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Physical Activity—All Kinds—Boosts Brain Power

Running—Weight Training—Washing Dishes

The Obama administration has adopted a national strategy to fight Alzheimer’s disease; the goal is to find effective treatments for this devastating disease by 2025. The focus is being shifted to people who don’t yet show many symptoms, before too much of the brain is destroyed. It works for heart disease, diabetes, and other diseases; with the right approach it should work for AD. A mix of treatments will be required; up to this point drugs are the main candidates. The “treatment” getting little attention is physical activity—the one modality known to boost brain power.

AD is a huge problem, currently affecting about 5 million people in the USA and expected to triple as Baby Boomers grow older. Worldwide, a new case of dementia is detected every seven seconds. The cost in suffering and health care is incalculable. A major advantage of physical activity is that the cost is low. Unlike drugs, it has no side effects and you can do it on your own. 

We have three impressive new studies dealing with physical activity and brain function, one involves mice and the other two humans. As you’ll see, the activities studied are diverse. There’s something for every age and inclination.

The Beckman Institute for Advanced Science and Technology at the University of Illinois is a leader in the study of physical activity and brain function. One of the most intriguing studies in this area was led by Justin S. Rhodes, a psychology professor at the Beckman Institute. Rhodes and his team studied mice put into four distinct living arrangements. Gretchen Reynolds reported on the findings in the April 13, 2012, New York Times Magazine.  

Unlike earlier mouse studies, the role of a running wheel was clearly delineated. Earlier enriched environments included running wheels among other playthings mice enjoy. Rhodes et al compared running to other attractions that engage the mouse mind without increasing heart rate.

One group lived in a world of gustatory delights, nuts, fruits, and cheeses occasionally dusted with cinnamon, all of it washed down with flavored waters. Their cages were special places with colored balls, plastic tunnels, nibble-able blocks, mirrors and seesaws; it was a mouse paradise. Group two had all of that, plus small running wheels. The cages of the third group were lab standard, no embellishments and regular chow. Finally, the homes of the fourth group contained running wheels, but no other toys or treats.

All mice completed a series of cognitive tests at the start of the study and were injected with a substance that allowed scientists to track changes in their brain structures. They then lived in the various environments for several months. Afterwards, the mice were again tested for cognitive function and checked for changes in brain structure.

“Only one thing had mattered,” Professor Rhodes said, “and that’s whether they had a running wheel.” Animals that didn’t run, no matter how enriched their world was otherwise, did not improve their brainpower in the complex, lasting ways the Rhodes team was studying. “They loved the toys,” Rhodes said. But unless they also exercised, they did not become smarter.

No matter how much the mice were stimulated by tastes and toys, it didn’t improve their brains. Only the running wheel did that.

That brings us to humans. A new study from the University of British Columbia in Canada, published in the Archives of Internal Medicine, found that progressive weight training improved certain types of cognitive function in senior women more than walking (aerobic exercise), or balance, tone and stretch classes. All three types of exercise produced positive changes, but resistance training produced better results when it came to “selective attention/conflict resolution, associated memory and regional patterns of functional brain plasticity.” The researchers believe this was probably because weight training becomes progressively harder as resistance increases, benefiting “multiple domains [in the brain] in those at risk for dementia.”

Each of the three different forms of exercise was done twice a week over six months, by roughly a third of 86 women between the ages of 70 and 80. The women all suffered from mild cognitive impairment, a common problem for women their age—and a major risk factor for Alzheimer’s disease. The women were at a critical stage where intervention might help stave off dementia.

The resistance training group used Keiser pressurized machines and free weights, performing 2 sets of 6 to 8 repetition, increasing the load when sets were completed in good form. The aerobic training group walked outdoors, sometimes with walking poles; heart rate percentage was gradually increased. The balance and toning group did stretching, range of motion, balancing, and relaxation techniques.

Cognitive testing was done before and after the six month programs. Magnetic resonance imaging was used to assess changes in patterns of brain function.

It is very important to find interventions that may “alter the trajectory of cognitive decline in seniors,” senior researcher Teresa Liu-Ambrose, PT, PhD, told Canada.com. More than half of those with mild cognitive impairment are eventually diagnosed with Alzheimer’s disease. “We can’t say that resistance training eradicates AD,” Liu-Ambrose continued, “but it does show promise in delaying the onset. It improves brain function in the processes that are associated with aging and the early stages of AD.”

She hopes this research will convince community centers, gym operators, and others that it is both safe and beneficial for seniors to weight train and to offer more programs to older adults. “Seniors are very capable and dedicated,” she added.

Weight training, however, is only one of many kinds of physical activity that may lower AD risk.

A study reported April 24, 2012, in the journal Neurology found that any kind of physical activity lowers the risk of cognitive decline and Alzheimer’s, even in people over 80. Uniquely, both exercise and nonexercise activities were studied.

Total daily activity was measured 24 hours a day for up to 10 days using actigraphy. An actigraph is a watch-sized device worn on the nondominant wrist that detects movement day and night. Much of the movement included regular daily activities, such as cooking, washing dishes, or cleaning. Actigraphy recorded average physical activity every 15 seconds, distinguishing between different levels of activity. If there is no movement, it recorded zero. While the device wasn’t able to sense whether the subject was playing basketball or doing another specific activity, by continuously recording the rate of movement every 15 seconds it did suggest the level of vigor, or intensity.

“A weakness of most prior studies was the use of self-reports of physical activity, which may be influenced by recall bias and usually omits low intensity, nonexercise activity,” Michael Schnaider Beeri, PhD, and Laura Middleton, PhD, wrote in an accompanying editorial. Importantly, additional self-reporting measures of physical activity in the study changed the results only slightly, “suggesting that total daily activity, including nonexercise physical activity, may be particularly important to augment cognition and forestall AD,” the editorial added.

The study included 716 people (76% women, average age 82) without dementia. All participants underwent annual clinical examinations including a battery of 19 cognitive tests. Over an average follow-up of almost 4 years, 71 of the subjects developed AD

“A higher level of total daily physical activity is associated with a reduced risk of AD,” the study concluded. People who scored in the bottom 10% of physical activity were over two times more likely to develop Alzheimer’s than those in the top 10 percent. Notably, the intensity level of activity produced an even great effect—those who did the least intense activities were almost three times more likely to develop Alzheimer’s than those doing the most intense activities. 

“The implication of this study is really astounding,” lead author Aron S. Buchman, MD, told USA TODAY. “Exercise is good, without a doubt, but this study is about more than exercise. Older people who might not be able to exercise can tailor activities that are right for them.” Even people with limited mobility, such as those in a wheelchair and the very old, can benefit from movement. It’s never too late.

The association between activity and risk suggests that any activity is better than none. But it also means that more activity reduces risk more. The key for the elderly and others is to be as active as reasonably possible.

The accompanying editorial emphasized that intensity of activity (as measured by actigraphy) was “consistently more strongly associated with improved cognitive outcomes than the primary overall daily activity measure.” Harder or more intense is better.

Dr. Steven Arnold, a professor of psychiatry and neurology at the University of Pennsylvania and director of the Penn Memory Center, told msnbc.com: “This study is very simple and has a very simple and very clear message: move more.” (Emphasis mine)

“The bottom line is that people who tend to be more active than others have a lower risk,” Dr. Arnold added.  

So, again, move more—vigorously if you can.

*  *  *

The overall take home message of the three new studies, it seems to me, is that a combination of many types of physical activity offers the best odds of keeping our brains operating well. You must, of course, also challenge your brain; use it or lose it still applies. Physical activity alone is not likely to turn any of us into Einstein clones.

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