Still?

August 25th, 2018| Topic: RaMbLeS | 0

Well, there’s good news for couch potatoes (like me)!

Found in “Dementia And Physical Activity (DAPA) Trial of Moderate to High Intensity Exercise Training for People with Dementia: Randomised Controlled Trial,” recently published in The British Medical Journal.

That those with Alzheimer’s benefit from exercise has been our fondest hope. But, alas, that may not be founded on fact.

In the DAPA trial, the average score on the Alzheimer’s Disease Assessment Scale-Cognitive Subscale worsened for those with dementia who had been assigned to a year of vigorous exercise. The difference was small, but statistically significant.

Said one of the authors, Bart Sheehan:

It does raise the possibility that, at this point, vigorous exercise might be damaging for people.”

Sheehan and colleagues undertook an authoritative trial, with about 500 subjects with mild to moderate dementia. Average age 77, and 61% men. Some were assigned to perform vigorous exercise for a year, others not. The former went to a gym twice a week, each time for 60–90 minutes, and exercised under the guidance of physical therapists, plus another hour each week at home on their own. The exercises included cycling, biceps curls, shoulder forward raise, lateral raise, and sit-to-stand with weighted vests or belts. Those who later evaluated the subjects were not clued into who had done the exercise and who had not.

After a year, the working-out folks were fitter than the sitting-still crowd. But when it came to cognitive function, things were not so rosy. These hardworking individuals’ cognitive functions worsened, compared to the that of the lazy ones. The researchers were surprised.

Sheehan again:

It didn’t come as a surprise that physical exercise was not effective as a treatment for dementia, because dementia is notoriously difficult to treat. I think what was a surprise is the very strong signal that it may make dementia worse. We ran the statistics again and again but found no mistake.”

And, despite the increased levels of fitness in those who worked out, it appeared that in health-related quality of life, they showed no improvement either.

Sheehan:

The finding should influence what clinicians say to people with dementia and their caregivers. Exercise won’t help with such core features of dementia as memory or the ability to organize oneself; it might actually do damage. People who are already exercising and enjoying it shouldn’t necessarily stop. But they must weigh the enjoyment and other health benefits—which are many—against the risk for harm.

Alright, I’m staying indoors from now on, rooted to my chair (not that I wasn’t already fixated in that posture). After all, one has only a fixed number of heartbeats to go through in this life. Why speed things up to get to the end of my allotment?

Not everyone agrees. Noted one physician in a comment:

Just one of many flawed “studies.” Not gonna stop me from the activities I enjoy. Sloth and gluttony translate into increased dementia if you don’t first succumb to type 2 diabetes, metabolic syndrome, fatty liver disease, hypertensive cardiovascular disease, stroke, or depressive boredom. Take your choice cowboy.”

(Sloth and gluttony [and sleep] sound pretty good to me!)

Listen, even the Bible agrees.

Be still, and know that I am God.
Psalm 46:10 KJV

There you go: “Be still.”

Bodily discipline is only of little profit.
1 Timothy 4:8a

On the other hand:

… godliness is profitable for all things,
since it holds promise for the present life and also for the life to come.
1 Timothy 4:8b

You ever seen a sweatin’ saint?