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Alzheimer's May Be Preceded by Physical Symptoms

Breaking News - May 2006 - Week 4

(May 24, 2006)

Healthcare in  the News

-- Poor physical function, such as problems with balance and strength, may be a warning sign of increased risk of Alzheimer's disease and other dementias, a new study suggests.

Picture of an elderly woman using a walker during a physical therapy session

While previous studies have found a relationship between physical function and cognitive ability, they have not explored how physical performance is linked to the development of dementia or cognitive impairment, which is often a precursor to dementia.

According to the National Institute on Aging (NIA), Alzheimer’s disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities.

Alzheimer's initially involves the parts of the brain that control thought, memory, and language, states theNIA. Although scientists are learning more every day, right now they still do not know what causes AD, and there is no cure.

"Our point [of the study] is that you don't want to separate the mind from the rest of the body," says study co-author Dr. Eric Larson, director of the Group Health Center for Health Studies in Seattle. "The two are inextricably linked in older people," he adds.

"Even the mildest degree of physical disability is going to predict a heightened risk for Alzheimer's," adds Dr. Gary Kennedy, a geriatric psychiatrist and chairman of the Geriatric Mental Health Foundation at Montefiore Medical Center in New York City.

"This adds a little to diagnostic precision when we're looking for who's at risk and who's not, so we can provide interventions that prevent," he says.

Mental and Physical Functions Assessed

For the new study,published intheArchives of Internal Medicine, investigators looked at 2,288 men and women aged 65 and older who did not have dementia when the study began.

Cognitive abilities were assessed and ranked at the beginning of the study. Physical function was assessed, according to several established tests: a timed, 10-foot walk; a "chair-stand test" that timed participants as they stood from a seated position five times; a standing balance assessment; and a measurement of grip strength in the dominant hand.

Assessments were updated every other year for an average of six years.

At the beginning of the study, individuals with lower physical-performance scores also had lower cognitive scores.

As the study progressed, people with higher physical-performance scores were three times less likely to develop dementia than those with lower scores.

The first physical indicators of a risk for dementia in people without cognitive impairment seemed to be problems with walking and balance. And among people with apparent mild cognitive impairment, a weak handgrip suggested they would progress to dementia, the study found.

In other words, balance and walking problems may occur during an earlier stage while a weak handgrip may occur during a later stage.

Regular Physical Activity May Help

The good news is that stepping up physical activity levels may have a stalling effect on dementia.

Earlier, the same research team had found that seniors who engage in some form of minimal exercise at least three days a week can cut their risk of developing Alzheimer's and other forms of dementia by as much as 30 percent to 40 percent.

The message from that study, Dr. Larson says, was "use it even after you start to lose it."

And that message may be equally applicable here.

"If you notice physical function declining, it's arguably a good idea to rehab yourself or have a strong physical exercise program early on," Dr. Larson says.

"I'm very excited about this," he says. "Something as simple as regular walking may lessen the rate of dementia."

Dr. Kennedy adds: "If you think the person has very subtle decrements in motor performance, it might be worthwhile to get them up and out and more physically active. It's never too late to start exercise."

Always consult your physician for more information.

For more information on health and wellness, please visit health information modules on this Web site.

More About Alzheimer's

Alzheimer's disease (AD) is a progressive, neurodegenerative disease that occurs when nerve cells in the brain die.It often results in the following:

  • impaired memory, thinking, and behavior
  • confusion
  • restlessness
  • personality and behavior changes
  • impaired judgment
  • impaired communication
  • inability to follow directions
  • language deterioration
  • impaired thought processes that involve visual and spatial awareness
  • emotional apathy

With Alzheimer's disease, motor function is often preserved.

When Alzheimer's was first identified by German physician Alois Alzheimer in 1906, it was considered a rare disorder.

Today, with one in 10 persons over age 65 (and nearly half of persons over age 85) affected, Alzheimer's disease is recognized as the most common cause of dementia (a disorder in which mental functions deteriorate and breakdown).

According to theNational Institute on Aging (NIA),up to 4.5 million Americans suffer from AD. The disease usually begins after age 60, and risk goes up with age.

While younger people also may get AD, it is much less common. About 5 percent of men and women ages 65 to 74 have AD, and nearly half of those age 85 and older may have the disease. It is important to note, however, that AD is not a normal part of aging.

AD is a slow disease, starting with mild memory problems and ending with severe brain damage, according to theNIA.

The course the disease takes and how fast changes occur vary from person to person. On average, AD patients live from 8 to 10 years after they are diagnosed, though the disease can last for as many as 20 years.

AD is distinguished from other forms of dementia by characteristic changes in the brain that are visible only upon microscopic examination during autopsy.

Although intense investigation has been underway for many years, the causes of AD are not entirely known. Suspected causes often include the following:

  • age and family history
  • certain genes
  • abnormal protein deposits in the brain
  • other risk and environmental factors
  • immune system problems

Always consult your physician for more information.

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