EXERCISE

In the healthy elderly, studies show that aerobic exercise has a significant impact on promoting function of the hippocampus and stimulating neuroplasticity, an important feature in maintaining healthy aging.1 Neuroplasticity is the invaluable ability of the brain to change itself permanently in order to learn new information or skills. Neuroplasticity, unfortunately, is one of the cognitive abilities threatened by Alzheimer’s disease. For people with Alzheimer’s, there are several studies that illustrate similar benefits of engaging in regular physical activity. One study that observed a group of 200 elderly patients with Alzheimer’s as they completed a 16-week regimen of moderate-to-high intensity aerobic exercise for one hour daily concluded that this regimen increased the patients’ cardiorespiratory fitness and their abilities to complete physical multi-tasking.2 Another study compared magnetic resonance images (MRIs) from individuals who logged 150 minutes of moderate- to-vigorous physical activity per week to those that engaged in no exercise and found that individuals at risk for Alzheimer’s had faster rates of brain atrophy and that physical exercise could attenuate this brain atrophy.3 An additional study showed that four months of exercise not only demonstrated preservation of cognitive activity but also reduced anxiety and depression in patients with mild Alzheimer’s, particularly frequent, high-intensity exercise. This suggests that the level of exercise intensity is important in achieving cognitive improvement.4 While these findings do not suggest restorative properties of exercise for patients with Alzheimer’s, slowing down the atrophy process and decreasing anxiety and depression are invaluable ways to improve quality of life while living with Alzheimer’s.

COMBINING EXERCISE AND COGNITIVE TRAINING

In a study that observed 18 patients with moderate Alzheimer’s disease,1 the patients partook in five one-hour exercise sessions per week for 16 weeks. The exercises were designed to develop coordination, balance, mobility, endurance, and strength. The researchers utilized simple training equipment, such as stationary bikes, medicine balls, ropes, cones, steps, tennis balls, and dumbbells. The researchers prompted the patients to participate in cognitive exercises simultaneously while carrying out the physical exercises. When a patient showed improvement in a particular exercise, the researchers slightly increased the difficulty of the exercise. Improvement in these cognitive exercises and the need for increased difficulty denoted higher neuroplasticity. The researchers concluded that the type of conjoined therapy utilized in the study can help to slow the cognitive impairment associated with Alzheimer’s disease.1  Another study6 conducted in 2016 included 33 participants with Alzheimer’s and showed similar results. The patients were divided into two groups: one group participated in cognitive training and physical exercise over the course of six months, and the other group participated in only cognitive training. After the six-month regimen had been completed, researchers found that the group participating in exercise and cognitive training showed a decreased level of cognitive impairment, with no notable change occurring in the cognitive training only group.6

DIET

In the same way that our hearts and livers are affected by the food we eat, the health of our brains is also partially contingent on the nutrition that we obtain from food. The Alzheimer’s Research and Prevention Foundation provides several dietary recommendations aimed at improving brain health and preventing Alzheimer’s.7 The foundation suggests limiting the consumption of saturated and trans fats, which have been shown to increase inflammation within the body and produce free radicals, known to damage brain cells. In addition, they recommend consuming foods high in vitamins C and E as a way to eliminate these excess free radicals. The guidelines also recommend a diet high in fruits, veggies, and omega-3-rich fish, such as salmon. Specific foods the foundation recommends for brain health include blueberries, spinach, and seaweed, all valued for their antioxidant properties.

Not sure of how much of each food group to eat? Aim for healthy fats such as olive oil, hemp seeds, and avocados to comprise 20 percent of your diet; lean proteins should make up about 40 percent of your diet (think fish, chicken, and turkey); and 40 percent of your diet should consist of complex carbohydrates such as whole grain bread, a variety of fresh veggies, and beans.

This diet recommendation might sound familiar; lean proteins (especially fish), ample healthy fats, and plenty of fresh vegetables are all common characteristics of the Mediterranean diet. The Mediterranean diet is recommended for weight loss and a healthy heart, but this diet is also great for preserving and protecting cognitive function as we age. In an ongoing longitudinal investigation of the8 Greek population, adherence to the Mediterranean diet was associated with better performance on cognitive tests, including tests for memory, language, and visuospatial perception. The associations were strongest for memory. In addition, this study concluded that fish consumption decreased the chance of developing dementia and the consumption of non-refined cereals, such as oatmeal, had a positive effect on cognitive performance.8 Further, another study9 established a connection between low intake of other meats (pork, beef, and chicken) in favor of higher fish intake in the Mediterranean diet as a way to preserve cognitive function and prevent brain atrophy.9 In addition to making sure you’re eating your daily allotment of fatty fish and fresh veggies, make sure you’re drinking your wine. You read that right—there are multiple studies that suggest light-to-moderate drinking (1–2 drinks per day) is significantly associated with a lower risk of any dementia.10 Specifically, older adults who chose wine over other alcoholic beverages saw a larger total brain volume compared to those who chose beer or liquor.11

SOURCES

1. Kandola A, et al. Aerobic exercise as a tool to improve hippocampal plasticity and function
in humans: practical implications for mental health treatment. Front Hum Neurosci. 2016 Jul 29;10:373.

2. Sobol NA, et al. Effect of aerobic exercise on physical performance in patients with Alzheimer’s disease. Alzheimer’s Dement. 2016 Dec;12(12):1207–1215.

3. Dougherty RJ. Meeting physical activity recommendations may be protective against temporal lobe atrophy in older adults at risk for Alzheimer’s disease. Alzheimer’s Dement

(Amst). 2016 Apr 9;4:14–7.
4. Hoffman K, et al. Moderate-to-high intensity physical exercise in patients with Alzheimer’s disease: a randomized controlled trial. J Alzheimer’s Dis. 2016;50(2):443–53.

5. Guerra SY, et al. [Exercise and Alzheimer’s: the body as a whole]. Revista Andaluza de Medicina del Deporte. 2017;10(3):120–124.

6. Kim MJ, et al. Physical exercise with multicomponent cognitive intervention for older adults with Alzheimer’s disease: a 6-month randomized controlled trial. Dement Geriatr Cogn Dis Extra. 2016 Jun 10;6(2):222–32.

7. Pillar 1: Diets and Supplements. 2017. Alzheimer’s Research and Prevention Foundation. http://alzheimersprevention.org/4- pillars-of-prevention/pillar-1-diet-supplements/. Accessed Dec 13 2017.

8. Anastasiou CA, et al. Mediterranean diet and cognitive health: Initial results from the Hellenic Longitudinal Investigation of Ageing and Diet. PLoS One. 2017 Aug 1;12(8):e0182048.

9. Gu Y, et al. Mediterranean diet and brain structure in a multiethnic elderly cohort. Neurology. 2015 Nov 17;85(20):1744–51.

10. Lettenneur L. Risk of dementia and alcohol and wine consumption: a review of recent results. Biol Res. 2004;37(2):189–93.

11. Gu Y, et al. Alcohol intake and brain structure in a multiethnic elderly cohort. Clin Nutr. 2014 Aug;33(4):662–7.