Monday, February 17, 2020

Ideas to help prevent Dementia Physical Activity

As I indicated yesterday, dementia is a serious problem and there are many risk factors for dementia, some are under our control and some are not. However, the existence of potentially modifiable risk factors means that prevention of dementia is possible through a public health approach, including the implementation of key interventions that delay or slow cognitive decline or dementia.

Risk factors for dementia, that are out of our control include age, gender, race/ethnicity and family history.  It is important to note that while age is the strongest known risk factor for cognitive decline, dementia is not a natural or inevitable consequence of ageing.

During the last two decades, several studies have shown a relationship between the development of cognitive impairment and dementia with educational attainment, and lifestyle-related risk factors. These lifestyle risk factors are those we can control. These lifestyles choices are associated with an increased risk of developing dementia, physical inactivity, tobacco use, unhealthy diets and harmful use of alcohol.

In addition to the lifestyle choices certain medical conditions are associated with an increased risk of developing dementia, including hypertension, diabetes, hypercholesterolemia, obesity and depression.

Other areas that may cause an increase risk of dementia includes social isolation and cognitive inactivity. Over time I will look at all of the factors involved that we can control.

Seniors need according to the research about 150 minutes a week of physical activity or about 30 minutes a day, to stay healthy. Studies have linked a physically active lifestyle to good brain health. In large observational studies with follow-up periods extending decades, physically active people seem less likely to develop cognitive decline, all-cause dementia, vascular dementia and Alzheimer's disease when compared with inactive people. Especially, the highest levels of physical exercise seem to be most protective. Physical activity seems to have beneficial effects on brain structures, which may underlie this association.

Being physically active has a positive effect on other modifiable cardiovascular risk factors, such as hypertension, insulin resistance and high cholesterol levels. As well some other positive effects of exercise are enhancing the immune system function, anti-inflammatory properties.

Physical activity for adults 65 years and above, include recreational or leisure-time physical activity, transportation (e.g. walking or cycling), occupational (if the person is still engaged in work), household chores, play, games, sports or planned exercise, in the context of daily, family, and community activities. In order to improve muscular fitness, bone and functional health, and reduce the risk of depression and cognitive decline, the following guidelines are recommended by the World Health Organization (always check with your doctor before beginning or changing your exercise regime):

If you are aged 65 years and above you should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week.

If you can not find 150 minutes a week then you could also do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity. Aerobic activity should be performed in bouts of at least 10 minutes’ duration.

For additional health benefits, you might consider increasing your moderate-intensity aerobic physical activity to 300 minutes per week, or engage in 150 minutes of vigorous-intensity aerobic physical activity per week, or an equivalent combination of moderate- and vigorous-intensity activity.

If you have poor mobility you should consider physical activity to enhance balance and prevent falls on 3 or more days per week.

Muscle-strengthening activities should be done involving major muscle groups, on 2 or more days per week.

If you cannot do the recommended amounts of physical activity due to health conditions, you should be as physically active as your abilities and conditions allow.

Overall the benefits of implementing the above recommendations, and of being physically active, outweigh the harms. At the recommended level of 150 minutes per week of moderate-intensity activity, musculoskeletal injury rates appear to be uncommon.

If you are thinking about changing your exercise regime, check with your doctor, but it would be appropriate to start slowly and use gradual progress to move to the higher levels of physical activity.

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