
Exercise 'doesn't slow' progression of dementia if you already have dementia - open-source-ux
https://www.nhs.uk/news/older-people/exercise-doesnt-slow-progression-dementia/
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howard941
To me the interesting bit is the underlying study showed exercise _increased_
the dementia's progression and was actually harmful. What mechansism's behind
that result?

Having gone through three parents+in laws including one we actively caretook
in home with this terrible disease I'm not surprised. The progression seemed
unstoppable and sickened us while not aiding the parents. The allusion to the
victim in a train barrelling through a dark increasingly confusing countryside
is so apt.

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tomp
> To me the interesting bit is the underlying study showed exercise increased
> the dementia's progression and was actually harmful. What mechansism's
> behind that result?

I'm no expert, but the association I had was a podcast I listened once with
someone interested in life extension (I think it was on a Tim Ferriss
podcast). They spoke about "mTOR activation" (IIRC), the basic idea was that
_having_ muscles is good (because they increase the need for glucose, helping
the pancreas and the liver in regulating it), but _building_ muscles is
potentially harmful, because it causes a release of growth hormone, and
essentially speeds up metabolism (and hence aging).

Don't quote me on this, and I'm sure there's better sources of this
information out there than me. Does this ring a bell to anyone?

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matte_black
Exercise causes the body to produce more anti-oxidants to counteract the
greater oxidative stress that comes from faster metabolism, thus preventing
aging over time.

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nradov
It's really not clear whether antioxidants slow down aging.

~~~
matte_black
Well it’s not really clear if faster metabolisms speed up aging in humans
either.

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mittermayr
This is an interesting one (referring to the title itself and its broad
message, rather than actual details which many will never read) -- because:
part of me is happy to see actual research reported, regardless of how
positive/negative it is to us as humans, possibly helping to balance out a lot
of the (perceived) over-reporting of "x may be the cure to y". Of course, the
other part of me is sad, because it likely triggers a lot of people to make
false decisions (exercise is a chore to many, including me), and it's super
easy to mute that motivation-to-exercise with a quick "I read it's not as
healthy as they said it was anyway, so...". Considering the context people
will be reading a highly-editorialsed version of this in the form of trashy
glam magazines, side-columns and Facebook shares in month's time, that is.

~~~
DanBC
I hope people see what this research is really showing, and that it's
accurately reported.

They're pretty clear that exercise can help prevent people getting dementia.

What this research shows is that once you have dementia exercise doesn't do
much to slow it down.

~~~
danieltillett
Or it could be the people that exercise in later life are not drawn from the
same pool of people that go on to get dementia.

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mirekrusin
Or they forgot to exercise.

~~~
danieltillett
Given the lead time to dementia this is not so outlandish.

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kevinali1
I find this phenomenon similar to many other diseases. A certain diet or
lifestyle works wonders in preventing it. But if you have it, there is little
you can do to treat it outside of medical treatment. Eg diabetes, kidney
failure, cancer.

~~~
montrose
This is not only an important point in itself, but could be an interesting way
to look at medicine: to model it as a process where something overflows. (I
don't know what I mean more precisely than that.)

~~~
kevinali1
Like a waterfall. Once you're over the edge, it's an entirely different ball
game.

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Spare_account
> _It 's important to note this does not change what we know about exercise's
> ability to protect against dementia. People who exercise more are less
> likely to get dementia, possibly because it maintains blood flow to the
> brain._

Exercise can delay the _onset_ of dementia. I wasn't aware it has been claimed
to slow its progress.

~~~
seunosewa
This makes me wonder if there are easier ways to get more blood flow to the
brain and enjoy the protective benefit, such as sleeping with your legs up
every night, or showering with very warm water every morning and evening.

~~~
VLM
There is considerable nervous system involvement in safe exercise. I wonder if
playing a twitchy video game would have similar cognitive effects. If hand-eye
coordination can improve in teens, I don't see why it can't improve in
dementia patients and improved coordination might mask some symptoms.

The assumption is exercise results in higher blood flow which does
"something". I know its easier to concentrate when you have practice
concentrating, and for many boring people, exercise might be their only daily
experience with concentrating, aside from the rare occasional dementia
testing. Possibly forcing concentration on a regular basis (via exercise, or
whatever alternative) results in better cognitive test results.

I suppose a lot depends on defining exercise as staring at a TV while walking
on a treadmill vs playing racquetball.

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rland
In all honesty, I'm surprised to find that exercise is not beneficial to
_something._ In seemingly every case, living+exercise > living. I'm sure these
researchers were thinking the same when they designed the study.

"Is he in bad shape? Eh, chuck in some exercise, that's gotta help."

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StanislavPetrov
>The researchers said their exercise programme "does not slow cognitive
decline in people with mild to moderate dementia".

> They were recruited through memory clinics – specialist services that help
> people who have problems with their memory – and GP surgeries. Carers were
> asked to take the decision on behalf of people whose dementia meant they
> were unable to.

I think we have to be very careful about what these researchers characterize
as "mild to moderate dementia". I would contend that people who are forced to
seek professional help - let alone those who are unable to make decisions for
themselves, are beyond the point of "mild to moderate dementia". A good
argument could be made that the vast majority of people with "mild" dementia
are not under professional care and do not require a caretaker to make
decisions for them. They are forgetful, absentminded, and/or showing other
"mild" symptoms of dementia.

~~~
hmahncke
Caregiver informed consent (and participant assent) for research is common
when working with populations with significant cognitive impairment. Human
research review committees essentially always require that to protect
participants.

You're certainly right that lots of people with early stage dementia are
community living and not diagnosed.

~~~
StanislavPetrov
>populations with significant cognitive impairment.

"Significant cognitive impairment" should not be characterized as, "mild
dementia". If it is too difficult to recruit people with mild dementia for a
study, then they should report their results as being relevent to only those
with "moderate" dementia.

~~~
hmahncke
The diagnostic criteria for mild dementia are significant cognitive impairment
that interferes with activities of everyday living. There are plenty of people
still living at home with a caregiver/spouse, and people living at home on
their own that meet these criteria.

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wozer
From the article:

> It's important to note this does not change what we know about exercise's
> ability to protect against dementia. People who exercise more are less
> likely to get dementia, possibly because it maintains blood flow to the
> brain.

> However, once the brain has been damaged by dementia, exercise may not help
> prevent further damage.

~~~
John_KZ
After reading the study, it seems like they just made some people aged over
70, with progressed dementia, get light exercise twice a week for 4 months.
That's it.

Unsurprisingly, there wasn't much of a difference.

Personally I'm pissed at the way this study is presented. It makes a lot of
people falsely assume that exercise is useless, while it's definitely not.

Unless you have one foot in the grave and more than mild dementia, exercise is
probably still good for you. In fact the study concludes nothing for longer
periods or different modes of exercise, even for people this old and with
dementia already onset.

Sending an old man to the gym for "mild-to-moderate intensity" aerobic
exercise is a bad idea in the first place.

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bill_from_tampa
"People who exercise more are less likely to get dementia, possibly because it
maintains blood flow to the brain. "

Or, perhaps, people who are able to exercise and have the drive and foresight
to exercise regularly for years don't have early stages of dementia. Unless a
study has been done that randomized persons at age 40-50 to 'exercise' and "no
exercise" groups, and followed them for 30-40 years, this is a hard question
to answer. Following groups of people who self-sort themselves into exercisers
and non-exercisers does not answer this question, as the exerciser group may
include less early-dementia persons (ie those 20-30 years from a clinical
diagnosis, but who may be experiencing early behavioral changes that are not
diagnostic).

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Numberwang
A vegan diet does.

~~~
tzahola
[citation needed]

~~~
Numberwang
[https://www.google.se/amp/s/www.livekindly.co/cnn-plant-
base...](https://www.google.se/amp/s/www.livekindly.co/cnn-plant-based-
dementia-prevention/amp/)

~~~
grenoire
Ah yes, livekindly.co and the freelance journalist. The CNN article that's the
meat (hah) and potatoes of that link suggests that it's not a vegan but a
Mediterranean style diet with some dairy and also chicken, turkey, and fish
included.

~~~
Numberwang
[https://www.karger.com/Article/Pdf/110296](https://www.karger.com/Article/Pdf/110296)

