An article by Eulàlia Cucurella; Gerontologist, Social Worker, Anthropologist and Master’s in care quality
Life expectancy in our society increases year after year. And if nothing changes, it is projected that by 2052, 37% of our population will be over 64 years of age and more than 6.2 million people will be over 80 years of age. A figure that triples if we compare it to the current one. The Dementia has become one of the main public health problems in developed countries. Alzheimer’s disease, already known as the epidemic of the 21st century, represents between 60% and 70% of all these dementias. The statistics reflected in the last World Alzheimer Report (2015) estimated that the forecasts of people with dementia worldwide will increase to 131,500,000 cases diagnosed on the horizon of 2050.
In this perspective, it is very important to active aging thanks to factors such as a good diet and the practice of physical exercise, among others. In fact, many of the changes linked to aging are more associated with the lifestyle that the person follows than with age. We can find very old people who have good elasticity, good maintenance of muscle mass or effort capacity.
Exercise or any physical activity helps improve self-esteem, self-confidence and at the same time also provides psychological well-being. Different studies have shown that its practice improves the synapse between neurons, learning, memory, as well as depressive and anxiety states. In addition, if this exercise is regular it helps us to maintain cognitive abilities such as orientation, memory, attention… But it also favors socialization which is very important when facing healthy aging and with more functional autonomy. And, in the case of people who start cognitive decline, they helps maintain its abilities for longer.
Exercise or any physical activity helps improve self-esteem, self-confidence and provides psychological well-being
Physical exercise and dementia
The School of Psychology and Exercise Science, Murdoch University in Australia, evaluated the relationship between exercise levels and brain amyloid load in carriers of genetic mutations that cause early-onset Alzheimer’s disease. The researchers found that in the group that did moderate physical exercise, amyloid accumulated at a slower rate. Therefore, they showed that physical activity produces improvements in our brain.
When making recommendations on physical activity, it will be necessary to take into account individual specificities such as: the level of cognitive deterioration and their physical conditions, as well as the “trajectory” of physical exercise or sedentary lifestyle in their life history, are aspects that we cannot forget.
Is activity and physical exercise the same?
The physical activity is a term that also encompasses all practices linked to movement, while the physical exercise It focuses on organized physical activity and for specific purposes such as maintaining or improving our health.
Thus, when we talk about physical activity we can establish general guidelines that are applicable to the majority of older people. In fact, all these activities can be graduated progressively according to the life habits of the person and their evolution.
The practice of exercise in people with Alzheimer’s
There is always some type of activity that adapts to the life trajectory and the level of health of each person. And all must take into account the level of the person from inactivity to a optimal and healthy physical conditionage, physical and mental conditions.
We must bear in mind that a high percentage of people diagnosed with dementia live in residences, gerontological centers or stay in social health centers. Some spaces in which the scheduled physical activity for each person is included in the care program that has been designed for the user.
In fact, if we compare the people who live at home with those who attend a day center or live in a residence, the second group has programmed different physical exercise activities such as maintenance of ADLs (Activities of Daily Living) for specialized professionals, in their care program. At home it is more difficult since the family member is not a professional and at the same time the person does not want to pay attention to him when he schedules activities for him.
People with Alzheimer’s admitted to centers have few possibilities of mobility and when they do, they concentrate on directed activities. On the other hand, the person who lives at home can maintain activities that allow them to move for a longer time. For example, making the bed or other household chores, walking, going up and down stairs or sidewalks when going for a walk or shopping. If due to your condition you can no longer do all these activities, we can accompany you and thus we will achieve the goal that do physical activity, even for mimicry.
It’s without doubt that personal functionality is a characteristic absolutely linked to healthy aging. This reaffirms the need to intervene and promote attitudes and strategies that allow, in advanced age, to maintain autonomy. In people suffering from Alzheimer’s, it is a question of achieving not only a good biological state, but also exercise the mind and achieve cognitive goals such as: body schema, rhythm, laterality, attention, verbal and non-verbal communication, concentration, temporal orientation and memory. Dancing, for example, can be a good activity: we move our legs and body, promoting circulation. Doing cardio exercises, we strengthen muscles, activate bipedalism against sedentary lifestyle, rhythm, memory, concentration, orientation, memories / reminiscence, physical contact… And only with a piece of music.
In some cases, at home, due to a habit of sedentary lifestyle or fear of falls, standing is not worked on, generating the opposite effect. Also for a protective and often paternalistic tendencywe cancel the person by depriving them of all possible activity, thus favoring the loss of mobility and functional capacity for ADLs.
Recommendations for the execution of physical activity
People with some type of cognitive impairment can benefit from the practice of some physical and sporting activity. However, the reality and characteristics of each individual must be taken into account, such as:
- The person’s ability to understand.
- Overcome the difficulty that the person may have in learning to do new activities. Structured exercises that are familiar to the person or past patterns of exercise can be emphasized.
- To understand the benefits of physical activity for health. However, it will be necessary to know if the presence of cardiovascular risk factors exists.
- Physical activity should include a combination of aerobic, strength, balance and flexibility exercise with a frequency of 2-3 weekly sessions and one hour.
If the practice activity is done in a residential center, it is necessary that the person leading the activity be a professional trained and prepared to work with people affected by dementiawho knows how to respect the possibilities of the person and their capacity for fatigue, pain…
On the other hand, if the practice is done at home, we can integrate exercises into daily life. Thus, we take for granted that activity that perhaps the person would refuse to do normally. We can find different household activities that lead to energy waste and that we do not consider as physical exercise. However, we could use them to motivate people with Alzheimer’s, or any type of dementia, with a tendency to be sedentary, due to their cognitive deterioration, or encourage them to practice them because in some cases they were their day to day. For example, we find all household activities such as: the movements that are made cleaning a glass or a mirror; sweep or mop the floor or clean the dishes. We can also do psychomotor exercises in the kitchen, peeling potatoes or choosing vegetables. Even if we have plants or a garden, these are also activities that can be very beneficial.
In fact, in the months of lockdown due to the pandemic, people have adapted their sports practice to the elements they had at hand: going up and down the stairs, taking a tour of the house or, even with Nordic walking sticks, walking on the terraces and balconies…
Thinking about exercising does not just mean going to a gym, running marathons or sports that may not correspond to our physical or cognitive condition. It is necessary, in the case of people suffering from Alzheimer’s, imagination and adapt all ADLs to practice any type of physical exercise which will involve at the same time: stretching, circulatory activation and breathing by movement, concentration, memory, temporal-spatial orientation, psychomotor skills… favoring cognitive aspects and delaying, if possible, the loss of functionality caused by the disease.