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Exercise regimes 'do not slow dementia'

Researchers found gym classes had no effect on slowing cognitive impairment

Mark Gould

Friday, 18 May 2018

Exercise programmes for people with mild to moderate dementia do not appear to slow signs of cognitive impairment, according to researchers* writing in the British Medical Journal.

The researchers from Oxford University found no improvements in thinking skills or behaviour in more than 300 people in their 70s who did aerobic and strength exercises over four months. However, they did find that their physical fitness had improved and they said that future trials should explore other forms of exercise.

The study, examined 329 dementia patients who took part in gym sessions lasting 60-90 minutes twice a week for four months. They spent at least 20 minutes on a fixed cycle and lifted weights while getting out of a chair and they were encouraged to do exercises at home for another hour each week. The exercise group was then assessed and compared with a group of 165 people with dementia who received their usual care.

"A moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes," the study concludes.

Professor Sallie Lamb, lead study author and professor of rehabilitation at Oxford University, said the results showed that people who had had dementia for two or three years could follow simple exercise instructions and improve their fitness and muscle strength.

"But these benefits do not, however, translate into improvements in cognitive impairment, activities in daily living, behaviour, or health-related quality of life," she told the BBC.

After 12 months, researchers found that cognitive impairment had declined in both groups, with the exercise group slightly worse off - but the difference was small.

Professor Martin Rossor, professor of clinical neurology at University College London, said the results weren't surprising given degeneration of brain cells started many years before symptoms began in Alzheimer's disease, for example.

"So, the message remains that exercise is good, but to start an exercise regime once the disease is well established may be of limited value," he added.

In spite of the research findings experts stressed that exercise is still thought to be one of the best ways to reduce the risk of getting dementia in healthy older adults. But the research suggests larger trials are needed to work out an effective exercise programme for brain health in those who already have the condition.

*Lamb S E, Sheehan B, Atherton N, et al. Dementia And Physical Activity (DAPA) trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial. BMJ 2018; 361:k1675

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