Exercise for Your Brain

It could delay the onset of Alzheimer’s disease

We know that exercise has all kinds of benefits, from improving your mood to helping your heart and managing your weight. If you’re at risk for Alzheimer’s, you have another excellent reason for keeping up with your exercise routine. It could save you from ever developing the disease.

That’s a tall order, but “there’s a lot of data suggesting that exercise has a positive effect on brain function,” says Stephen Rao, PhD. Furthermore, he says, exercise activates the areas of the brain affected by Alzheimer’s to a greater extent in individuals at risk for the disease.

Dr. Rao is in the midst of a clinical trial that is zeroing in on that very population. He and his team of researchers are using functional magnetic resonance imaging (fMRI) to study brain activation patterns of individuals who have risk factors but no symptoms of dementia. The point is to determine, over time, whether certain lifestyle interventions – exercise, in particular – actually can delay the onset of cognitive decline.

This is important because age is one of the risk factors for the most common form of Alzheimer’s, which is the focus of Dr. Rao’s clinical trial. “After the age of 60, the incidence of the disease doubles every five years,” he says. “Delaying the onset of symptoms by five years would cut the disease in half. A delay of 10 years would cut it down by more than 85 percent.”

Think what that could mean in terms of an individual’s quality of life and for healthcare in general. “At present, 5 million people in the United States have Alzheimer’s. We expect to see a doubling in 2030 and a tripling by 2050,” says Dr. Rao, who holds the Ralph and Luci Schey Chair in Cognitive Function and is Director of the Ralph and Luci Schey Foundation Center for Advanced Cognitive Function at Cleveland Clinic's Neurological Institute. “This disease alone would be responsible for bankrupting our medical system if we don’t do something about it.”

There is no cure for Alzheimer’s and, although some drugs are effective in managing symptoms, no drugs exist that can alter the course of the disease, Dr. Rao says. “What I’m most excited about in this trial is that we’re recruiting people before they become symptomatic,” he says. “The key is to identify interventions that actually will make a difference in delaying cognitive decline.”

Participants must be 60 to 85 years old, have a family history of Alzheimer’s, undergo genetic testing, and be willing to take part in exercise or cognitive training as well as have fMRI scans. The imaging, which has no known health risks, gives researchers a baseline reading and shows them short-term changes in brain activity, which is an important indicator, Dr. Rao says. “People at risk who have greater brain activity at baseline are less likely to show a decline in cognitive performance over time,” he explains.

The study, called “Neural Effects of Exercise, Cognitive or Combined Training in Alzheimer’s Disease (AD) at-Risk Elders,” is funded by the National Institutes of Health. With additional support, however, “we could expand the size and scope of the projects,” examining, for instance, the impact that diet has on brain pattern activity, he says.

“I think that these lifestyle interventions can make a difference.”

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