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“[Amazingly] physical activity cut in half the odds of developing…cognitive impairment.” Thorleif Etgen, MD, assistant professor of psychiatry and psychotherapy, Munich, Germany

“There’s a lot of emerging evidence that shows that resistance training not only has similar benefits as aerobic training, but it also has very specific benefits.” Teresa Liu-Ambrose, PhD. PT, assistant professor, department of physical therapy, University of British Columbia, Canada  

Aerobics Combats Mental Decline—Once-weekly Lifting Improves Cognitive Skills

Most of the research on exercise and cognitive function has involved aerobic exercise, but the effects of strength training are now being explored. Experts believe the greatest benefits may occur when aerobic exercise is paired with resistance training. (For background information, see http://www.cbass.com/TrainBrain.htm and http://www.cbass.com/RebootBrain.htm )

Two new studies, taken together, show that strength and endurance training have complementary cognitive benefits. A balanced approach seems likely to provide the greatest brain boost.

A community observation study from Germany found that moderate or high physical activity is associated with a lower risk of cognitive impairment. 

A second study, from Canada, showed that infrequent progressive-resistance training improved the cognitive skills of selective attention and conflict resolution in senior women.

Both studies were published in the January 25, 2010, issue of the Archives of Internal Medicine.

Aerobic Training Combats Impairment

The first study, led by Thorleif Etgen, MD, Department of Psychiatry and Psychotherapy at a university in Munich, Germany, examined data collected on 3903 people over 55 enrolled between 2001 and 2003 and followed up every 3 months for two years. All patients had completed a 6-item cognitive impairment test and a questionnaire that divided them by activity level: none (584), moderate (1523), and high (1796).

Moderate activity was defined as strenuous activities (including walking, hiking, biking, and swimming) fewer than 3 days a week. High activity was defined as 3 or more days a week 

At the time of enrollment, 418 participants (10.7%) had cognitive impairment. Of these, 21.4% were in the no activity group, compared to 10.5% and 7.3% in the moderate and high activity groups, respectively.

At the end of 2 years, the researchers found that 207 additional people (5.9%) had developed impairment. The new impairment group included 13.9% with no physical activity, but only 6.7% and 5.1% with moderate and high activity.

Dr. Etgen said he was amazed by the magnitude of the findings. “Physical activity cut in half the odds of developing incident cognitive impairment. We were also surprised that moderate physical activity had nearly the same effect as high physical activity.” 

“The take-home message is: keep on moving,” said Etgen.

Positive results like these for aerobic activity prompted researchers from Vancouver General Hospital and the Department of Physical Therapy at the University of British Columbia to examine the cognitive benefits of resistance training. In introducing the study they noted that an earlier analysis had found that “the greatest benefit of aerobic exercise on cognition occurred when it was paired with resistance training.” They sought to explore the “spectrum of cognitive functions” improved as a result of once or twice weekly resistance training.   

Lifting Improves Mental Skills

“To our knowledge, no study to date has examined the minimum frequency of resistance training required for cognitive benefits,” wrote lead researcher Teresa Liu-Ambrose, PhD, PT, and her colleagues.

“We know that [resistance training] benefits bone health, prevents muscle loss, and helps strengthen mass,” Liu-Ambrose added. “However, most studies looking at the benefit of exercise for cognition have focused on aerobic training.”

Her team enrolled 155 community-dwelling women (age 65 to 75) and randomly assigned them to once-weekly (54) or twice-weekly (52) resistance training classes, or a control group ( 54) doing twice-weekly balance and toning classes. The classes were for 12 months.

Importantly, the resistance training protocol was high intensity, a departure from the high volume protocol seen in most studies. All major body parts were covered, from the large muscles of the lower body to the smaller muscles of the upper body. Two sets of 6 to 8 reps were performed for each exercise. Resistance was increased when 2 sets of 6 to 8 reps were completed with "proper form and without discomfort." The number of sets completed and the load lifted for each exercise were recorded for each participant at every class.

The balance and toning classes consisted of stretching, range of motion exercises, exercises to strengthen the pelvic floor muscles, balance exercises, and relaxation techniques. Other than bodyweight, no additional loading was applied.

All participants took an executive function test of selective attention and conflict resolution, and a task performance test. Gait speed was also measured.

Both resistance training groups significantly improved their performance on the executive function test compared to the balance and toning group. Task performance improved by 12.6% and 10.9% in the once-weekly and twice-weekly resistance training groups, respectively; the skill deteriorated by 0.5% in the balance and toning group.

“To our knowledge, this is the first study to demonstrate that engaging in progressive resistance training as infrequently as once a week can significantly benefit executive cognitive function in…senior women,” Liu-Ambrose and her colleagues wrote.

“Most notably, our results suggest that the effects of resistance training on executive cognitive functions appear to be selective: that is, resistance training enhanced selective attention and conflict resolution in older women, but cognitive abilities associated with manipulating verbal information in working memory and shifting between task sets or instructions were not improved,” they added. 

Finally, enhanced selective attention and conflict resolution was significantly associated with increased gait speed. “This finding was quite clinically relevant because walking speed is a big indicator of a person’s general well-being and also a predictor of mortality,” Liu-Ambrose explained. 

Liu-Ambrose says resistance training should be more widely promoted. “Exercise is currently promoted clinically but I think it’s typically more, ‘Take more walks.’ But there’s a lot of emerging evidence that shows that resistance training not only has similar benefits as aerobic training, but it also has very specific benefits.”

In an editorial comment, Marco Pahor, MD, professor, Department of Aging  and Geriatrics, University of Florida, wrote: “Both studies [German and Canadian] provide very promising evidence that physical activity in any form can improve cognitive function…Both studies are extremely compelling and set the stage for larger multicenter trials to come.”

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Diet, aerobics, and weights, that’s the formula for leanness and total fitness. We’ve been saying that for three decades. I believe we can safely add that "total fitness" includes the brain.

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