In 2023, Australia introduced its inaugural guidelines aimed at promoting physical exercise as a means to mitigate cognitive decline and enhance mental health.
Engaging in consistent physical exercise has been evidenced to lower anxiety and depression, as well as reduce the risk of dementia development by up to 30 percent.
Professor Nicola Lautenschlager, the director of the Psychiatry of Old Age unit at Melbourne University, pointed out that there are no definitive guidelines in Australia regarding the recommended types and frequency of exercise.
With over twenty years of rigorous global research behind us, there is now a robust foundation of evidence supporting the efficacy of non-pharmacological interventions or lifestyle adjustments in creating a significant impact, she noted.
The challenge now lies in implementing this knowledge effectively.
In addition to physical activity, research has identified 12 risk factors that can increase the likelihood of developing dementia.
Individuals who maintain a healthy lifestyle through a balanced diet, avoiding smoking, limiting alcohol intake, and effectively managing depression and anxiety are less likely to experience cognitive decline.
On the contrary, medical conditions such as high blood pressure, diabetes, and head injuries are linked to an increased risk of developing dementia.
Currently, more than 15 percent of Australia’s elderly population is living with dementia, and this number is expected to rise to over 20 percent in the next 30 years.
In February 2023, federal data revealed that dementia had surpassed other diseases as the leading cause of disease burden, injury, and premature death for older Australians leading cause of disease burden, injury, and premature death for individuals over 65 years old.
While some memory loss is a normal part of aging, confusion, and progressive memory decline are not typical age-related symptoms.
Dr. Lautenschlager, who works in a memory clinic, diagnoses individuals regularly and notes that many people are concerned about memory loss as they age due to the high prevalence of dementia. She believes that dementia is likely the primary chronic disease of the 21st century, affecting a significant number of individuals.
There is a pervasive fear and anxiety surrounding dementia, with many feeling as though it is inevitable as they grow older. It is almost seen as a consequence of increased longevity and improved healthcare.
However, Dr. Lautenschlager emphasizes that regular exercise can have a significant impact on memory, and cognitive function, and may help prevent dementia.
The study presents a set of exercise guidelines that include four essential recommendations focused on alleviating mild cognitive decline in the elderly population.
First and foremost, older people are advised to engage in moderate-intensity aerobic exercise for a minimum of 150 minutes per week, in addition to their regular physical activities, such as walking to the supermarket.
Aerobic exercises suitable for individuals over the age of 65 include brisk walking, yoga, water aerobics, and gardening.
The study consistently revealed that aerobic exercise plays a crucial role in maintaining brain health and function, thereby reducing the risk of chronic diseases like diabetes in older adults, as stated by Lautenschlager.
Furthermore, the guidelines suggest that older individuals should incorporate progressive resistance training using elastic bands or weights into their routine at least twice a week, along with balance-improving activities.
Originally intended to develop exercise guidelines, the researchers seized the opportunity to conduct a second study when the COVID-19 pandemic struck in 2020.
Following the enforcement of COVID restrictions by federal and state governments, individuals aged 65 to 74 experienced a significant, while those aged 74 and above became more susceptible to psychological distress due to isolation.
In response to these challenges, the team introduced an individualized physical activity intervention known as Exercise for Cognitive Health (EXCEL).
The majority of the study was carried out during the peak of the pandemic in Melbourne, where strict COVID measures were in place, according to Lautenschlager.
Each of the over 50 participants received a personalized package that included access to over 700 exercise videos, a headband, weights, and a Fitbit.
The exercise program was customized for each individual based on factors such as medical history, age, previous injuries, preferred activities, and general interests. Over 12 weeks, participants had regular check-ins with their coach and physiotherapist via Zoom.
One common theme that emerged was the role of coaching in helping participants translate their intentions into action by boosting confidence and providing strategies to overcome obstacles. Initially, we set the bar low as many participants had not exercised in a long time. However, as time went on, their confidence grew, and they became more committed and enthusiastic.
One participant shared that her coach motivated her to start moving, emphasizing that any form of exercise was better than none. She expressed, “I’ll just go for a walk around the block – at least I can say I’ve taken a walk.”
Certainly, I would venture beyond just strolling around the block. Upon completion of the 12-week program, she came to realize the significant improvement in her health and fitness. “I no longer get as winded as I used to,” she remarked. “I actually have to exert myself to feel out of breath, whereas previously, even a short walk down the street would elevate my heart rate, which is no longer the case.”
Lautenschlager noted that as the Covid pandemic presented an opportunity for a second study, it was essential to test the program under non-pandemic conditions.
“We saw the highest level of interest in the program when the pandemic was at its peak, as people were confined to their homes with limited activities,” she explained. However, once restrictions were lifted, adherence to the program declined significantly.
Moving forward, Lautenschlager emphasized the need for future studies to focus on motivating and engaging older individuals while addressing daily distractions. She also stressed the importance of personalized and tailored interventions.
The study lays the groundwork for enhancing comprehensive care protocols for older Australians experiencing mental health symptoms and cognitive issues, according to Lautenschlager. Furthermore, it demonstrates how information and communication technology can help bridge the gap of distance and isolation for this age group.