Does Exercise Aid Brain Health?

The Debate’s Yet to be Decided

Published in Woonsocket Call on August 31, 2016

According to AARP’s latest health aging survey findings, age 40 and over respondents who regularly exercise rate their brain health significantly higher than non-exercisers. They also cite improvements in their memory, ability to: learn new things, managing stress, and even making decisions. On the other hand, the findings reveal an overwhelming majority of these respondents see the benefits of exercise, but only 34 percent are meeting the Global Council on Brain Health’s (GCBH) recommended 150 minutes of moderate to vigorous exercise per week.

These findings in the 37 page Survey on Physical Activity report, conducted by GfK for AARP, directly align with AARP’s Staying Sharp program, a digital platform that promotes brain health though holistic advice supported by science.

“With Staying Sharp, we sought to empower consumers with the tools needed to create a holistically brain healthy environment for themselves—along with a way to track and measure their progress,” said Craig Fontenot, VP of Value Creation. “The results of this survey only further validate the advice suggested on the platform and give us confidence that we’re providing our members with helpful, impactful information.”

The AARP survey findings, released on July 26, found that more than half (56 percent) of the age 40 and over respondents say that they get some form of exercise each week. However, only about a third (34 percent) of these individuals actually achieve the recommended 2 ½ hours of moderate to vigorous activity each week. There was little difference in reported amounts of exercise by age or gender.

The AARP online survey, with a represented sample of 1,530 Americans age 40 and over, found that walking is the most common form of physical exercise reported with 53 percent of the age 40 and respondents saying that they walk for exercise. A smaller percentage is engaging in more vigorous activity such as strength training/weight training (15 percent) or running/jogging (8 percent).

According to the survey’s findings, most of the age 40 and over respondents see the benefits to engaging in physical activity and do not find it particularly unpleasant or difficult. For example, three quarters believe exercise would improve their health, physical fitness, and quality of life.

Having willpower, enjoying exercise, identification as an “exerciser,” lack of enjoyment and feeling like you have the energy to exercise or lack money to exercise are the key factors that differentiate exercisers from non-exercisers, the researchers say.

The study found that the largest share of non-exercisers are “contemplators” in that they see the benefits and are considering taking up exercise (34 percent). About one-quarter (24 percent) are considered “non-believers” and see no need for exercise and were satisfied being sedentary. However, two in ten (19 percent) are “preparers” and say they have a firm plan to begin exercising in the near future.

Finally, the most common leisure activity that age 40 and over respondents would give up if they were to engage in exercise is watching TV/streaming movies (65%).

Removing the Barriers to Exercise

Colin Milner, CEO at the Vancouver, BC-based International Council on Active Aging, says, “These findings demonstrates the amazing and ongoing benefits of regular exercise. Our challenge, to get more people to actually move. By doing so the country and millions of individuals would improve their physical and mental health,” he notes.

Adds Milner, “The most important thing is to remember is that our bodies and brains were meant to be used. If we fail to do so they will cease to perform at the level we need or desire, and that is detrimental to our overall health and well-being.”

“Part of our challenge [to not exercising] is to remove the barriers that prevent us from leading an engaged life. A recommendation would be to list out the reasons you are not exercising or eating well, why you are feeling stressed or are not socially engaged, then set out to replace these with reasons to exercise and eat well, to be stress free and socially engaged. Once you have done this consider what steps you need to take to make this a reality,” he says. ICAA’s Webpage, “Welcome Back to Fitness” (http://icaa.cc/welcomeback.htm) gives the basics to help people begin exercising.

An avid squash player, Richard W. Besdine, MD, Professor of Medicine and Brown University’s Director, Division of Geriatrics and Palliative Medicine, preaches the importance of physical activity to all his colleagues and friends. “There are a large number of research studies documenting that exercise is good for all organs in your body,” he says, adding that that regular exercise can also reduce cancer rates, control diabetes, improve one’s emotional health and even reduce depression.

When asked about AARP’s survey findings about the impact of exercise and brain health, Besdine says he applauds the survey’s objectives of examining the relationship between physical exercise and brain health, but its findings are self-reported at best, not empirically derived.

Besdine points out that there is a growing body of studies that empirically study the relationship between exercise and brain health and findings indicate a positive impact on brain functioning. People who exercise are less likely to be cognitively impaired and those who are mildly impaired may even slow or stop the progression of their mental disorder, he says.

“Although AARP’s survey is very interesting it is very limited because it is self-report and cross-sectional, says Deborah Blacker, MD, ScD, Director of the Gerontology Research Unit at Massachusetts General Hospital who is also a Professor of Psychiatry at Harvard Medical School.

AlzRisk, part of the AlzForum, a website that reports the latest scientific findings on the advancement of diagnostics and treatments for Alzheimer’s disease, posts a scientific review of 16 scientific articles reporting on the relationship of exercise habits to the later development of Alzheimer’s disease. Blacker, AlzRisk’s leader, says that this more solid body of evidence suggests that exercise may play a modest role in protecting a person from Alzheimer’s disease, but further scientific research is required.

Like Besdine, Blacker still sees the positive benefits of exercise even if the scientific data is still coming in. “We know that physical exercise is good for preventing cardiovascular disease and diabetes. If it may also help to prevent cognitive decline, for me that is an even better reason to exercise,” she says.

The Bottom Line

“Staying physically active is one of the best things that someone can do for their physical health and mental health. Physical activity can help you lose weight, lower your blood pressure, prevent depression, and, especially for older adults, promote memory and help you think clearly,” said Nicole Alexander-Scott, MD, MPH, Director of the Rhode Island Department of Health. “We are working hard to make sure that people from every zip code throughout Rhode Island have access to our state’s wonderful parks, beaches, and other natural resources and are getting the amount of physical activity they need to live long, full, productive lives.”

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The Best of…Experts: Eat Less, Exercise

             Published January 2007, Senior Digest

            As we begin the New Year, many people launch promises through New Year’s resolutions or take this time to reflect on overall better lifestyle improvements.    State aging and health care experts say that if your goal is to live longer, consider squeezing in time to enhance your fitness and health through ongoing exercise and better eating.

           Phillip G. Clark, ScD, Professor and Director Program in Gerontology and Rhode Island Geriatric Education Center, notes that exercise is key to living a healthier life.  “Use it or lose it,” he tells Senior Digest.   If older adults don’t continue to use their capabilities, whether physical or mental, they may eventually lose those abilities. So, it is important for aging baby boomers and seniors to continue to be as active as they can, within the limits of any impairments or health problems they may have.

           Before beginning any program always check with your doctor to be sure it is okay. “Your doctor will advise you on other special conditions or limitations you may need to address in developing your own program,” Dr. Clark says.

Exercise, the Best Pill

          Dr. Clark believes that exercise is the “best pill,” Regular exercise for older adults are linked to all sorts of positive physical and mental health outcomes and advantages, he says.  People just feel better physically and mentally especially if they exercise properly on a regular basis.

          The University of Rhode Island (URI) gerontologist compares physical activity to a savings account.  Dr. Clark says, “If you ‘put’ deposits into your exercise savings on a regular basis, you can ‘draw’ on these when you are sick or have to hospitalized to help minimize the impact of any setback on your functioning.”  

          To exercise, costly weight machines and bikes are not necessary, Clark says.  “Keep it simple,” Dr. Clark recommends.  “For many older adults, just walking regularly can have a number of positive benefits. In the winter when the weather is bad, some folks walk around inside their local senior housing building or at the mall,” he says.

             Deb Riebe, PhD., a Professor in URI’s Department to Kinesiology, says that research has found resistance training is another viable option for aging baby boomers and seniors to consider staying fit.  .

 Consider Resistance Training and Balance Exercises

             The URI exercise physiologist notes that muscle strength peaks at age 30 for most people.  After age 50, there is a real decline in muscle strength.  By your 60s or 70s, if you don’t exercise or participate in a resistance training program it will become more difficult to perform simple activities of daily living, like carrying the vacuum cleaner or groceries, says Riebe.

             Strengthening your muscles can be done simply by lifting small hand weights that can purchased in local stores, adds Riebe, noting that you can use your own body weight to strengthen your muscles in your legs by sitting in your dining room and than standing up.  Perform this simple resistance training exercise 10 times.

             “Balance exercises are also very good to prevent a person from falling.  “A good example of a balance exercise is to stand up on one leg using a chair for support,” she says.  

             Don’t use lack of time as a reason to not exercise, warns Riebe.  “Fit 30 or 40 minutes of exercise into your daily routine.  But for those who chose not to you can always park your car far away from a store and walk a little longer distance.  Or you do a few exercises during a television commercial, “combining leisure with a quick work out,” she says.

              Even when socializing with friends or family, Riebe recommends going out and taking a walk around the neighborhood.  “Everyone will benefit,” she says… 

               Anne Marie Connolly, MS, Director of Rhode Island’s Get Fit Rhode Island, Program, oversees Governor Donald Carcieri’s worksite wellness initiative for state employees.  Programs like Rhode Island’s are being launched nationwide by the mandate of state health commissioners and insurance companies attempting to reel in spiraling health care costs. 

               To improve health behavior, brochures, on site lectures (controlling stress and high blood pressure) and behavior change classes (physical exercise and smoking cessation) are aimed at the 20,000 state workers, whose average age is 47 years old.

 Good Nutrition Important, Too

              Connolly, a professor and research associate at URI’s Kinesiology Department stresses the importance that nutrition plays in maintaining one’s good health.  “Research tells us that people should eat smaller portions, increase their fruit and vegetable and decrease fat, high calorie foods and sweets from their diet,” she recommends.

              For persons with high blood pressure, heart disease or diabetes, consider asking your physician for a consult to see a nutritionist.  Connolly notes that this visit is covered by most of health insurance companies.  “A change in your diet can make significant improvements in many chronic conditions.” 

              Connolly observes that some people don’t buy vegetables and fruits because of cost.  “Look around for supermarkets that offer smaller packaging or portions of vegetables and fruits. Salad and fruit bars enable a person to buy to portion or quantity they need,”: she says.  Even in senior housing, you can work with others to buy cheaply.  Split a head of lettuce with a neighbor. Create a schedule to rotate the purchasing of fruits and vegetables, too.   

              As to exercise, Connolly suggests people start off slowly, more important find an exercise that you will like to do.  As a consultant to Club Med, she came to believe that exercise should be fun and not a chore.  “Look back and see what you did when you were younger,” Connolly adds.  “One woman who took tap dancing in her younger years picked it up again.  It does not have to have to be the same intensity as when you were younger.”   

              For persons with arthritis, try going to a local senior center or YMCA and enroll in exercise programs specifically designed for that chronic condition.  “Water exercise is extremely wonderful for people with arthritis,” she says.

               Connolly notes that some Medicare providers even give special discounts for senior citizens who join health care club chains, costing the older person just $10.00 per month.  Check out your Medicare health care plan’s benefits to see if you are eligible to participate.

              Experts agree that the exercise benefits both young and old. “What is remarkable about the human body, people of all ages respond to physical exercise in the same way,” Connolly says.  .

               Herb Weiss is a Pawtucket-based writer whose articles on health, medical and aging issue.  This article was published in January 2007 in Senior Digest. He can be reached at hweissri@aol.com.

Loneliness Can Be Hazardous to Your Health, Even Lead to Untimely Death

            Published July 13, 2012, Pawtucket Times

“One is the loneliest number that you’ll ever do
Two can be as bad as one
It’s the loneliest number since the number one”

             Three Dog Night’s well-know lyrics on its first gold record may well mirror research findings of a study published last month in the Archives of Internal Medicine by University of California- San Francisco geriatricians.  That is, older persons can be lonely without really being alone because of lack of emotional connect, the feelings of emptiness or desolation being linked to serious health problems and even death.

             The UCSF geriatricians lead by Carla Perissinotto, MD, MHS, analyzed data in the Health and Retirement Study, a nationally representative study by the National Institute on Aging conducted on 1,604 older adults between 2002 and 2008. Researchers limited their analysis to participants 60 and older and the mean age being 71 years.

             Perissinotto notes in her study that it was one of the first studies to examine the relationship between loneliness and functional decline and death.

             “In our typical medical model, we don’t think of subjective feelings as affecting health,” said Dr. Perissinotto, an assistant professor in the UCSF Division of Geriatrics. “It’s intriguing to find that loneliness is independently associated with an increased rate of death and functional decline.”

 Lonely in Relationships

             UCSF researchers say that one of the more surprising findings of the team’s analysis is that loneliness does not necessarily correlate with living alone. The study found 43 percent of surveyed older adults felt lonely, yet only 18 percent lived alone.  

             “We are interested in identifying the different factors that cause adults to become functionally impaired and ultimately at risk for nursing home admission,” Dr. Perissinotto. “The aging of our population and the greater odds of institutionalization make it important for us to think about all the factors that are putting elders in danger, including social and environmental risks,” she noted.

             Researchers at UCSF focused on death and a decrease in the ability to perform daily activities such as upper extremity tasks, climbing stairs, and walking. People who identified themselves as lonely had a statistically significant 59 percent greater risk of decline. For death, 45 percent were at greater risk of death.

             “This is one of those outcomes you don’t want to see because it was terrible to find out it was actually true,” Dr. Perissinotto said. “We went into the analysis thinking that there was a risk we could find nothing, but there actually was a strong correlation.”

            The UCSF Research team believes the impact of loneliness on an elderly patient is different from the effects of depression. While depression is linked with a lack enjoyment, energy and motivation, loneliness can be felt in people who are fully functional but feel empty or desolate.

             The “baby boomer” generation – those born between 1946 and 1964 – represents the largest population growth inU.S.history. Some of them now are part of the 39.6 million population of people older than 65. That number is expected to more than double to 88.5 million by 2050.  As that population continues to expand, Dr. Perissinotto said she hopes to be able to start to integrate social and medical services for elderly patients more comprehensively, and be more mindful of what kinds of social interventions they require.

             Physicians “asking about chronic diseases is not enough,” she said. “There’s much more going on in people’s homes and their communities that is affecting their health. If we don’t ask about it, we are missing a very important and independent risk factor, she says. “We don’t think we can change genetics, but we can intervene when someone is lonely and help prevent some functional decline.” 

             That’s what 85-year-old jazz singer Barbara Dane is trying to avoid as she continues to entertain in theEastBaywell into her 80s.  “When your spouse dies, there’s a missing space in your heart,” says the widow. “You still want to know that someone cares about you. Connection to other people becomes even more important at this point in your life.”

               Dane, who has performed for over 70 years, credits her active social life to her positive outlook on life. She adds, “A lot of people around me are aging, and some are not doing so well,” she said. “Some who never developed social skills are having the hardest time and those are the ones we need to watch out for.”

 Everything is Interconnected

            Phillip Clark, ScD, Professor and Director, Program in Gerontology and Rhode Island Geriatric Education Center, says that these findings are consistent with what gerontologists have been saying for years; namely, that the experience of aging can only be understood by taking into account its physical, social, and psychological dimensions, because they are all interconnected with each other. “When we get older, we find that different parts of our lives and our health are increasingly related to each other,” he says.

             Dr. Clark states, “Although this recent study does distinguish between the research literature on social support and its specific results on loneliness, certainly the two areas share a common insight: that the psychosocial context of aging can either enhance or undermine our health as we get older.”  For instance, having one close friend—a confidante—as we get older can help buffer us from some of the negative effects of the losses often associated with aging. Just one person with whom we can share our joys and sorrows can make all the difference, he adds.

             The implications of this study are clear to Dr. Clark.  Professionals [including physicians] who work with older adults must be attuned to the psychosocial contexts of older adults and ask questions about how they are feeling, not just physically but also mentally.

             Dr. Clark believes it is not normal that we become depressed or lonely as we get older, and things can be done to address these problems so that older adults have a rewarding and healthy later life.

             Herb Weiss is a Pawtucket-based freelance writer who covers aging, health care and medical issues.  He can be reached at hweissri@aol.com.  This Commentary appeared in July 13, 2012 issue of the Pawtuckt Times.