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The BBC are reporting: Poor balance predicts Alzheimer's
Quote:
Problems with walking and balance may be the first sign of Alzheimer's disease, say US researchers.
A study of 2,288 elderly people found that such physical symptoms were associated with an increased risk of developing dementia.
Researchers from the University of Washington said they believed that exercise could help to stall the progression of the disease.
Their study appears in Archives of Internal Medicine.
Previous research has suggested that exercise may reduce the risk of Alzheimer's - possibly by boosting blood flow to the brain. Researchers monitored patients every two years for signs of physical and mental decline.
At the start of the study, none of the participants had any sign of dementia but after six years 319 individuals had developed dementia - 221 of them had Alzheimer's disease.
Those with good physical performance scores at the start of the investigation were three times less likely to develop dementia than those with poor scores.
The researchers assessed physical function using a variety of tests.
The first indicators of future dementia appeared to be problems with walking and balance. A weak hand grip was a later sign.
Study leader Dr Eric Larson said: "We were surprised to find that physical changes can precede declines in thinking.
"If confirmed, this study might also help explain the association of physical exercise with a reduced risk of dementia, suggesting that exercise, by improving and maintaining physical function, might benefit cognitive function through a connection between the two."
Exercise
A previous study by Dr Larson had shown that regular exercise reduced the risk of dementia and Alzheimer's disease by up to 40%.
He added: "Physical and mental performance may go hand in hand, and anything you can do to improve one is likely to improve the other."
Harriet Millward, deputy chief executive, Alzheimer's Research Trust said anything that helped to diagnose Alzheimer's at an early age would be useful.
"This is the first study relating dementia to physical function rather than intensity or regularity of exercise.
"It suggests that people who can't do some physical tasks as well may be at higher risk of developing dementia.
"It is too early to say whether some of the tests the researchers used, such as gait or handgrip, might be used to help diagnose Alzheimer's," she added.
Dr Susanne Sorensen, head of research at the Alzheimer's Society said: " "The studies findings are constant with the Alzheimer's Society's message that leading a healthy life may reduce your risk of developing dementia," she added."
Performance-Based Physical Function and Future Dementia in Older People
Li Wang, MS; Eric B. Larson, MD, MPH; James D. Bowen, MD; Gerald van elle, PhD
Background: The association of physical function with progression to dementia has not been well investigated.We aimed to determine whether physical function is associated with incident dementia and Alzheimer disease (AD).
Methods: We performed a prospective cohort study of 2288 persons 65 years and older without dementia. Patients were enrolled from 1994 to 1996 and followed up through October 2003. Main outcome measures included incident dementia and AD.
Results: During follow-up 319 participants developed dementia (221 had AD). The age-specific incidence rate of dementia was 53.1 per 1000 person-years for participants who scored lower on a performance-based physical function test at baseline (<10 points) compared with 17.4 per 1000 person-years for those who scored higher (>10 points). A 1-point lower performance-based physical function score was associated with an increased risk of dementia (hazard ratio, 1.08; 95% confidence interval, 1.03-1.13; P<.001), an ncreased risk of AD (hazard ratio, 1.06; 95% confidence interval, 1.01-1.12; P=.01), and an increased rate of decline in the Cognitive Ability Screening Instrument scores (0.11 point per year; 95% confidence interval, 0.08-0.14; P<.001) after adjusting for age, sex, years of education, baseline cognitive function, APOE ε4 allele, family history of AD, depression, coronary heart disease, and cerebrovascular disease.
Conclusions: Lower levels of physical performance were associated with an increased risk of dementia and AD. The study suggests that poor physical function may precede the onset of dementia and AD and higher levels of physical function may be associated with a delayed onset.
Arch Intern Med. 2006;166:1115-1120
__________________ Stephen Tucker Eastern Health
Podiatry Manager
There is also evidence that walking may prevent (or delay the onset of) cognitive impairment:
Arch Intern Med. 2001 Jul 23;161(14):1703-8.
A prospective study of physical activity and cognitive decline in elderly women: women who walk
Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K.
BACKGROUND: Several studies have suggested that physical activity is positively associated with cognitive function in elderly persons. Evidence about this association has been limited by the cross-sectional design of most studies and by the frequent lack of adjustment for potential confounding variables. We determined whether physical activity is associated with cognitive decline in a prospective study of older women. METHODS: We studied 5925 predominantly white community-dwelling women (aged > or =65 years) who were recruited at 4 clinical centers and were without baseline cognitive impairment or physical limitations. We measured cognitive performance using a modified Mini-Mental State Examination at baseline and 6 to 8 years later. Physical activity was measured by self-reported blocks (1 block approximately 160 m) walked per week and by total kilocalories (energy) expended per week in recreation, blocks walked, and stairs climbed. Cognitive decline was defined as a 3-point decline or greater on repeated modified Mini-Mental State Examination. RESULTS: Women with a greater physical activity level at baseline were less likely to experience cognitive
decline during the 6 to 8 years of follow-up: cognitive decline occurred in 17%, 18%, 22%, and 24% of those in the highest, third, second, and lowest quartile of blocks walked per week (P< .001 for trend). Almost identical results were obtained by quartile of total kilocalories expended per week. After adjustment for age, educational level, comorbid conditions, smoking status, estrogen use, and functional limitation, women in the highest quartile remained less likely than women in the lowest quartile to develop cognitive decline (for blocks walked: odds ratio, 0.66 [95% confidence interval, 0.54-0.82]; for total kilocalories: odds ratio, 0.74 [95% confidence interval, 0.60-0.90]). CONCLUSIONS: Women with higher levels of baseline physical activity were less likely to develop cognitive decline. This association was not explained by differences in baseline function or health status. This finding supports the hypothesis that physical activity prevents cognitive decline in older community-dwelling women.
__________________
Cheers,
Hylton
Hylton B. Menz, PhD
Associate Professor and Reader
NHMRC Australian Clinical Research Fellow
Director, Musculoskeletal Research Centre
La Trobe University
Poor balance predicts Alzheimer's
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