Exercise sharpens the mind for people with dementia

(Edmonton) Dorothy Forbes has spent more than a decade researching how to help people suffering from dementia receive the best possible care, a fate that unfortunately eluded her late mother.

Watching her mother Margaret Chapman slip into the grip of Alzheimer's disease was a stressful and painful chapter for Forbes, her mother and her entire family. Everything took a tragic turn when her mother suffered a fall and fractured her spine, ending up on a surgical unit in acute care.

"She had dementia and was very confused. She didn't understand where she was, the time of day or anything like that. The nurses and doctors didn't understand her illness or needs-it was terrible," Forbes recalls. "She went in walking and within weeks she died."

That experience convinced Forbes to focus her research at the University of Alberta on improving care for patients with dementia, their families and caregivers. Her recent efforts include a new paper that confirms exercise not only keeps the body fit and young, it also provides a significant boost to mental cognition for those with dementia.

Exercise provides a cognitive boost

"Exercise can improve cognitive functioning and help with activities of daily living, which are very significant aspects of dementia," said Forbes, an associate professor in the Faculty of Nursing. "If we can delay their memory problems and delay their dependence on activities of daily living, it improves their quality of life and health."

For her research, Forbes completed a comprehensive review of 16 randomized controlled trials published between 1997 and 2012. The majority of the 937 participants were over 65 and from the United States, France, Australia, the Netherlands and other countries.

The results showed little evidence that exercise altered the behaviour of participants or addressed symptoms of depression.

Forbes explained research in this area has a great deal of variability from the type and severity of dementia to the type of exercise programs used in testing. Participants cited in the review displayed a range of symptoms and lived in a variety of settings, from their own homes to care facilities.

This variation could explain some differences in results between individual trials, Forbes said, and more research is needed to better understand which exercises most benefit people with certain types of dementia.

But with an aging population, the results provide solid evidence that people with dementia should get active by going for a walk or engaging in an activity like swimming. Forbes said many care institutions could do a better job of encouraging exercise, even if it's encouraging groups of people to get active together.

"I don't think it's on people's radar enough; they just don't know the value that exercise can bring, even in long-term care facilities," she said.

Family experiences shape research

Forbes' mother's experience not only shaped her research interest; it's also had an influence on her two sons, Scott and Sean, both co-authors on the paper and U of A alumni of the Faculty of Physical Education and Recreation. Scott is now completing a post-doctorate at the University of Calgary, and Sean is a researcher in the Department of Physical Therapy at the University of Florida.

"My mother's disease was a really unpleasant experience for her and the whole family. We all realized how few resources there are for families to support their loved ones with dementia."

Their research was published Dec. 4 in the Cochrane Library.