Exercise has plenty of benefits in older adults - dementia or not!

There was a recent study published in the British Medial Journal that unfortunately attracted a number of misleading and unhelpful headlines. 

The study title was : "Dementia and Physical Activity trial of moderate to high intensity exercise training for people with dementia: randomised controlled trial". But - headlines referring to it included "exercise doesn't help in dementia" or "benefits of exercise in people with dementia called into question".

The study itself was interesting, but, the reporting missed the point. Its not ALWAYS about the ‘cure’!

Sure, the exercise didn’t achieve an outcome of improving diagnosed cognitive measures, BUT why is that the only possible useful outcome reported? It improved physical fitness and I am more than willing to bet that the increased the amount of time spent with the participants had benefits way beyond mere medically measurable outcomes. Far too often, time constraints on carers (and in this study, where participants were not in residential care, the lack of training in exercise of non-professional carers) mean that those with dementia do less and less activity, and engage less and less with the world around them – which is damaging in itself in many more ways than a direct cognitive impact.

These researchers compared the exercise group to another receiving ‘usual care’ – the exercise group received instruction and at least 3 hours a week in a supervised exercise class as well as support to help them stay engaged and do activities at home, for 4 months – that’s lots of time spent getting to know the participants and engaging with them. In contrast, the control group had ‘usual care’ – There was no control for social engagement – no 3 hours a week for 4 months spent just chatting or otherwise engaging with this group.

People living with dementia deserve better. YES, it would be fabulous to find a ‘cure’ and we do know that exercise is one of a raft of preventive measures that can reduce dementia risk. BUT, the headline of this study ‘that the benefits of exercise are called into question’ (or worse in other media reports of this study that it ‘doesn’t work’!) is just not helpful and is too simplistic. And this study, had they considered more than just measurable cognitive outcomes, might have demonstrated the benefits beyond those. That’s not criticise the study itself as I said: it is good work – the problem is in the reporting and the headlines given: wider review of the literature reveals that the benefits of exercise in dementia more generally are not ‘called into question’ – engaging in physical activity reduces social isolation, increases appetite so reduces the chance of ongoing malnutrition, helps reduce falls and no doubt assists in minimising feelings of helplessness in carers given a focus in assisting their loved one. This sort of reporting sadly might reduce the chance that community care organisations and individuals encourage engagement in exercise for people living with dementia. That would be a very disappointing outcome indeed.