Oct 22, 2012

Poor Physical Performance Increases Odds of Dementia in Oldest Old

“The results reveal that even modest declines in physical performance are associated with increased odds of dementia. The strongest association is seen with gait slowing, followed by five chair stands, grip strength and standing balance.”

When I first came to take of my mother, Dotty, in 2003 she couldn't walk a block, was scraping her feet on the ground (gait), had trouble getting up and down from a chair or automobile seat, and was falling down often and could not get back up on her own.

There was not much research on any of this for the oldest old at the time.

I decided on my own to take her into the gym for the first time when she was 88 years old (2004).

Subsequently, I had her walking on a treadmill, doing stand-up-sit-downs from the end of a workout bench, and working on several of the standard muscle machines you see in any gym (shoulder pull, leg press, chest press).

She stopped falling and never fell for again for 7 years. She did trip on something three times but the fall was not caused by her lack of balance.

By Bob DeMarco
Alzheimer's Reading Room

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The research below was done on people over 90 years of age. However, in order to get in bad shape they had to do little or nothing long before this age.

I have heard all the excuses, hips, knees, etc. They are always alternative exercises.

My point right now. If you are older you should start doing what is necessary now so you don't fall into the category described below. Or, if you are caring for the older old take action.

If you want a happy, easier to care of, Alzheimer's patients than the first thing you should do is get them on a real exercise program.

You decide - burden or Joy. Take control of what you can.

Study of Patients Ages 90 and Older Links Poor Physical Performance, Increased Odds of Dementia

Poor physical performance on activities including walking was associated with increased odds of dementia in a study of individuals 90 years and older, according to a report published Online First by Archives of Neurology.

Individuals 90 years and older are a unique segment of society that has not been well studied. Previous studies have suggested a relationship between poor physical performance and cognitive impairment in the younger elderly populations, according to the study background.

The study conducted by Szofia S. Bullain, M.D., and colleagues from the University of California, Irvine, involved 629 participants from the 90+ Study on aging and dementia performed at the university from January 2003 through November 2009. The average age of participants was 94 years, and most (72.5 percent) were women.
“Our cross-sectional study found a strong dose-dependent association between poor physical performance and dementia in the oldest old, with higher odds of dementia associated with poorer physical performance,” the authors note. “The results reveal that even modest declines in physical performance are associated with increased odds of dementia. The strongest association is seen with gait slowing, followed by five chair stands, grip strength and standing balance.”
The odds ratios for every unit decrease in a physical performance score were 2.1 for a four-meter walk, 2.1 for chair stands, 1.9 for standing balance and 1.7 for grip strength, according to the study results.

Participants who were unable to walk (score of 0) “were almost 30 times more likely to have dementia than people with the fastest walking time,” the study results indicate. Even minimal slowing in the walking speed (less than or equal to 1.5 seconds, from score 4 to score 3) was associated with four times greater odds of dementia, according to the results.
“In summary, similar to younger elderly populations, our study found that poor physical performance is associated with increased odds of dementia in the oldest old. The establishment of this association may serve as a major stepping stone to further investigate whether poor physical performance is in the causal pathway and a potentially modifiable risk factor for late-age dementia,” the authors conclude.

(Arch Neurol. Published online October 22, 2012. doi:10.1001/jamaneurol.2013.583.

This study was supported by grants from the National Institute on Aging.

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Original content Bob DeMarco, the Alzheimer's Reading Room

The Alzheimer's Reading Room is the number one source of high quality expert information for the entire Alzheimer's and dementia communities.