Exercise as a therapy for preventing cognitive decline

Summary: The recent paradigm for the treatment of cognitive impairment has shifted to non pharmacological interventions such as exercise.  Some results published recently have shown a positive role of exercise in preventing cognitive decline. The common message of all these studies involving different population and different cultures is that exercise is beneficial in preventing the cognitive decline. In the future,  evidence based exercise therapy can be introduced  by developing a thorough systematic exercise protocol  and integrating it with molecular profiling of the underlying cellular and molecular changes induced by the exercise protocol.   

Cognitive impairment is one of the major public health problem faced by the modern society affecting primarily the elderly population. It can have many possible causes such as metabolic and endocrine dysfunction, medicinal side effects, depression and Alzheimer’s disease. While there are some medications that are used as cognitive enhancers, no known medication that could prevent or treat the cognitive decline have been developed yet.  Developing a drug that could prevent or treat cognitive decline is a challenging prospect. Therefore, more efforts have been put into conventional or non pharmacological interventions such as diet and exercise. Assessing the current studies, the results are encouraging and in the near future we could be up for some type of exercise therapy for the prevention/treatment of cognitive impairment. Here, I am trying to summarize some of the studies related to exercise and cognition published in 2017. The common message of all these studies involving different population and cultures is that exercise is beneficial in preventing cognitive decline.

A systematic review published in the British Journal of Sports Medicine showed that physical exercise improves cognitive function in the elderly. This meta analyses took into the account 39 different studies till November 2016.  The study looked into several different types  of aerobic exercise, such as resistance training , multicomponent training and tai chi (Chinese martial art),  and found that moderate intensity aerobic exercise decreases the cognitive decline in patients older than 50 years irrespective of their cognitive status.

Similar result was obtained in another study published by Piedra et al. in the Journal of Alzheimer’s Disease. The study investigated the effects of exercise intervention on cognitive function in the elderly latinos/hispanic population (older than 60 years). The participants were examined for their cognitive function(baseline) before initiating the exercise intervention program.  Then, following the exercise intervention program, the cognitive function was again measured after 1 year and 2 year periods.   The results showed that participants involved in the exercise intervention program had higher cognitive function scores after 1 year and 2 year follow ups as compared to their initial baseline scores.

Not only is exercise beneficial to the elderly people. It is also beneficial to the adults of any age suffering from chronic diseases. The study published by Cai et al. in Clinical Interventions in Aging have found that exercise is beneficial in preventing the cognitive decline in the adults (older than 18 years) with chronic disease. This metaanalyses and systematic review took into account 36 different studies till September 2016. The studied participants were diagnosed with chronic diseases such as arthritis, asthma, cancer, COPD, diabetes, heart disease, or AIDS. This study found that exercise is beneficial in improving the cognitive function of patient suffering from chronic disease irrespective of  the type of clinical disease, type of exercise, frequency, and intensity of the exercise intervention.

These are some of the recently published studies related to exercise and cognition in 2017. The results of these studies clearly showed that exercise could potentially act as a non pharmacological therapy in preventing cognitive decline.  However, development of a systematic exercise protocol supported by molecular profiling of underlying exercise induced changes could be of immense help in establishing evidence based exercise therapy. 

Particularly,in regards to exercise, the rule of thumb is any amount of physical activity is beneficial and as the above studies suggest, it is beneficial to prevent/slow the cognitive decline as well.


Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2017 Apr 24. pii: bjsports-2016-096587. doi: 10.1136/bjsports-2016-096587. [Epub ahead of print] Review.

Piedra LM, Andrade FC, Hernandez R, Boughton SW, Trejo L, Sarkisian CA. The Influence of Exercise on Cognitive Function in Older Hispanic/Latino Adults: Results From the “¡Caminemos!” Study. Gerontologist. 2017 Mar 15. doi: 10.1093/geront/gnw256. [Epub ahead of print] 

Cai H, Li G, Hua S, Liu Y, Chen L. Effect of exercise on cognitive function in chronic disease patients: a meta-analysis and systematic review of randomized controlled trials.Clin Interv Aging. 2017 May 11;12:773-783. doi: 10.2147/CIA.S135700. eCollection 2017. Review.

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Exercise increases academic performance in children

Throughout the human history, physical activity has been the mainstay for the survival of mankind. But with the emergence of new technologies, there is sudden change in the lifestyle leading human to embrace a sedentary life style and forget the principal component of evolution. Paradoxically, with the increase in research in this area, the relevance of physical activity has become even important today irrespective of the age and moreover for the children as it impacts their academic life.

If the result of research published in the British Journal of Sports Medicine is to be believed, exercise helps in improving the academic performance of children, specifically the girls.The more intensive the exercise, the greater was the influence on the test results.

The study test the relationship between physical activity and academic performance in adolescents. Physical activity of 4755 children were analyzed objectively by accelerometer when there were 11 years. Then the academic performance of these children was measured at 11 and was followed up at 13 years and 16 years.

Results showed an increase in performance in English in both sexed and increase in the performance of science in female only. Going by the results, female students benefit more from exercise than their male peers.

In brief, this study showed a long term positive impact of physical activity in the academic performance of children.

There are also a lot of other researches that are focused on exercise and academic performance. Barring a few, most of these researches have shown a positive influence of physical activity in the academic performance of children.
The increase in academic performance as a result of physical activity is also well supported by brain research done in animals. Increase in synaptic plasticity proteins is well documented in animal brain following physical activity or exercise. Increase in these synaptic plasticity proteins specifically in hippocampus is crucial for learning and memory.

To sum up, physical activity should be encouraged in schools and care should be taken that children are familiar not only with modern day gadgets, but also with the importance of physical activity that was the prime driver of human evolution.

Booth JN,Leary SD, Joinson C, et al.Br J Sports Med 2014;48:265–270

Picture source: http://www.clemson.edu/extension/hgic/graphics/4032/activities_kids.gif

Note: Some of the views expressed here are not related to the reference article.

Aerobic training might be an answer to alzheimer’s disease(AD)


Picture taken from http://guardianlv.com/

Alzheimer’s disease(AD) is a neurodegenerative disease responsible for most cases of dementia in elderly population. A lot of trials with drugs are ongoing in order to find the prevention and cure of AD. But recent research have shown life style modification and behavioral changes to be as effective as drugs in the prevention of AD.

A study published in the journal of gerontology has shown 6 months of aerobic exercise effective in reducing the symptoms of AD in the elderly population.

This study used 6-month cycling intervention to older adults of a selected community with mild-to-moderate AD. The exercise was a standardized, supervised, and individualized, moderate intensity cycling for 15 to 45 min a session (excluding 10-min warm-up and 10-min cool-down activities), 3 times a week for 6 months.

The outcomes of this training regimen were evaluated by measuring the cognition, ADL(Activities of daily living), BPSD(Behavioral and psychological symptoms of dementia) and caregiver distress at the end of the experiment.

The data was collected from older adults with mild to moderate AD and they were followed up for 6 months. The results showed neither significant cognitive decline nor deterioration of the neuropsychiatric symptoms during the 6 month period. Also, aerobic exercise significantly reduced the stress in the caregivers.

There are other papers which have shown the benefit of exercise in neuropsychiatric as well as neurological disorders. Nevertheless, every research paper has its own limitations. But this finding that showed the effectiveness of exercise in preventing the progression of AD is very encouraging. Although, more detailed and precise research need to be done, opening of sports center for the elderly people to engage them in mild-moderate intensity aerobic exercise might be a good idea. Like they say prevention is better than cure, these type of sports center for elderly people might help in preventing AD, thus preventing the social as well and economic burden in the future.

For more details, see the reference article below:

Impact of 6-Month Aerobic Exercise on Alzheimer’s Symptoms                                     Fang Yu, William Thomas, Nathaniel W. Nelson, Ulf G. Bronas, Maurice Dysken,and Jean F. Wyman, Journal of Applied Gerontology published online 11 December 2013,DOI: 10.1177/0733464813512895


Active Brain and Brain Exercise

A brain is called an active brain when it is involved in the activities that fire or stimulates the neurons. Active brain, also called busy brain is a state of brain in which the neurons are firing continuously or are involved in the activities that fire or stimulate neurons. The main key to active brain is that neurons should be stimulated continuously so that they become habituated to stimulation once the necessity arises. It can be achieved through physical exercise or mental exercise. Mental exercise can also be called brain exercise. Based on the mechanism, brain exercise can be classified into two types:

  • Direct: Brain exercise that directly engages the neurons. For example: mental stimulating games, chess, Sudoku.
  • Indirect: Indirect brain exercise involves physical activity that does not directly engage the neurons. For example jogging, running.

Chess, a good mental exercise

Some games like football, basketball or cricket which requires strategic thinking and planning have direct as well as indirect effects in making the brain active.

Advantages of active brain and brain exercise:

Like we need to do weightlifting regularly if we want to build our triceps and biceps and run regularly to be a sprinter or marathon runner, to be a mental athlete, we need to exercise the brain regularly. Brain exercise has similar effect to our brain as the weightlifting have to our muscles.

Dementia is a collective symptom for the decrease in cognitive capacity. It involves memory loss, poor judgement, challenges in planning or solving problems. Exercising the brain regularly can halt or slow the progress of dementia. It increases the cognitive reserve in the elderly population.

Aging is a physiological process that affects each cell and organ of our body. Every organ tend to slow down with aging and so as our brain and the neurons. The normal brain aging can be further worsened by deposition of deposition of harmful substances leading to brain disease. Memory loss is the most common problem encountered during aging. The problem is neurons are less active or the brain is less active during old age. In a sense, then tend to become lazy and do not fire when needed. These lazy neurons must be activated or we should try to maintain the active neurons. This is possible only through active brain and brain exercise is the key to active brain. If you experience the memory loss, then you need to counteract the memory loss by activating your neurons through memorization of your day-to-day activities at the end of the day. If you make the habit of memorizing, then that will provide your neurons the necessary stimulus to become activated and helps you in halting or stopping memory loss.

Here are some simple tips for making your brain active:

  • Memorizing daily activities at the end of day before sleep.
  • Playing board games like chess, tiger moving.
  • Solving puzzles, crosswords and playing Sudoku.
  • Involving oneself in intellectual activities in society like debate and quiz.
  • Learning new language.
  • Make the habit of reading books.
  • Try to make the habit of critical thinking, multidimensional way of observing things.

There are a lot of ways of making the active brain. The key to the active brain is engaging yourself in the activities that are brain storming. Besides, don’t forget about the diet and exercise. These are equally important for active brain and healthier brain. To sum up, brain exercise is a simple and cost-effective way of achieving brain health. The key to brain exercise is active brain and active body.

Exercise as a treatment for depression

Depression is hugely prevalent in current society irrespective of country, religion,class and society. There are around 121 million people affected by depression worldwide. Several antidepressants drugs and behavioral therapy are available for its treatment. But the recent focus has been more on alternative therapies like exercise, which is shown to be beneficial in people with depression.

Exercise Vs Depression(Source: http://www.hivehealthmedia.com)

Exercise does not provide the best therapy to the person fulfilling the criteria of depression. But it can be recommended, given that it provides moderate effect in improving the depressive symptoms.A study in humans since 1981 has showed that regular exercise helps in improving the mood of people with mild to moderate depression. Improvement of mood is also quite useful in person with severe depression.

Comparing exercise with cognitive therapy or antidepressants, researches have not shown any significant difference between each mode of therapy in the depressive illness. But the effect of exercise is shown to last longer than the effect with antidepressants. In light of these findings, it seems exercise is of help. But the optimum type, frequency and duration of exercise, whether it should be performed supervised or unsupervised, indoors or outdoors, or in a group or alone is yet to be determined.

However some studies are published which have experimented several exercise regimen and are found useful. One of them is : For an average 68 kg person, some research has shown running 60 minutes a day for 3 days in a week or walking fast 35 minutes a day for 5 days in a week can improve the mild to moderate depressive symptoms.




Exercise for brain

Its a common problem in old age that we tend to forget different things. Amnesia, as its commonly called for forgetting things can be physiological(normal) or pathological(abnormal). Human cells are mortal, so are neurons. As we age, several unwanted chemicals tend to accumulate in our brain causing loss of neurons, or loss of connectivity between neurons. This is responsible for the memory loss and other cognitive problems that arises with old age

Many research have been done to halt the loss of neurons in old age.Several cognitive enhancers are available in the markets which boast their effectiveness. While the research for the drugs to cure this cognitive decline is being carried, several conventional methods are also being tried. Exercise being one of them.

Stretching Out

Stretching Out (Photo credit: Tyne & Wear Archives & Museums)

There are many different results of exercise and brain research coming recently. The common result of all these research is that exercise definitely helps in maintaining your brain health. Exercise releases various growth factors from our body that are necessary for neuronal growth and development. Also it increases the blood flow to the brain, causing more transport of these growth factors to the brain for the neuronal development.

There are many studies studying different type of exercise and their effect in different aspect of brain functions. I want to suggest that don´t run after the discussions. As for me,every type of exercise is beneficial for brain, be it aerobic, anaerobic or strength training. So don´t shy away from exercise. But most studies have shown aerobic exercise in the form of walking and swimming to be more beneficial for brain. For those who exercise for the brain, walking is a better exercise than swimming. The contact between your leg and the ground while walking helps in release of a specific growth factor called VEGF that is one of the main player in maintaining the brain health.

And doing exercise in a natural environment rather than inside the sports hall is important for your brain. So jogging for some 30 minutes around your home daily might be helpful in maintaining your brain health and preventing the cognitive decline.

Go for it guys and all the best.