by Joe Giandonato, MBA, MS, CSCS
June is Alzheimer’s and Brain Health Awareness Month
Earlier this month, the Food and Drug Administration approved the use of a monoclonal antibody that targets amyloid beta, a chief constituent of amyloid plaque that is implicated in neurodegeneration associated with Alzheimer’s Disease. Though preliminary reports suggest hope in treating the devastating disease which has robbed 6 million living Americans of their dignity and independence, the drug’s approval has been vehemently debated on the grounds of spurious initial clinical trial data validating its potential efficacy.
Alzheimer’s disease is postulated to be caused by amyloid beta peptides originating from the amyloid precursor protein and transduced by proteases to yield Aß which aggregates within the hippocampus, a nexus of learning and memory functions embedded within the brain’s temporal lobe. Additionally, an accretion of kinases tangles tau proteins, structures that facilitate neurotransmission within the brain. Collectively, the emergence of these malevolent entities ordinarily manifests as cognitive impairment, a hallmark symptom of Alzheimer’s Disease, which worsens over time.
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Research has previously demonstrated that sedentary living is a risk factor for neurodegenerative disease, particularly Alzheimer’s and implicated in roughly 1/3rd of cases (4). Higher Body Mass Indices (BMIs) were also correlated with increased Alzheimer’s disease risk (3) and the likelihood of developing Alzheimer’s doubles every five years beyond the age of 65 (1). Incorporation of regular physical activity revealed improvements in neurocognition via performance on a battery of cognitive testing. A cohort of 66 participants engaged in a combination of aerobic exercise (15-20 minutes) and resistance training (30-40 minutes) three times per week for 8 months. Upon conclusion of the protocol, significant improvements on cognitive tests measuring executive function and memory were observed (2). A meta-analysis comprised of 16 studies established a connection between physical activity and Alzheimer’s risk, revealing for every 500-kcal expended via physical activity each week corresponded with a 13% decreased risk of developing Alzheimer’s disease (5).
A confluence of factors, such as increased life-expectancy in developed countries across the globe as well as widespread reductions in leisure time physical activity prior to and amid COVID-19 as well as prolonged social isolation associated with quarantining and pre-emptive measures intended to curb the virus’s spread will likely contribute to greater prevalence of dementia and Alzheimer’s disease in the future. Engagement in regular physical activity, among other healthy behaviors, should be promoted among entire populations, irrespective of age as prior research has shown physical activity throughout the lifespan can temper neurodegenerative disease risk.
Physical activity should be embraced and promoted as a measure to improve quality of life throughout the lifespan. Medical and fitness professionals should collaborate on inclusive and customized solutions to accommodate those with unique adaptive, medical, and technological needs, especially elderly persons. Beyond improving the health and livelihood of the individual, physical activity can perhaps allay the immense familial and societal burdens associated with Alzheimer’s Disease.
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References
- Brookmeyer, R., Evans, D.A., Hebert, L., Langa, K.M., Heeringa, S.G., Plassman, B.L., & Kukull, W.A. (2011). National estimates of the prevalence of Alzheimer’s disease in the United States. Alzheimer’s and Dementia, 7 (1): 61-73.
- Etnier, J.L., Karper, W.B., Labban, J.D., Piepmeier, A.T., Shih, C., Dudley, W.N., Henrich, V.C., & Wideman, L. (2018). The Physical Activity and Alzheimer’s Disease (PAAD) Study: Cognitive outcomes. Annals of Behavioral Medicine, 52 (2): 175-185.
- Kivimäki, M., Luukkonen, R. Batty, G.D., Ferrie, J.E., Pentti, J. Nyberg, S.T., Shipley, M.J., Alfredsson, L., Fransson, E.I., Goldberg, M., Knutsson, A., Koskenvuo, M., Kuosma, E., Nordin, M., Suominen, S.B., Theorell, T., Vuoksimaa, E., Westerholm, P., Westerlund, H. Zins, M., Kivipelto, M., Vahtera, J., Kaprio, J., Singh-Manoux, A., & Jokelau, M. (2018). Body mass index and risk of dementia: Analysis of individual-level data from 1.3 million individuals. Alzheimer’s and Dementia, 14 (5): 601-609.
- Norton, S. Matthews, F.E., Barnes, D.E., Yaffe, K., & Brayne, C. (2014). Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. The Lancet Neurology, 13 (8): 788-794.
- Xu, W., Wang, H.F., Wan, Y., Chen-Chen, T., Yu, J., & Tan, L. (2017). Leisure time physical activity and dementia risk: a dose-response meta-analysis of prospective studies. BMJ Open, 7: e014706.