Exercise matters

Almost one-quarter of the over-65 population has some degree of cognitive impairment, Dr. Sandra E. Black told the audience at the 2008 Women’s Health Matters Forum and Expo in Toronto in January. The professor of neurology at the University of Toronto’s medical school noted, however, that exercise can play a significant role in maintaining brain health. “Run in place – you’ll protect your brain,” she teased people standing at the back of the packed seminar room.

Alzheimer’s disease and stroke represent dual threats to brain function, Black said. Patients may suffer dementia, which she defined as memory impairment plus difficulty in at least one other cognitive domain. This can disrupt social interaction or affect competency on the job.

Although brain shrinkage occurs in Alzheimer’s disease, Black said the primary problem is the formation of plaques made of a protein called amyloid. Other proteins form tangles within nerve cells. As these tangles and plaques develop they interrupt nerve cell communication in the brain, eventually interfering with memory retrieval, reasoning and language perception. (Alois Alzheimer first described the disease in 1906. The patient, Auguste Deter, a 51-year-old woman, sadly remarked, “I have lost myself.”)

Black also pointed out strokes can happen silently, leaving tiny lesions in the brain. When these are present, less Alzheimer’s pathology is needed to cause dementia, making the coexistence of the two disorders extremely significant.

Early in the 20th century, people could expect to live an average of 47 years; many over 65 seemed old and ill. By 1990, life expectancy had reached 75, and 65-year-olds were much healthier than their earlier counterparts. Now the challenge is to help these aging people preserve cognition and mental health, Black said.

Stroke and Alzheimer’s share important risk factors, among them aging, family history, high blood pressure, head injury, high blood cholesterol levels, smoking and a sedentary lifestyle.

Cut back on salt, she advised, and go for high fibre low-fat natural nutrients. Keep blood pressure with normal ranges — levels over 140/90 contribute to two-thirds of strokes and half of heart disease cases.

Social interaction matters, too, she said. Staying in touch with children, family and friends and remaining engaged in life slows decline. Mentally effortful leisure activities lower the risk of dementia, she noted, advising people to read, play board games, play musical instruments and dance (good for mental and physical well-being).

Black noted exercise should be a lifelong habit, adding that exercise influences survival, even in old age. Before starting a program of physical exercise, she recommended having a check-up first.

Exercise should be vigorous to raise a sweat, she said. If possible, do 30 minutes, three times a week. And she added, you can never be too old to exercise.

Photo ©iStockphoto.com/Carmen Martínez Banús

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