Exercise linked to lower risk of death in dementia patients

Any vigorous physical activity after a diagnosis of dementia is associated with a 30% risk of death, finds research published online. British Journal of Sports Medicine.

The findings have led the researchers to conclude that those affected should be encouraged to continue or start an exercise routine, especially as the average life expectancy after a diagnosis of dementia can be years. only 4-5.

Previously published studies have linked physical activity to a lower risk of death in people with the disease, but these studies have focused on one point at a time. So it’s not clear whether changes in the amount or intensity of exercise before and after the test would have an impact, say the researchers.

To test this further, they took data from the Korean National Health Insurance Service Database, which includes 60,252 people newly diagnosed with dementia between 2010 and 2016 who had gone they are examined 2 years before and after they are diagnosed with the disease.

The average age of the participants was 74, and 43,276 (72%) of them had Alzheimer’s disease and 7536 (12.5%) had dementia.

Physical activity was assessed at each visit using the International Physical Activity Questionnaire-Short Form (IPAQ-SF).

Exercise, such as running, aerobics, fast cycling and climbing for more than 20 minutes was defined as vigorous intensity; moderate intensity included brisk walking, double tennis, and cycling at a moderate pace for more than 30 minutes; light intensity included activities, such as walking for more than 30 minutes.

Regular exercise was defined as vigorous-intensity exercise 3 or more times per week, for at least 20 minutes, or moderate-intensity exercise 5 or more times per week, for at least 30 minutes.

Participants were classified according to changes in regular physical activity in the 2 years before and after their diagnosis: non-exercisers (78%; 47,050); dropouts (just over 10%; 6212); beginners (8%; 4801); and carers (just over 3.5%; 2189).

During the total monitoring period of about 4 years until the end of 2019, 16,431 participants (27%) died.

Regular physical activity before and after a diagnosis of dementia was associated with a significantly reduced risk of death, regardless of the type of dementia.

And higher levels of physical activity after diagnosis were associated with a reduction in the risk of death that was quantitatively, but not strongly, dependent.

Compared to being inactive, maintaining an exercise routine was associated with a 29% lower risk of death. If this was a milder force, the risk was 30% lower. The risk reduction for moderate and vigorous activity was, respectively, 26% and 30%.

And any vigorous exercise after diagnosis was associated with at least a 20% lower risk of death.

Considering physical activity as a continuous variable, the risk of death decreased by 3% for each increase of 100 MET weekly-; which is equivalent to adding 5 minutes of brisk walking on 5 days of the week-; exercise after diagnosis for all types of dementia.

METs describe the amount of energy (calories) expended per minute of physical activity, compared to the amount of energy expended at rest.

This is an observational study, so it cannot determine causation. And the researchers believe their findings may be due to regression, where those with less dementia and fewer functional limitations may be able to remain active. lines. Information on the type of physical activity they say is also not available.

However, the researchers say: “Building on the solid protective effect of [physical activity] against all-cause mortality, our study suggests that even at low levels, [physical activity] it can significantly reduce the risk of death in people with dementia.”

They conclude: “Our study highlights the potential clinical value of encouraging people with dementia to maintain or initiate physical activity, regardless of its intensity, by after their examination.”