Physical exercise and dementia: Delaying cognitive and motor decline via exercise

Dementia leads to a decline in so-called cognitive (thinking processes) and physical abilities (muscle strength, balance, and endurance). As a consequence, activities of daily living (ADL) are hampered, patients become more dependent on care, quality of life deteriorates, and care burden increases. Current pharmacological treatments have limited effects. With the recent recognition that ‘exercise is medicine’, physical exercise is suggested to be an effective non-pharmacological alternative.
This thesis presents the development and the cognitive, physical, and ADL effects of a nine-week-long exercise program in older patients with dementia. Two different exercise programs were compared: (1) twice a week 30-minute-long walks plus twice a week 30-minute-long leg strength exercises and (2) four times per week 30-minute-long walks.
The results showed that the combined walking+strength training program led to better cognitive and motor functions than the walking-only program. These improvements transferred to improved ADL. However, nine weeks after the exercise program was completed, most of the cognitive and motor effects disappeared.
In sum, exercise plays an important role in reducing the cognitive and physical decline in older patients with dementia. Compared with a walking-only and control program, the largest cognitive and physical effects are achieved through a combined aerobic+strength training program, and the improved ADL may contribute to the preservation of quality of life. Future research in people at risk of developing dementia or at an initial-stage of dementia will focus on the doses-response relationship and the underlying mechanisms of physical (in)activity on cognition (title: ‘train the sedentary brain’).