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Exercise Helps Alzheimer's Patients

It decreases depression, hospitalizations, new research finds

TUESDAY, Oct. 14, 2003 (HealthDayNews) -- For years, doctors have said exercise can slow some of the damage -- particularly physical impairment -- caused by Alzheimer's disease.

Now, a new study supports that advice.

Alzheimer's patients who were coached through a home exercise program by caretakers who also were trained in managing behavioral problems were less depressed and in better physical shape than a matched group of patients who were left to their own devices, says the report by researchers at the University of Washington in Seattle.

The trial was not aimed at the mental deterioration that is the best known and most dreaded aspect of Alzheimer's disease. Instead, the researchers tried to affect the less publicized loss of physical ability that makes patients more prone to injuries and to lose mobility, putting extra burdens on themselves and the people who look after them.

"Improved physical conditioning for patients with Alzheimer's disease may extend their independent mobility and enhance their quality of life despite progression of the disease," says the study, which appears in the Oct. 15 issue of the Journal of the American Medical Association.

The trial included 153 Seattle-area residents with Alzheimer's disease. Of these, 76 were assigned to get the normal care for the disease. The others were given that same care, plus they and the people who looked after them were also enrolled in a RDAD (Reducing Disability in Alzheimer's Disease) program developed by university researchers.

For three months, training sessions taught the caretakers how to get the Alzheimer's patients to do exercises designed to increase strength, mobility, balance and flexibility.

These are the simplest possible exercises, says study author Linda Teri, a professor in the university's department of psychosocial and community health: "Stretching, bending, even just walking in a straight line." Some patients worked out with half-pound weights on their wrists or with elastic bands they pulled apart.

Because Alzheimer's patients sometimes become belligerent, the caretakers were trained to avoid conflicts with the patients. "Patients can resist attempts to care for them if they are depressed," Teri says. "The idea was to make the patients feel that an activity was something they wanted to do."

After three months, the patients in the RDAD group were three times more likely to exercise for at least one hour a week and had two-thirds fewer days of restricted activity. The physical ability of those in the RDAD group improved over the next two years, while it deteriorated in the patients not given the training. And only 19 percent of those in the RDAD group had to be institutionalized in nursing homes, compared to 50 percent in the other group.

The Washington study adds some solid numbers to "the general idea about exercise, which has been around for a while," says Dr. Steven H. Ferris, director of the Alzheimer's Disease Clinic at New York University School of Medicine.

But the earlier animal trials and limited human studies that fostered that belief were far from definitive, he says. "This [Washington] trial is impressive -- randomized, prospective with a control group and a reasonably large number of patients," Ferris says.

But, Ferris adds, while the trial results are "intriguing, [they are] not the final answer. I would have liked to see a longer treatment period and a longer outcome period."

Still, the results support the exercise advice that is given at his and other clinics, Ferris says. "We have been saying for years that it is important to keep patients as busy as possible, both physically and mentally," he says. "We do counseling with families to help improve the home environment, giving very concrete advice."

Cornelia Beck is a member of the Alzheimer's Association's Medical and Scientific Advisory Council. In a prepared statement, she says: "Through programs of exercise and caregiver training, such as the one demonstrated in this study, people with Alzheimer's may be able to maintain their physical health and share more positive interactions with their caregivers. That is potentially a big quality of life improvement for patients, caregivers and family members -- in fact, everyone touched by this devastating disease."

More information

To learn more about exercise for healthy aging, visit the National Library of Medicine. For more on Alzheimer's disease, visit the Alzheimer's Association.

SOURCES: Steven H. Ferris, M.D., director, Alzheimer's Disease Clinic, New York University School of Medicine, New York City; Linda Teri, Ph.D., professor, department of psychosocial and community health, University of Washington, Seattle; Oct. 15, 2003, Journal of the American Medical Association
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