Alzheimer's disease and exercise

Summary

People with Alzheimer's disease can benefit from exercise. Physical activity can help to reduce depression for people with Alzheimer's disease and protect against falls and fractures.

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A person with Alzheimer’s disease gains the same kind of benefits from regular exercise as anyone else, including improved cardiovascular fitness, strength and endurance. Research suggests that exercise can also address some of the symptoms associated with the disease.

Exercise helps to reduce depression rates among people with Alzheimer’s and helps protect against the side effects of physical deterioration such as falls and fractures. People with Alzheimer’s disease who regularly exercise are also less likely to be institutionalised because of behavioural problems. However, always consult with the person’s doctor before starting on any new exercise program.

Exercise reduces depression

In 2003, the University of Washington in Seattle USA conducted a study of 153 people with Alzheimer’s disease and their carers. The participants were randomly split into two groups; one group received routine medical care, while the other was given exercise programs consisting of flexibility, strength and balance exercises. The caregivers were taught home-based exercise routines and basic behavioural management techniques. After three months, the patients who exercised were less depressed than those in the other group, and showed marked improvements in their physical functioning.

Improved health

Some of the specific benefits of regular exercise for people with Alzheimer’s disease include:

Improved mood
Better sleep
Reduced likelihood of constipation
Maintenance of motor skills
Reduced risk of falls because of improved strength and balance
Reduced rate of disease-associated mental decline
Improved memory
Improved behaviour, such as reduced rate of wandering, swearing and acting aggressively
Better communication and social skills.

A sense of achievement

Alzheimer’s disease gradually robs the affected person of their ability to function independently. Exercise offers the person opportunities to learn new skills while they are losing most others. Since improvements in physical fitness can be measured, regular exercise can give the person and their caregivers a sense of achievement and pride. The regular accomplishment of meaningful activities enhances the life of a person affected by Alzheimer’s disease.

Suggested workout

Aim for a program that improves flexibility, strength, stamina and balance. Be guided by the person’s doctor and other health care professionals, but a suggested workout would include:

Warm-up consisting of a five minute walk and a few minutes of gentle stretching
Aerobic exercise for around 20 minutes
Strength training for up to 30 minutes
Cool down consisting of up to 10 minutes of stretching.

Try to encourage the person to exercise at least three, preferably four, times per week.

Getting started on an exercise program

Suggestions include:

The affected person should consult with their doctor first and have a full medical check-up. Other health conditions, such as arthritis or high blood pressure, may limit the types of exercises they can safely perform.
A physiotherapist can tailor an exercise program that takes the person’s current health and abilities into account.
Start slowly. For example, perhaps five minutes of continuous exercise is all the person can manage at first. Over a period of months, add one extra minute at a time until the person can comfortably exercise for 30 minutes.
Demonstrate the activity yourself and ask the person to follow your lead.
Boredom kills off motivation, so mix up the activities to keep it interesting.

Types of exercise

If the person used to enjoy a particular form of exercise, such as golf, encourage them to take it up again with your support. Other suggestions include:

Walking - this is one of the best all-round exercises and it’s free. Walking also helps to work off the restless urge to wander that is typical of Alzheimer’s patients. Try combining the walk with a useful errand, such as going to the shops for milk or exercising the dog.
Cycling - a tandem bicycle allows you to sit up front and control the bike, while the person sits in the back seat and pedals. If the person has problems with their balance, you could try hiring a three-wheeled bicycle for them to ride while you cycle alongside them.
Gym work - such as treadmills, stationary bicycles and weight machines.
Swimming - be sure to supervise closely.
Aerobics - you could attend classes together, or hire appropriate low impact aerobic workout videotapes.

Exercise that doesn’t feel like exercise

Exercise is any physical activity that raises the heart rate. Suggestions for activities that don’t feel like structured exercise include:

Dancing - seniors clubs often include dancing parties in their social calendar. If the affected person doesn’t know how to dance, simple dances such as square dancing can be learned and enjoyed, as long as their partner can take the lead.
Gardening - raking and mowing the lawn are good forms of exercise. Make sure you are on hand to help if required.
Housework - such as vacuuming and folding laundry. Most people with Alzheimer’s disease can continue to perform certain types of housework if they are supervised.

Record progress

Set achievable goals and keep a journal to record the person’s progress. Decide on how you intend to measure this. For example, you can see improvements in aerobic fitness by measuring how far the person can walk in five minutes.

To make sure that some kind of progress is noticeable, list everything such as the time spent exercising, the kilograms lifted and number of repetitions. Reward progress, no matter how small. Depending on what the person responds to, perhaps you could celebrate each workout with a healthy snack or some small thing they enjoy.

Safety concerns

Suggestions include:

For outside activities, make sure the person is wearing a medical alert bracelet or pendant and some kind of identification in case they wander off and get lost.
Supervise the person closely whenever they are using dumbbells or barbells.
Make sure the person wears heavy shoes when working out with weights in case they drop a dumbbell on their foot.
If the person can still talk while exercising, they’re in a comfortable aerobic state. Keep the conversation flowing to monitor how puffed they’re getting. Slow it down if they can’t talk without gasping.
For outdoor activities, make sure the person is sun smart - cover up with clothing and a hat, and apply sunscreen to all exposed areas of skin.
Ensure that the person drinks plenty of water before, during and after exercise.
If the person complains of feeling dizzy or faint, or says they have any kind of pain, stop the activity and consult with their doctor.

Where to get help

Your doctor
Local gym
Local senior citizen’s clubs
Physiotherapist
National Dementia Helpline Tel. 1800 100 500
Department of Health Victoria, Prevention and Population Health.

Things to remember

Exercise reduces depression rates among people with Alzheimer’s and helps protect against the side effects of physical deterioration such as falls and fractures.
Always consult with the person’s doctor before starting on any new exercise program.
A physiotherapist can tailor an exercise program that takes the person’s current health and abilities into account.

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Fact sheet currently being reviewed.
Last reviewed: May 2012

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People with Alzheimer's disease can benefit from exercise. Physical activity can help to reduce depression for people with Alzheimer's disease and protect against falls and fractures.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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