Alzheimer’s disease and related dementias are among the world’s foremost health and economic challenges, impacting over 55 million people worldwide and costing more than 1.3 trillion U.S. dollars in 2019 alone. With no imminent cure, there is an urgent need for interventions that reduce dementia risk in healthy older adults.
One of the most easily manipulated risk factors for dementia is physical activity. However, there are no exercise prescriptions for older adults’ brain health. Unfortunately, this has two negative effects. First, people may undervalue the clinical utility of exercise for dementia prevention, and second, it poses a barrier to the recommendation of exercise for healthy aging in primary care settings. By providing evidence-based exercise prescription principles for dementia prevention as a starting point to help guide clinical practice and research, our graphic review, which was published in Exercise, Sport, and Movement, aims to address this issue. We reviewed the current state of knowledge regarding aging-related changes at the level of the brain, building on existing scientific evidence.
We included details on why memory is impacted in healthy aging and how these changes progress toward dementia. We described pertinent physiological mechanisms that exercise influences the brain to support memory in order to assist readers in comprehending how exercise promotes brain health. In the end, we combined this fundamental knowledge into practical exercise prescription principles to assist individuals and practitioners in developing exercise programs that are supported by evidence and promote brain health. Our use of the FITT framework, which details the frequency, intensity, duration, and type of exercise and provides the necessary components for formulating effective exercise prescriptions, was a notable strength. We emphasized the similarities and differences between ACSM-recommended cardiorespiratory, musculoskeletal, and neuromotor fitness exercises and those suggested for brain health.
We offer a adaptable formula for creating exercise prescriptions that can be tailored to each individual’s needs because we recognize that no one size fits all. That said, the evidence suggests that certain types and intensities of exercise should be incorporated into every exercise prescription for brain health. The term “type” of exercise should specifically include aerobic activities like walking, cycling, swimming, and other similar activities, as well as resistance activities like yoga and Tai Chi and free weights. According to the individual’s baseline cardiorespiratory fitness capabilities, an exercise’s “intensity” should include moderate to vigorous activities. In contrast, exercise “frequency” and “time” (duration) permit more freedom. Instead of setting a rigid threshold, the emphasis is on some physical activity is better than no physical activity (i.e., being sedentary), with the understanding that brain health is best supported by consistent engagement in regular exercise.
To get people talking about exercise with their clients, we suggest that practitioners download Figure 4, the final figure in our graphical review. Practitioners are also encouraged to use behavioral change techniques like brief action planning and SMART goal setting to help their clients create and commit to an exercise plan that is feasible for them. A referral to an ACSM Certified Clinical Exercise Physiologist® can ensure that each patient receives the appropriate guidance for practitioners with limited experience with exercise prescription. The importance of optimizing exercise programs for better brain health has never been greater in light of the growing elderly population and the rising incidence of dementia. We hope that, one step at a time, these guidelines for recommending exercise for brain health will assist in preventing cognitive decline.