Wednesday, May 14, 2008

Exercise and Alzheimer's

People with Alzheimer's feel better, both physically and emotionally, when they get regular, moderate exercise.

Moderate exercise helps many people with Alzheimer's disease feel better — both physically and emotionally. As little as 20 minutes of walking three times a week can boost mood, decrease risk of falls, reduce wandering and delay nursing home placement in people with Alzheimer's.

Reducing the toll of depression

Up to 70 percent of people who have Alzheimer's disease also have symptoms of depression. They gradually lose the ability to participate in activities they once enjoyed, and may eventually withdraw from all activities.

Research shows that exercise lessens that tendency. In a sample of people with Alzheimer's, a moderate exercise program totaling at least 60 minutes a week for three months reduced rates of depression. Conversely, scores on a depression questionnaire worsened in a control group that did not exercise.

Preventing falls

People with Alzheimer's have a higher risk of falls and fractures than do people the same age without the disease. Once injured, they're also more likely to re-injure themselves. These factors are directly related to impaired mobility and loss of independence.

Moderate exercise improves strength and coordination, which can reduce the risk of falls and injury.

Improving sleep

Sleep disturbances are common in people with Alzheimer's disease. Some become agitated at bedtime, wander at night or sleep fitfully. Caregivers become exhausted when they can obtain only a few hours of sleep at a time, night after night. Regular physical activity is a natural sleep-enhancer. A daily walk or exercise class can help a person with Alzheimer's sleep more soundly at night.

Cutting down on wandering

As Alzheimer's disease progresses, the tendency to wander away from home and get lost increases. Wandering and the dangers that go with it often prompt caregivers to move their loved ones into nursing homes. In many cases, people with dementia appear to wander because of boredom or loneliness.

Programs that engage individuals in meaningful activities, exercise and social interaction may reduce the frequency of wandering. Walking — the most readily available form of exercise — can be combined with a useful activity, such as:

  • Walking the dog
  • Pushing a person in a wheelchair
  • Picking up trash in the neighborhood

How to get started

Starting an exercise program is hard for everyone. Having Alzheimer's just makes it harder, because the disease makes it more difficult to learn new behaviors. As a caregiver, you may have to join in the exercise program. It may work even better if you exercise with other people with Alzheimer's and their caregivers.

A thorough physical exam will reveal any health problems that may impose restrictions on an exercise program. You might ask your doctor for a "prescription" for exercise that you can show your loved one periodically, to encourage participation.

The safest physical activity for someone with Alzheimer's is walking with another person. Many malls have programs that offer a climate-controlled environment for walking. Such outings can be stimulating social interactions, as well.

Pedaling towards fitness

Some people with Alzheimer's may still enjoy biking. If balance is a problem, adult tricycles are an option.

Or you might take a person with Alzheimer's for a ride in a conveyance powered by two sets of pedals, such as the paddle boats available for rent at some lakes. Many tourist towns now have four-wheeled canopied carts — which are powered by at least two sets of pedals — so the whole family can go for a ride.

Household chores fuel self esteem

Some types of repetitive household tasks can provide exercise while allowing someone with Alzheimer's to feel like he or she is helping out. One caregiver helped her husband rake and bag the leaves from their yard. Each morning, she would open the bags and spread the leaves on the lawn, ready to be raked up again.

Sweeping, mopping, washing windows and folding laundry are all tasks that have been learned by rote. These real-life tasks may be more meaningful and satisfying than just busywork and games.

Improve quality of life

Exercise can help control many of the general health problems common in older people, such as high blood pressure, high cholesterol and diabetes. It also improves flexibility, strength and mobility. When you exercise with your loved one, you both benefit.

In addition to giving you an enjoyable activity to do together, exercise can reduce some of the behaviors that make it so difficult to care for a person with Alzheimer's. This can delay placement in a nursing home and improve your loved one's quality of life.

If you or company is interested in starting an aerobics class for your assisted living or independent home please email me at: