Can walking keep your mind young? (Robert Caplin for The New York Times)For people in their 60s, regular walking appears to lower the risk of dementia.
The finding, published this week in the medical journal Neurology, is the latest study to show that exercise helps delay some of the worst ravages of aging for both the body and the mind.
The recent research tracked the exercise habits of 749 men and women in Italy who were over age 65 and were in good health, with no indication of memory problems at the beginning of the study. After four years, they found that the most-frequent walkers had a 27 percent lower risk for developing vascular dementia than those people who walked the least.
What’s important about the study is that it again shows exercise doesn’t have to be excruciating to reap the benefits. “It’s important to note that an easy-to-perform moderate activity like walking provided the same cognitive benefits as other, more demanding activities,” said study author Dr. Giovanni Ravaglia of University Hospital S. Orsola Malpighi, in Bologna, Italy.
Last year, the Annals of Internal Medicine reported on a study of more than 1,700 adults over 65 that also showed regular walkers have lower dementia risk. In that study, walkers who exercised three or more times a week showed a dementia risk of 13 per 1,000 person years, but the adults who walked less often had a risk of 19.7 per 1,000 person years. That translates to a nearly 40 percent reduction in risk.
Walking may help stave off dementia because it improves cerebral blood flow and lowers the risk of vascular disease. The Neurology study didn’t see a connection between exercise and Alzheimer’s, but the authors note that other studies have shown a benefit, so more research needs to be done before ruling out exercise as a way to lower risk for Alzheimer’s.
Healthy living doesn't happen at the doctor's office. The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at 
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My husband is 85 and has had Alzheimer’s for over 15 years. He walked around playing golf every day from the time he was in his 50’s and we walked at least 2 miles every day until he was no longer able to do that–about 6 years ago. I am tired of these short term studies claiming one can avoid dementia by exercise, the right diet and keeping one’s brain active. My husband was an avid reader, followed current events, played bridge and his national game of towlee(backgammon). He was a Chemical Engineer known for the development of new manufacturing processes. I know Alzheimer’s can affect anyone, but people who are not familiar with the disease are being given the impression that lazy, poorly educated people with bad diets are the primary victims.
From TPP — Thanks so much for taking the time to comment. I think you make an important point. Nobody is suggesting that a healthy lifestyle will guarantee you a perfect old age. However, one way to look at this is that perhaps your husband’s healthy lifestyle kept him well for 79 years. While healthy living didn’t prevent this disease, perhaps it delayed it. I realize this is little comfort, and I hope people don’t misinterpret this data as suggesting Alzheimer’s is a disease that afflicts lazy people with bad diets. Too many of us know wonderful people who have been affected by this terrible disease. Hopefully, studies like this will simply encourage more people to adopt healthier lifestyles and live as well as possible for all the years they have left.
— Elinor ZindWithout reading the original report, the obvious comment here is that perhaps people walk less as they develop dementia . Which is the cause and which the effect?
— Ed238This is compelling research.
— Raymond ShawHowever, it’s subject to an alternative interpretation, because the work is essentially based on a correlation.
That is, there is a statistical relationship between the amount of walking people do and the rate at which they develop dementia. It cannot tell us definitively that one causes the other.
For example, it may be that some other characteristic of the non-walkers is a risk factor for developing dementia, and that same characteristic isn’t present to the same degree in the walkers, so they are less likely to develop dementia later on. The walkers and non-walkers could differ on many other characteristics.
But I emailed the post to my wife and said “let’s get serious about starting to walk, like we keep saying we should do…”
Thanks for posting this article.
These Keens were made for walking and that’s just what I’ll do…………..
— lisa pambidWith all sympathy for Ms. Zind, comment no. 1, it has been said that playing golf is a sad way to break up a good walk. Walking a few hundred yards only to stand around for minutes as the next shots are taken is not what is usually understood to be walking-as-exercise.
Washington DC
— Ian GilbertWe should understand that vascular dementia (VaD) and Alzheimer’s Dementia (AD) have very different pathologies and disease courses and therefore an activity may easily be preventative for one, but not the other.
Vascular dementia, about which this article speaks, is related to multiple infarcts (or strokes) in the brain and risk would be thought to decrease with cardiovascular execise (which decreases stroke risk factors).
AD, caused by the build up of “plaques” and “tangles” in the brain has long been thought to progress more slowly with increased socialization, so decline may be cushioned by a walking group, but walking per se, should not be expected to decrease the risk of AD directly(as the study showed).
Walking groups, however, are harmless, and for those who are functional enough to participate, have added benefits beyond decreased risk for VaD!
Amanda Itzkoff, MD
Psychiatry, Mount Sinai Hospital
Amanda.itzkoff@gmail.com
— Amanda Itzkoff,MDFrom TPP — Thanks for adding this useful information to the discussion.
I recently read reports that claim that playing mahjong and shopping can decrease the chances of developing Alzheimer’s.
Judging by the direction that the
research is moving, i think it’s time to dive deeper into the studies and try to sort out what is fact and what is fiction.
From TPP — The issue is always the same — associations vs. cause and effect. As many readers have pointed out, it may be that people with healthy brains are simply better equipped to go shopping or play mahjong. The difference with exercise, however, is that there is a physiological explanation that could help explain some effect, but still, nobody knows for sure.
— bobMy grandmother took all kinds of walks, and swam and played golf. She was physically fit as a whistle. Didn’t stop her from turning into a vegetable. She was a very fit vegetable.
— Paula GoodmanThank you, Ms. Zind, for saying what those of us who have had a loved one with Alzheimer’s know - it is in the genes, not one’s lifestyle. Although Neurology was reporting primarily on vascular dementia, they also noted studies that supposedly show a benefit from exercise with regard to Alzheimer’s. My father, who died of Alzheimer’s, was extremely active before the disease hit, walking miles every day in his post-retirement part-time job delivering documents throughout the city on foot. He belonged to two bowling leagues. He did the crossword puzzle in the newspaper every day - in ink. He was slim, had low blood pressure, and low cholesterol. I am getting the feeling that the medical community is trying to blame patients for their diseases. Or maybe people want to believe they have more control over their lives than they really do. I say, live your life as you want. Then, no matter how long you live, you will have enjoyed it.
— DGFirst of all,I sincerely thank very much for the reporting about walking vs dementia,I am not just walking , I mountain climbing almost everyday for about one hour and twenty minutes or so, I just in my forties only,maybe dementia is premature to say however I obtain the benefit from mountain climbing is countless,no matter physical or mental most importantly I feel very relaxed and more excited after mountain climbing. So I enjoy in the process of the activity,dementia may be a long time ahead of me , but the research reporting boost my confidence in exercising.
— David BlackLike many diseases, genetics, lifestyle and environment unto to themselves do not cause, let alone explain, the incidence of Alzheimer’s disease (AD). Rather it can be a combination of all three factors. Studies of known genetic factors, such as the APOE4 e3 allele for instance, have found autosomal dominance to be a factor in only 10% of AD cases. Other factors, such as concussions, exposure to chemical toxins in the air, depression, and anesthetic gases used in surgery (which have been found to trigger aptosis or cell death processes similar to AD), have all been researched and found to be related in the incidence of AD.
In addition, there is no conclusive research to date that has shown plaques and tangles to be the cause of AD. More and more research is reinforcing the theory that plaques and tangles may simply be an artifact of AD. Studies based on autopsies have shown that people can have significant levels of plaques and tangles and yet not be cognitively impaired.
Any exercise that imporoves circulation, as in walking, is for good for cell health, whether the cells be in the heart or the brain or in the vascular system itself. But exercise unto itself may not provide protection from other factors. My first patient at a memory while doing a clincal stint was a an avid 51 year old lawyer who surfed daily and who was having cognitive problems, possibly due to the numerous concussions he had received while surfing for many years.
Having said all this, I’m still doing daily 5 mile walks in the morning at 56 years old after 10+ years because I find it clears my head and I can think better during the day. But it won’t be any guarantee I’ll avoid getting AD, hopefully not util I’m at least 100.
Bruce Ryon, RN, MS, PhD(c), UC San Francisco
— Bruce RyonDementia Project Coordinator, Kaiser Permanente
Delaying the onset of many maladies is worth the effort of exercise and a good diet !
— Nicholas McClaryI am heartened to finally hear from people like Ms. Zind. My mother died in May 2007 after living with Alzheimer’s for nearly 15 years. She was a graduate of Smith College, raised hundreds of thousands of dollars for charities over the years, and exercised all of her life.
Each time I see one of these reports of studies that tout exercise, mind games, and other lifestyle choices that can stave off or slow the disease, my response has always been, “Well, my Mother did the Saturday NYTimes crossword puzzle to completion every week….right up until she was finally diagnosed with Alzheimer’s.”
But people need hope, and newspapers need stories that people will read.
Thanks Ms. Zind.
— EOLet me add the example of my own father–until recently an avid swimmer and a research scientist–to the list of people who were physically and mentally active and still got Alzheimers. When we fear something like Alzheimers, it is always comforting to think that there are ways we can avoid the fate for ourselves, but it’s not that easy. Of course it is better to be active, physically and mentally, and from what I understand that may possibly postpone the disease or make the experience of it different. But like other things in life, we don’t really don’t control the outcome.
— BRLive it, love it.
— tomI must agree in part with Dr. Amanda Itzkoff #6 above, since it is well known that Vascular Dementia (VaD) and Alzheimer’s Dementia (AD) are two very different diseases as regards the direct causation of tissue injury. Yes, it is true that they both impact and can destroy memory and cognitive function. For when the brain starts to die those things that we notice so clearly, the ability to coherently communicate are also the most fragile parts of a human being. But the hallmark of distinction of these symptoms is that Vascular Dementia is just that; a vascular disease that in some patients can be prevented, treated, alleviated and possibly cured. Vascular Dementia as a causation of a destructive process of the brain, is far better understood than Alzheimer’s Disease. Its cause and effect is as perceivable as sunlight entering a dark room. It is clearly seen, makes clear sense and when alleviated can in some patients relieve the symptoms. Comparatively, Alzheimer’s Disease is still clouded to us. No penetrating vision has revealed to the same extent the cause and effect of Alzheimer’s as has been accomplished with Vascular Dementia. And so prevention and treatment of these two diseases should not at this time be looked upon as having commonality. Lifestyle changes may impact one disease and not the other.
— Kenneth EllmanIn this discussion two areas seem to be confused and overlap which makes our understanding of this curse of humanity more difficult to fully understand.
First it is silly to disagree with the fact that the better physical condition a person is in, the more able that person will be to fight off and recover from medical injury of various types. It is simply that the greater health you are in allows your body to sustain and recover from and to prevent, more insults, attacks and damage. We know beyond question that health, particularly vascular health is directly associated with diet and also with prevention of self abuse such as smoking, etc. That does not mean that we have found a fountain of youth. We have just developed a firm and incontrovertible statistical picture of lifestyle decisions that directly effect the health of individuals. So we do have some limited control over our course into aging and how we will die, die we will.
Second, what is all too often overlooked is that we live in a biological sea. As a human creature we are perceived as food and opportunity to eat for many other pathogens that live with us. This is as sure as that the sun rises each day. Keep in mind that it is now well established that certain aspects of heart and circulatory disease are infectious in origin, and are the result of us being eaten alive by pathogens. Such types of cardiovascular disease can and must be treated as an infectious disease the same as Strep Throat, Syphilis or other living biological attacks upon us. This also applies to a large number of Neurologic Disease. The list goes on and on from Dental Disease to Ulcers and their potential widespread systemic effect.
While genetic vulnerability, inheritance, malnutrition and direct physical injury are distinct disease processes, the overwhelming reality we have lived with as animals in this world is that of continual infectious assaults. I would not be at all surprised if much of the neurologic disease we see, including Vascular Dementia and Alzheimer’s Disease has its origins in infectious process. Perhaps in combination with the immune response to the attack.
So, there is certainly no divergence or contradiction between leading as healthy a life as we are able to do which aids in resistance to and recovery from disease; and the fact of inevitability of disease. At the same time we must recognize that leading a healthy life in and of itself will not protect us from the ravages of the biologic environment we suffer and thrive in. We will still see people who live a good life and suffer a terrible death. Only our expanding knowledge of who we share this world with, how those other creatures who live with us, view us and the development of medical defenses against those things who would eat us, will deal with that. The goal is not to avoid dying for life is dependant upon death. The goal is to die in the manner over which we have some control and to in a sense choose our own death.
Kenneth Ellman
email:ke@kennethellman.com
I would like to share a tidbit from a program on my area PBS station. The name of the show was either “Mind Exercise” or “Brain Exercise”. I know I’m not a details person and even these two possibilities could be off the mark.
I, too, have heard the conventional wisdom of keeping your mind sharp by doing puzzles such as crosswords and sudoku. The comment in the program was that challenging your brain with something new was more effective than doing something that you have already mastered. My guess is that by continuing to do crossword puzzles when you have become an expert, you are reusing the same circuitry of the brain over and over. By learning something new, such as the infamous foreign language, you are charging up a different circuitry. I’m trying to learn to count in different languages which I will use for keeping up the number of reps in my weight training.
Continuing to do whatever you have mastered certainly is relaxing, satisfying and reason for pride. It truly is heartbreaking to believe you or your loved one has done all the right things and still be afflicted with severe dementia or other condition. We do the best we can and take the results of these studies as possibilities rather than guarantees.
— JAH in NCI must appreciate that this is a useful study. It suggests that Walking may lower Dementia Risk.
— Farida ZainulabdinPerhaps the prevalence of ice and snow on the streets, making walking
— Denise Halmost impossible for anyone over 30, is the reason more elderly suffer from dementia in Minnesota than in Florida. But having been to Florida, I remain skeptical. Denise H (MN)
I agree with the others who have questioned the causal link implied here. I feel that my time has been wasted when I read about results of studies such as these that establish a correlation between two factors and make the blind leap to assume causation. I will be interested if and when the more rigorous study has been done.
— Neal BDementia is mental impairment resulting from diseased arterial blood supply to the brain, the part affecting one’s memorizing power. It is a gradual process caused by a build-up of fat and cholesterol to the lining of the blood vessels there. The cure and precautionary measures are the same as for possible heart attack to the heart and strokes in other parts of the brain. It involves adopting a healthy new way of eating and a better lifestyle.
— Kevin ShumFor lifestyle, every bit counts, be it walking, brisk walking, swimming, golfing, tai chi, yoga,………………a long, long list. The minimum requirement is three times per week, each lasting 30-45 minutes. In fact this kind of exercise will also help to improve one’s blood sugar and cholesterol. Don’t be a couch potato. Get up and walk. It’s a lifelong battle and you cannot stop.
The study reveals simple walking will help. It’s an encouragement; strenuous, aerobic exercise not a must. People can replace it by some other physical activities, which they like more and enjoy doing it.
The three guys in the picture, after the walk, can have a drink of red wine (one or two maximum), which is also good to their cardiovascular health.
I am not in my 60s or above, I am in my 50s, but a few years ago I got very ill from what turned out to be toxic mold and since then I’ve been struggling to get better.
Mold causes systemic inflammation and it definitely and dramatically effects the bloodflow to the brain.
Mold also causes mold allergy, by hypersensitization. This is the subject of a huge and nasty cover up because it is effecting a lot of people and there are liability issues. (Read last January 9th’s Wall Street Journal cover story.)
Mold is also a big problem in many schools which is giving a lot of kids a very unhealthy start in life. But dementia in older people is one of the worst problems.
I think that this is a huge, hidden health menace.
The older you get, the more inflammation your body has naturally, because of changes in the actual tissue itself. Add one bad mold exposure and what happens to people is terrible. Their immune systems go haywire trying to mobilize against it and this can trigger chronic fatigue. I think the mechanism is much like what happens with cancer chemotherapy, i.e. “chemo brain”. That makes sense because many chemotherapy drugs are actually based on mold toxins.
Mold illness is everywhere and it is often misdiagnosed as dementia. This happens when it is caused by hidden mold in someones house or workplace, or even from mold in the air in some places, where there are a lot of rotting leaves, for example. Stachybotrys mold can create toxins that can persist for twenty or thirty years in a building so the actual water incursion could have been years in the past, as long as it was never cleaned out, it can create problems. Also, stachybotrys does not show up on spore testing, the cheapest most common kind of mold testing, because most (>99%) of stachybotrys spores don’t detach from their conidiaphores, they just stay inside of walls, unfindable by spore testing. Then their trichothecene toxins leach out over time and find their way into people’s bodies. The spores and the toxins are not connected. (But the so-amoral, well-paid defense ‘experts’ try to imply they are, just one of many big lies you see daily in this area) Growing mold produces MVOCs, which can cause multiple chemical sensitivity. Also, measuring them is very difficult. Obviously, as people keep windows shut more, we are realizing that IAQ is a serious problem.
When I see how they build new buildings now, it makes me scream. Many newer buildings are built with fake wood, which is laden with so much formaldehyde that they are dangerous. It leaches out over years. Its also used in furniture.
Indoor air pollution from formaldehyde, from pesticides, from plastics, other chemicals, etc, can cause similar problems.
Its amazing how little people know about these simple things. But they are really important.
There are a number of things that people can do. Obviously, mold is caused by water incursion. People need to fix all leaks and if there is mold in their house, clean it up. Some people recommend bleach but bleach can also damage the body, those who have actual experience with this issue recommend physical removal of all moldy materials and replacement. Often the mold is inside walls and so sheetrock needs to be removed and replaced. Painting over mold does not remove it.
Daily taking of fish oil, several grams a day, if possible, helps lower inflammation.
Occasional use of the bile-acid binding drug cholestyramine can remove a number of biotoxins (like those in mold) from enterohepatic recirculation, where they accumulate. That helps a LOT of people.
Antioxidants like the super-antioxidant n-acetylcysteine and many others help a lot of people.
The amino acid L-Arginine can help some people with cerebral hypoperfusion.
A heat recovery or energy recovery ventilator (a balanced, two way, powered ventilation system that warms or cools incoming air with outgoing air) can prevent buildup of toxins in indoor air by exchanging the air in a building several times a day. They start at around $325 for a basic Panasonic unit (EBay price) which looks like a bathroom vent fan with two vent hoses.. Simple to install.
(Embattled urban dwellers in public housing, take note, they can allow people to stay in apartments in older buildings that otherwise might be uninhabitable because of hidden mold.)
They are mandatory on new construction in Canada, but most Americans have never heard of them. When you consider how much we need them, because of the other stuff we have in the air, this is insane.
With so much abandoned housing stock out there, because of the subprime lending crisis, you know this problem will get worse. When will we stop our denial and start fixing it.
— Mark DawsonBoth my mother and her mother had dementia and my mother had Alzheimer’s, at least according to her doctors (I have some doubts about whether her dementia was Alzheimer and I have the impression that there is more than one form of non-VaD dementia). Both of them were extremely actively physically and mentally and it did not prevent them from developing dementia. I think it’s cruel and unhelpful to suggest that people can prevent dementia by exercise and mental activities. It’s bad enough to have this terrible problem without making victims feel that they could have prevented or delayed it except for their own laziness or lack of motivation.
— MaryMy father donated his brain to Johns Hopkins where an autopsy revealed early signs of Alzheimer’s, yet the disease he suffered from was not Alzheimer’s but another progressive, degenerative brain disease: Progressive Supranuclear Palsy (PSP). He was in his mid-60s when he died.
The disease itself is not fatal, but the complications are: starvation (if a feeding tube is refused), or pneumonia, etc.
While he did have some personality changes before his diagnosis of PSP, they were consistent with PSP and not necessarily Alzheimer’s.
Even toward the very end of his life, my father was aware of events around him and could communicate even though his voice was gone. His personality seemed unchanged to us in general.
He was trapped in his body, but his main problem was not dementia.
— KateThe initial discussion and the responses posted here are perfect examples of how scientific studies are often mis-reported in the popular press (I’m not saying that happened here) or are misunderstood by people who are unaware that science doesn’t deal in absolutes. This wasn’t a study that determined how to prevent dementia - it was a study that indicated certain behaviors were correlated with a change in the Relative Risk of developing dementia. Now to me that is valuable information whether the exercise was cause or effect. Other researchers may be able to build on this to discover even more influential risk factors.
Rather than crticizing the paper with anecdotal stories about active people who still developed one of the many forms of dementia, accept the study for what it is - one more step toward the elimination of this terrible disease - and not as a statement that diet and exercise *prevents* dementia.
— C. Reaves