effective strategy to improve Alzheimer's Disease
## What is Alzheimer's Disease?

Alzheimer's Disease (AD) is known as the most common form of dementia accounting for up to 70% of dementia cases. Yet the causes are still largely unknown, although a variety of factors are possibly involved including age, genetics, other diseases, lifestyle, environment, head injuries and education.
AD leads to a progressive decline in the ability to remember, learn, think and to reason, sufferers also have difficulty using the right words, and in recognizing people, places and objects. "A person with Alzheimer's lives in a span of a few seconds. They cannot relish the past; they have nothing to look forward to; they live in a world of illogic."

## Symptoms of Alzheimer's Disease
### Early Clinical Stage

* Mild memory loss for recent events and words
* Deterioration of instrumental daily living activities eg. money management

### Middle Clinical Stage

* More memory issues
* Progression of language issues
* Gradual decline of daily living activities, need care at home

### Late Clinical Stage

* Extreme memory loss of short and long term events and inability to communicate
* Issues with basic daily living activities eg. dressing, toileting, feeding
* Deterioration in mobility

### Death

* Death from infection eg. pneumonia

## Risk Factors of Alzheimer's Disease

With the modification of AD risk factors there could be potential implication's for prevention of development to occur. Risk factors include;

### Sociodemographic Factors

* Age: risk increases with age.
* Gender: women have a higher prevalence.
* Environmental/ Lifestyle: diet, alcohol consumption, smoking, education levels and ethnic differences.

### Genetic Factors

* Family History: 3.5 times higher risk.
* Disease: mutation of ẞ-amyloid precursor protein gene.
* ApoE genotype: involved in neuronal repair.
* Down's Syndrome: most individuals with down's syndrome have the neuropathological features of AD by age 40.

## Exercise as a Treatment for Alzheimer's Disease
### Strengths

Research indicates that persons with AD were impaired on measures of physical performance and function, compared to data collected on non demented older adults.
* Medical practitioners suggest that incorporating exercise's such as balance activities, flexibility exercises, strength training and especially aerobic/endurance exercise, results in weakened cognitive impairment and delayed onset of dementia progression.
* The integration of exercise into standard care practices for individuals suffering from AD appears relevant and feasible as it assists in increasing strength, balance, flexibility and endurance which can improve the patients quality of life and mobility, as well as improve their cognitive functions.

### Weaknesses

Although the benefits of exercise for AD are known, there are also weaknesses associated with exercise and AD patients. These Include;
* Its hard for AD patients to access organised fitness programs as they cannot independently travel to fitness centers that offer various group activities.
* Many caregivers typically lack the skills to structure and supervise proper exercise sessions for their AD patients, therefore the patients either go unexercised or have to attend group fitness sessions.

## Recommendations

Literature indicates that exercise is an effective strategy to improve aspects and symptoms of AD. Research recommends that;
* Incorporation of balance, flexibility, strength and aerobic exercise into daily living is beneficial.
* Employ a carer during middle to late stages of AD, to assist with daily tasks and exercise.
* Teach carers the necessary skills to allow the exercising of patients to be effective and structured.
* If skilled carers are unavailable, seek exercise classes with a suitable facility.

## Further reading

Alzheimer's Australia: https://fightdementia.org.au/ National Dementia Helpline: 1800 100 500

## References

* 1 2 3 4 5 6 7 8 9 M Longley, M Warner - Alzheimer's Disease: Policy and Practice across Europe, 2002 - books.google.com
* 1 2 3 A FJORM - Dementia 3Ed, 2005 - books.google.com
* 1 2 3 L Teri, SM McCurry, DM Buchner, RG Logsdon… - Age, 1998 - rehab.research.va.gov
* 1 2 JE Ahlskog, YE Geda, NR Graff-Radford… - Mayo Clinic …, 2011 – Elsevier
* ↑ Y Rolland, G Abellan van Kan, B Vellas - Journal of the American Medical …, 2008 – Elsevier
* 1 2 3 4 SM Arkin, N Morrow- Howell- The Gerontologist, 1999- gerontologist.oxfordjournals.org