Recommending exercise to boost mental sharpness in your aging patients? What clinicians need to know to prescribe right, measure better, and increase buy‐in

Abstract

AbstractBackgroundAs our population ages, many individuals are at risk of developing age‐related cognitive decline. A wealth of scientific evidence supports that being physically active may prevent or delay the onset of cognitive impairment and dementia and related functional impairments. However, key barriers remain: 1) optimal exercise parameters for cognitive brain health have not been fully elucidated; 2) while most clinicians recommend physical activity, and older adults recognize its health benefits, the overwhelming majority of older adults fail to regularly participate in regular physical activity. Key preliminary results from two studies will be presented and discussed.MethodFifty‐one sedentary aging participants at risk for cognitive decline (age 62.9±6.8, 76.9% female) participated in Study 1. All participants completed an eight‐week moderate to high intensity exercise protocol and underwent assessments of neurocognitive and cardiorespiratory performance. In Study 2, a separate sample of fifteen individuals (68.1±6.5 years, 76.8% female) participated in a focus group to discuss factors influencing their exercise engagement.ResultStudy 1: All participants combined demonstrated significant improvements in cognition (measured by the Repeatable Battery for the Assessment of Neuropsychological Status [RBANS]) and cardiorespiratory fitness assessed by pre‐to‐post improvements in heart rate recovery (HRR) after eight weeks of exercise (p<0.05). Additionally, multiple regressions revealed a relationship between cognition (RBANS list learning [ß = .22] and RBANS list recognition [ß = 1.86] and fitness (p<0.05). Study 2: The focus group revealed that participants felt providers’ physical activity recommendations were too general, and did not consider their physical and contextual limitations, leading them to feel less likely to follow through with them.ConclusionOur data suggests that committing to a regular exercise regimen, even for a brief two‐month period, can promote improvements in cardiorespiratory fitness and cognition. We discuss the potential utility of heart rate recovery, an easy clinical measure that takes just a few minutes, to estimate cardiorespiratory fitness that appears to be relevant for exercise‐induced improvements in cognition. We discuss simple strategies to effectively translate current guidelines into the needs of the individual, considering the challenges and demands of the clinical setting.