With earlier studies suggesting a link between physical activity and reduced risk of cognitive decline, researchers are investigating whether different forms of exercise can stave off Alzheimer's and other forms of dementia in the fast-growing population of older Americans.
"Until we have more effective treatments for these disorders, what we're really looking at is prevention," said research psychologist Jennifer Kaci Fairchild, the local coordinator for Exert, which is underway in 14 locations across the United States. Fairchild is a "geropsychologist" whose work focuses on older adults at the VA Palo Alto Health Care System and Stanford University.
"People are living longer than ever before, and age is the single greatest risk factor for Alzheimer's disease," she said, adding that one in three people older than 85 will have Alzheimer's when they die. "We're looking at ways to prevent or delay Alzheimer's — developing it at 95 is very different than developing it at 65."
While exercise has been demonstrated to help prevent and manage many chronic illnesses, it's only in the past decade that researchers have started to understand its effects on the brain, Fairchild said.
"It's one of the areas that holds the greatest promise in terms of having benefits cognitively in late life," she said. "Having a physically active lifestyle is just a piece of the puzzle — you have to have a cognitively active lifestyle and be socially connected — but it's a hugely important piece."
Participants in the Exert study — which is still recruiting members and is not limited to veterans — will get an 18-month membership to the YMCA and 12 months of personal training. They'll be randomly assigned either to an aerobic training group or to a group that focuses on stretching, balance and range of motion and then be expected to complete the assigned exercise program four times a week for 18 months.
During the first year, a trainer will supervise two of the four weekly sessions. In the final six months, participants will be expected to come to the Y to complete their exercise programs on their own.
The study will assess 300 people nationally, 21 of them in the Palo Alto area, Fairchild said. Among the local subjects is 90-year-old Henry Goetz of Mountain View, who began the exercise regimen in July.
"What's good about this is I have to meet with a trainer and I make a commitment that I'm going to see her twice a week," Goetz said. "There's a tendency to stay with it because you don't want to disappoint her. You feel a little bit of responsibility to make sure you do it. I'm not sure if I had to do this all on my own I'd be able to continue, but making a commitment to somebody else makes sure you do it."
In a separate study, Fairchild is assessing whether water aerobics and explicit cognitive training can improve memory, concentration and decision-making in older veterans who are beginning to experience memory problems. The "Water-Vet Study" was conceived as a way to include older veterans whose arthritis, pain or joint issues make it hard for them to exercise in a gym.
"(Participants) say that when they get in the water the pain just goes away, and they're able to get their heart rate up and keep it up for longer," Fairchild said. "We have guys with walkers jumping into the pool next to guys who run half marathons, and they're able to exercise together."
Water-Vet participant Dean Kwarta, a Vietnam-era Navy pilot, commuted from his San Jose home to the Palo Alto VA Aquatic Center three mornings a week for eight months. Previously sedentary and with arthritis in his ankles, Kwarta said he found the exercise so beneficial he's continued on his own with water aerobics five days a week at a YMCA near his home.
"I see the benefits of exercise, and it definitely changed my eating habits, too," he said. "In the process I ended up losing 30 pounds, so that actually motivated me to continue on."
Kwarta, who retired from HP in 2012, also noticed positive results on the social side.
"This is the first time I've hung around with military guys in probably 30 or 40 years," he said. "It's sort of like getting a second wind. I was in the retirement phase, just becoming more and more sedentary, and this gave me an opportunity to get re-involved with society, essentially."
In yet another exercise-related project, Fairchild is targeting people who take care of veterans with traumatic brain injury or dementia to determine whether physical exercise and other training can improve caregivers' health and well-being.
"At the VA we're faced with a new type of caregiver — the caregivers for the traumatic brain injuries coming back from the recent conflicts," she said. "They're going to be caring for someone for 20, 30, 40 years. How can we help them be the best caregiver they can be?"
More information about the Exert study is available at Exertstudy.org or by calling 650-493-5000, ext. 65992. Information about the Water-Vet study is available by calling 650-493-5000, ext. 68957, and about the caregiver study by calling 650-493-5000, ext. 65992.
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