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Taking your brain for a walk: the secret to delaying dementia

Regular brisk walking three times a week increases the size of brain regions linked to planning and memory, a study has shown

Regular brisk walks can slow down the shrinking of the brain and the faltering mental skills that old age often brings, scientists say.

Studies on men and women aged 60 to 80 found that taking a short walk three times a week increased the size of brain regions linked to planning and memory over the course of a year.

The prefrontal cortex and hippocampus increased in size by only 2% or 3%, but that was enough to offset the steady shrinkage doctors expected to see over the same period.

“It may sound like a modest amount but that actually like reversing the age clock by about one to two years,” said Professor Kirk Erickson, a neuroscientist at the University of Pittsburgh.

“While the brain is shrinking, we actually saw not a levelling out but an increase in the size of these regions. It was better than before we started the study.”

People who took part in the study scored higher on spatial memory tests, and some reported feeling more mentally alert, according to Erickson. “They feel better, they feel as if the fog has lifted. Anecdotally, it seems to benefit these cognitive functions,” he said.

Erickson recruited more than 100 adults who confessed to doing little if any exercise in their daily lives. Half were randomly assigned to walk for 30 to 45 minutes three days a week. The rest spent a similar amount of time doing stretching exercises.

Medical scans showed minor increases in the two brain regions in both groups. But the effect was greater in the walkers, Erickson said at the annual meeting of the American Association for the Advancement of Science.

“With modest amounts of exercise, we were able to increase the size of these structures that typically deteriorate and precede the cognitive complaints that often come in late adulthood,” Erickson said.

“You dont need highly vigorous physical activity to see these effects. People are misled to believe they need years of vigorous physical exercise. But it only needs to be moderate, and not even for that long.

“The results suggest that brain and cognitive function of the older adults remain plastic and highly malleable. There is not this inevitable decline that we used to think it was.”

Scientists are unsure what changes in the brain underpin the increases in size of the two regions, or how long the improvements last. Exercise is unlikely to stave off the brain decline for long, but it could delay the inevitable decline and slow the onset of dementia.

There is a desperate need for any approach that could slow the rising epidemic of dementia. An estimated 44.4 million people now have dementia worldwide, and that number is expected to reach 75.6 million in 2030, according to figures from Alzheimer Disease International.

Erickson said: “The prefrontal cortex is involved in a lot of higher-level cognitive functions and the hippocampus is involved in memory formation. And when it shrinks, it leads to Alzheimer disease and dementias.

“If we measured these people for a long period of time, wed probably be slowing the decline rather than completely mitigating it. But it might slow it down for a long period of time. We cannot say it the magic-bullet cure for Alzheimer. There isnt one.”

Read more at: http://www.theguardian.com/society/2014/feb/17/brain-walk-delaying-dementia-memory

Some simple steps to preventing falls

  • Eat a healthy and balanced diet to maintain good bone health.
  • Too many medications increases the risk of falls. Some medicines can make you faint and unsteady.
  • Have your GP review your medication.
  • Assistive aids such as walking frames and perching stools can help maintain independence in activities of daily living.
  • Maintaining strength and flexibility is important. So keep moving. Light exercise will help.
  • Reducing physical activity can increase the risk of falls.
  • Poor vision can result in falls.
  • Have your eyes tested regularly.
  • Avoid alcohol (especially with medication) or cut down on the amount of alcohol consumed.
  • It is important to maintain strength, balance and coordination.
  • As well as increasing general fitness, balance training is one of the most proven and cost effective ways to reduce falls.
  • A trained physiotherapist specialising in this area can help you improve your balance.
  • Balance exercises can be made simple and enjoyable. Wear appropriate footwear.
  • Thin soled flat shoes are better for balance and walking. Keep your feet healthy. Foot problems can affect a person balance and stability.
  • Ask your chiropodist for advice and have regular foot check-ups.Check your home environment for hazards, particularly trip hazards such as loose carpets, mats and trailing cords.
  • Ensure that the stairs and landing have good lighting and fit stair rails or grab rails where required and use them when going up and down the stairs.
  • Think about how you can rearrange furniture to improve access. Keep stairs and corridors free of clutter.
  • Giving pets bright coloured collars will make them easily noticeable. Non-slip mats and rugs in bathrooms and kitchens provide safer access.
  • Consider using a bath board fitted across the bath instead of stepping into the bath. Well placed hand rails also help getting in and out of the bath easier and safer.
  • If you have a high step into your property consider installing a hand rail next to the door and a half step to make access easier.
  • Keep porches and garden pathways clear of grass, moss and other clutter.

The small things that make the big difference:

  • Try not to sit in one position for too long as you may get stiff.
  • Keep changing positions and tense and relax your arms and legs a few times in between.
  • Try to maintain good posture and ensure that your back is well supported when seated.
  • If you feel faint when you stand up (this may be due to your blood pressure suddenly dropping) ensure you take your time when you move and avoid sitting up or standing up too quickly. This is especially important at night as you could be disoriented. Sit up on the edge of the bed for a few seconds before standing up and also stand for a few seconds before you start walking. If you have to use the toilet several times at night due to medication, think about alternatives such as a commode next to your bedside.
  • Ensure there is adequate night lighting in the bedroom and corridors. Always feel the chair or bed behind both legs before you sit down. This will ensure that you are square with the chair or bed and prevent you from sitting on the floor. This is one of the reasons why elderly people fall. If you have difficulty getting up from a low chair, have the chair raised. Shuffling forward to the edge of the chair and leaning forward while pushing down on the arms of the chair will help you from leaning backwards or over balancing.
  • If you use a walking aid, ensure you use it correctly. Erratic use of walking aids increase the risk of falls.
  • If you have difficulty carrying things with you while walking indoors, use a kitchen trolley with brakes to transport food or other heavier objects. Outdoor walkers may also be used, but always try them first before you purchase one.
  • It better to get a family member or employ someone for tasks like changing light bulbs and cleaning high windows and blinds if you feel unsteady on your feet.

If you have a fall at home:

Do not panic, stay calm and focused. If you are unhurt and feel you can get up, ease yourself onto your elbows. Then move onto your hands and feet and hold onto a firm surface such as a chair to support yourself. Then facing the chair ease yourself to a standing position, turn yourself gently and sit on the chair.

If you feel you are hurt and cannot get up, shout for help or bang on the wall with your stick or shoe. Use your pendant alarm if you have one or crawl to a telephone and call for help. If you fall on a hard floor, try to move to a carpeted area. Reach for something (like a blanket or coat) to cover you. Find a nearby pillow or roll up some clothes to use as one. Try to move away from draughts and from direct heat like fires and radiators. Keep moving, roll from side to side and move your arms and legs and avoid staying in one position while you are waiting to be helped.

Always tell your GP or carer about your fall. Many falls are not reported by older people or their caregivers due to the misconception that falls are inevitable with old age, which is not the case. Often, older people themselves are unaware of their risks of falling, nor do they report the presence of risk factors to others who might be able to help. Falls can be prevented or the risk minimized if the reason behind a person falls can be identified. This can be accomplished by a thorough and comprehensive assessment and the development of an individualized plan of intervention, support and education.

Falls is a complex area as there is often not one reason that may cause a person to fall and the reasons may range from a simple trip on a loose mat to the more serious cardiac problems.

There is good research evidence which shows the effectiveness of different interventions to reduce the risk and impact of falls amongst older people.

Evidence shows that a multifactorial intervention which incorporates exercises designed to improve strength and balance and safety changes at home can lead to a reduction in falls.

The author is a rehabilitation expert at Falls Assist UK.

Falls Assist UK has a growing network of highly qualified health professionals that employ a variety of tools to perform a multifactorial comprehensive assessment and provide a proven programme that helps to reduce the risk of falls.

www.fallsassist.com