Exercise 'doesn't slow' progression of dementia if you already have dementia
nhs.uk
nhs.uk
Having gone through three parents+in laws including one we actively caretook in home with this terrible disease I'm not surprised. The progression seemed unstoppable and sickened us while not aiding the parents. The allusion to the victim in a train barrelling through a dark increasingly confusing countryside is so apt.
> ADAS-cog results run on a scale from 0 to 70, with higher scores suggesting greater impairment. The usual-care group had an average score of 23.8, compared with 25.2 for the exercise group (adjusted estimate -1.4, 95% confidence interval [CI] -2.6 to -0.2).
They have to repeat the study with more patients to be able to reduce the error estimation in the average. (Or run study for a longer time so the increment or decrement effect accumulates and it's easier to measure.) But if the first study had no interesting result it may be more difficult to get the foundlings for another similar study.
I'm no expert, but the association I had was a podcast I listened once with someone interested in life extension (I think it was on a Tim Ferriss podcast). They spoke about "mTOR activation" (IIRC), the basic idea was that having muscles is good (because they increase the need for glucose, helping the pancreas and the liver in regulating it), but building muscles is potentially harmful, because it causes a release of growth hormone, and essentially speeds up metabolism (and hence aging).
Don't quote me on this, and I'm sure there's better sources of this information out there than me. Does this ring a bell to anyone?
They're pretty clear that exercise can help prevent people getting dementia.
What this research shows is that once you have dementia exercise doesn't do much to slow it down.
Interesting findings, but nothing all that useful outside bar room banter.
What is your estimate of the right control group size should be, for such a study?
I am learning from that study that, on 494 patients, they found no clear cut link between exercise and dementia evolution. Are you saying there is a clear cut one?
Maybe there is a link, but if it was very significant, hopefully the study would have detected a correlation.
My bottom-line for my life: don't focus on pushing physical exercise if your loved one has dementia, there is no clear cut link detected today. It is interesting as for some, their "intuition" may make them believe there is one.
Please correct which part of my reasoning is wrong here. I am talking about real life, not a conversation at a bar.
Exercise can delay the onset of dementia. I wasn't aware it has been claimed to slow its progress.
If you're well educated, alert (maybe from exercise?) and so on then the early signs of dementia may just be less obvious. If you forget a few names but can do the cryptic crossword or run a mile then relatives will not push you to get tested.
The assumption is exercise results in higher blood flow which does "something". I know its easier to concentrate when you have practice concentrating, and for many boring people, exercise might be their only daily experience with concentrating, aside from the rare occasional dementia testing. Possibly forcing concentration on a regular basis (via exercise, or whatever alternative) results in better cognitive test results.
I suppose a lot depends on defining exercise as staring at a TV while walking on a treadmill vs playing racquetball.
There are observational studies that associated exercises with delayed onset of dementia, but they cannot show the direction of causality - it could be that people who are healthier and not at risk for dementia tend to exercise more as a result.
There are RCTs showing improvement in cognitive function in healthy older adults, which one might hope means that the onset of dementia is delayed - but that has not actually been shown.
"Is he in bad shape? Eh, chuck in some exercise, that's gotta help."
> They were recruited through memory clinics – specialist services that help people who have problems with their memory – and GP surgeries. Carers were asked to take the decision on behalf of people whose dementia meant they were unable to.
I think we have to be very careful about what these researchers characterize as "mild to moderate dementia". I would contend that people who are forced to seek professional help - let alone those who are unable to make decisions for themselves, are beyond the point of "mild to moderate dementia". A good argument could be made that the vast majority of people with "mild" dementia are not under professional care and do not require a caretaker to make decisions for them. They are forgetful, absentminded, and/or showing other "mild" symptoms of dementia.
You're certainly right that lots of people with early stage dementia are community living and not diagnosed.
"Significant cognitive impairment" should not be characterized as, "mild dementia". If it is too difficult to recruit people with mild dementia for a study, then they should report their results as being relevent to only those with "moderate" dementia.
> It's important to note this does not change what we know about exercise's ability to protect against dementia. People who exercise more are less likely to get dementia, possibly because it maintains blood flow to the brain.
> However, once the brain has been damaged by dementia, exercise may not help prevent further damage.
Unsurprisingly, there wasn't much of a difference.
Personally I'm pissed at the way this study is presented. It makes a lot of people falsely assume that exercise is useless, while it's definitely not.
Unless you have one foot in the grave and more than mild dementia, exercise is probably still good for you. In fact the study concludes nothing for longer periods or different modes of exercise, even for people this old and with dementia already onset.
Sending an old man to the gym for "mild-to-moderate intensity" aerobic exercise is a bad idea in the first place.
Or, perhaps, people who are able to exercise and have the drive and foresight to exercise regularly for years don't have early stages of dementia. Unless a study has been done that randomized persons at age 40-50 to 'exercise' and "no exercise" groups, and followed them for 30-40 years, this is a hard question to answer. Following groups of people who self-sort themselves into exercisers and non-exercisers does not answer this question, as the exerciser group may include less early-dementia persons (ie those 20-30 years from a clinical diagnosis, but who may be experiencing early behavioral changes that are not diagnostic).
Sadly the vegan crowd overlaps too much with the pseudoscientific new age/alt med/antivaxxers crowd, so skeptical types are quick to dismiss any suggestion that such a diet is healthier.
And people generally don’t like to hear that eating meat is bad for them anyway.
If anyone is interested in why you instinctively react so negatively to the idea that your diet is unhealthy and unnecessarily wasteful/harmful, there’s a great Ted Talk on it: https://youtube.com/watch?v=o0VrZPBskpg