Aerobic + Strength Exercise Doesn't Slow Cognitive Decline

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While a fitness regime improved physical fitness in people with mild to moderate dementia, it "does not slow cognitive impairment", researchers reported in The BMJ medical journal. While some of the headlines were a bit alarmist - such as The Independent's "Exercise could make dementia progression worse not better" - most of the reports were balanced and accurate.

From February 2013 to June 2015, the researchers screened and randomized 329 participants to an exercise and support program and 165 to usual care, following them for about a year. They were recruited through memory clinics - specialist services that help people who have problems with their memory - and GP surgeries.

The researchers carried out a randomised controlled trial (RCT), which is usually the best way to see if a treatment works.

Participants were an average 77 years old, and 61% were men.

Previous research had suggested that exercise could prevent mental decline, and stave off diseases like Alzheimer's, so experts and charities said they were surprised by the findings. Those taking part in the exercise programme had their physical fitness measured at the start of the programme and again after 6 weeks. The exercise group were fitter, but had marginally higher Alzheimer's disease assessment scores compared with the rest.

Indeed, patients who participated in the exercise programme showed slightly worse scores. Although it improved short-term physical fitness, this "did not translate to improvements in activities of daily living, behavioural outcomes or health-related quality of life". Other (secondary) outcomes included activities of daily living, number of falls, and quality of life. However, they added that it was uncertain "whether the effect on cognitive impairment we observed is important".

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It is well known that exercise is beneficial for physical and mental wellbeing, improving strength and cardiovascular fitness as well as boosting mood and self-esteem.

Around 850,000 people in Britain now suffer from dementia and there are now no treatments to reverse or slow down the condition. It involved a relatively small number of people (although much larger number than earlier clinical trials on the topic), and lasted for only 12 months - a period of time too short, perhaps, to produce positive results among the exercise group.

According to Alzheimer's Research UK, the average annual cost per person for someone with dementia, with regards to NHS care, care homes, and unpaid care from friends and relatives, can be huge.

The study found that the connection could be made regardless of the level of schooling people had received, and other health indicators.

This sort of exercise may actually worsen the condition, it was revealed.

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