It is commonly known that exercise provides physical benefits. For Alzheimer's patients, exercise may provide mental benefits as well. An exercise program for Alzheimer's patients should be aimed at not just preventing physical and mental decline, but increasing overall function. New research suggests that through exercise, Alzheimer's patients may be able to learn faster and better than their sedentary counterparts.
The Facts
According to Dr. Carl W. Cotman of the University of California Irvine School of Medicine, while oxidative damage increases with aging, there is a tremendous increase in oxidative damage in Alzheimer's patients. The brain uses oxygen to make energy. However, in this process, there is a byproduct known as oxidative damage that injures cells and causes dysfunction. Dr. Cotman compares oxidative damage in the brain to molecular rust. It is this process that causes the symptoms of Alzheimer's disease including memory loss, personality and behavioral changes, disorientation, language problems and poor judgment. Fortunately, there may be a way to combat this damage.
Benefits
Through Dr. Cotman's research with mice, he discovered that exercise increases BDNF, brain derived neurotropic factor, a brain protein. He compares BDNF to a brain fertilizer. It builds new neurons and synapes, which are responsible for processing and transmitting information. BDNF increases vascular functioning and increases learning. According to Dr. Cotman, this is more than any medication can do. While more research is needed in humans, the benefits of exercise in Alzheimer's patients is promising. In a nursing home environment, exercise most likely will be done in a group setting. This social stimulation seems to benefit brain functioning as well.
Recommended Exercises
The types of exercises recommended for an Alzheimer's patient vary depending on what stage of the disease the patient is in. In a nursing home setting, it will be necessary to customize the exercise program to fit each patient's unique needs. This may require having several different exercise sessions. Low-intensity exercises are recommended for Alzheimer's patients. It is important that they do exercises they enjoy and at which they can be successful. In the early stages of Alzheimer's, walking, riding on a stationary bike or doing light strength training is recommended. Exercises that improve balance may decrease the risk of falls in Alzheimer's patients. As Alzheimer's progresses, doing simple chair exercises and range of motion exercises may be more effective.
Time Frame
The ideal time of the day for Alzheimer's patients to exercise is the morning, when they are focused and less likely to be agitated. In the evening, Alzheimer's patients tend to be restless, termed "sundowning." The recommended length for exercise sessions varies depending on the what stage of the disease the patient is in. It may be helpful to break up the sessions into mini-sessions to keep the participant's attention. For example, a 45-minute session may be divided into three 15-minute sessions with different types of exercises in each session.
Challenges
It is important to have an exercise group leader who is consistent and patient. Major changes and variations to an exercise program can cause stress and confusion for Alzheimer's patients. The leader must encourage patients to attend by offering frequent reminders. He should demonstrate how the exercises are done each session, as participants may forget from session to session. It is important that the leader creates a calm environment. He may want to consider playing soothing music in the background. In the later stages of Alzheimer's, behavioral outbursts in patients may be a challenge to manage. Sometimes it can be helpful to have a caregiver or family member attend the exercise session to provide extra support if needed. Alzheimer's patients, regardless of the stage that they are in, require constant supervision to ensure their safety.
