By Traci Tefft, RN, MSN
If you haven’t heard enough reasons why you should exercise, maybe this fact will convince you. Regular exercise reduces the risk of developing dementia. Exercise has persistently been promoted to combat obesity and the related health risks but now there is another compelling reason—dementia.
Dementia is a growing health concern in our country. As the baby boomer generation (born 1946–1964) achieves senior citizen status combined with the increase in longevity, the number of people suffering from dementia has escalated. Prevalence estimates for dementia range from 1–2 percent at age 65 to as much as 30 percent at age 85 (DSM V, 2013). In the United States, this converts to approximately 5 million people (www.alz.org) and a staggering 24 million worldwide (Wilson et al., 2011). The United States mortality rate due to dementia is approximately 500,000 per year (www.alz.org).
Dementia is an incurable progressive neurodegenerative disease. The average span of the disease is 10–20 years. The etiology of the disease is unknown, other than a small percent possess a genetic biomarker known as apolipoprotein E (APOE). Brain scans show neural tangles and plaques that appear to interfere with brain function. Although there are different types of dementia, 60–90 percent is the Alzheimer’s type (DSM V, 2013). Generally, dementia results in a progressive decline in memory and function and is often accompanied by behavioral and psychological problems. Medications such as memantine (Namenda) and donepezil (Aricept) may temporarily slow down the advancement of the disease but do not stop it (DSM V, 2013). Psychotropic drugs may help with the behavioral and psychological symptoms that include anxiety, agitation, aggression, restlessness, wandering and depression.
The toll on the individual, family and health care system is immense. In the early stages, the individual suffers as they slowly and steadily lose independence in function. Family members struggle with the reality that their loved one has an incurable disease and can no longer care for themselves or others. At some point, usually related to safety of the individual or caregivers, a pivotal decision is made to hire third parties to care for their loved one. This may be in the form of home care or placement in a long term care facility. The economic costs associated with dementia are as high as $159-215 billion annually with 75–85 percent related to non-medical home or institutional care (www.rand.org). This does not include the costs incurred by unpaid caregivers, such as family members, who may also incur medical costs related to this burden (www.alz.org). It is predicted that these costs will rise to over $500 billion by the year 2040 (www.rand.org).
Almost everyone has been touched by this terrible disease, whether it is a parent, grandparent, friend, acquaintance or patient. The emotional and economical toll is huge. How can we reduce our risk for dementia? Although there is not an identifiable cause of dementia, a significant risk factor is lack of physical activity. A remarkable study in the United Kingdom followed 2,235 men for 25 years (1979-2004) and compared healthy behaviors with cognitive status (Elwood et al., 2013). Exercise was found to be an important predictor of cognitive impairment and dementia, less exercise increased the risk of dementia (Elwood et al., 2013). Two large evidence reviews also discovered the association between exercise and dementia, with increased levels of physical activity directly reducing the risk of developing the disease (Gregory, Parker, and Thompson, 2012; Ahiskog, Geda, Graff-Radford and Petersen, 2011).
Are you ready to exercise? The latest recommendations published in 2011 by the American College of Sports Medicine (ACSM) suggest adults should engage in moderate aerobic physical activity for 150 minutes per week which is approximately 30 minutes, 5 days a week. In addition, it is important to include muscle strengthening and flexibility activities at least two or three days per week, as well as balance exercises. Find activities that you enjoy doing so you are more likely to continue. Walking, jogging, biking, dancing, swimming, tennis, gyms, fitness classes (Zumba, kickboxing, boot camp, yoga, Pilates)—the choices are endless. Many activities involve little to no cost although supportive footwear is important. Water exercise is an excellent option for people needing to relieve joint stress, such as with arthritis. Participation in these physical activities will improve your physical health, enhance your mental outlook and decrease your risk for developing certain diseases, such as dementia. The cost savings to the individual and society are immeasurable.