The organ that sets humans apart from all the other animals on the planet/Wikimedia Commons

Exercise runs down dementia risks

From the world of exercise is medicine, now comes the suggestion that even some of those genetically predisposed to dementia may be able to out walk, out run or out pedal that scourge of old age if they put in the effort.

Chinese and Swedish researchers who tapped the United Kingdom’s Biobank to track the medical records of more than 61,000 people ages 39 to 71 for a dozen years found that as cardiorespiratory fitness increased brain health improved as well while the risks of dementia and Alzheimer’s disease went down.

Given the rise in early onset dementia and Alzheimer’s disease, this is no longer just news for those over age 65 or the children who end up taking care of those with these diseases. The diseases have made a big move into the 30 to 65 age group, but more on that farther down.

For now, a focus on the latest research reported in the peer-reviewed British Journal of Sports Medicine showing that the benefits of exercise apply even to those with moderate to high genetic risks of dementia. In fact, they value might apply even more if you know of a family history of dementia or Alzheimer’s.

There is now something you might be able to do to help prevent it catching you.

“In this large, community-based, longitudinal study from the UK Biobank,” they concluded, “we found that higher cardiorespiratory fitness was associated with: (1) better baseline global cognitive function and performance in multiple cognitive domains; (2) lower risk of dementia and a delay in the onset of dementia across middle and older age; and (3)(a) 35 percent reduction in the risk effect of genetic predisposition on all dementia risk.”

Already a big problem

Among America’s aging population, Alzheimer’s disease – one form of dementia – was reported to be at epidemic levels five years ago, and the situation has improved only slightly in the wake of the Covid-19 pandemic that weighed heavily on those suffering from the disease.

“At the onset of the COVID-19 pandemic, the rate of dementia increased slightly, as many expected,” according to Vicki Freedman, a researcher at the University of Michigan’s Institute for Social Research. “But these increases were swamped by sharp increases in deaths among older adults living with dementia that occurred in 2020-2021. As a result, the downward trend in dementia for 2011 to 2021 was even steeper than the pre-pandemic trend.

“The rate of dementia declined from 11.9% in 2011 to 9.2% in 2019, and, after a small uptick to 9.6% in 2020, dropped to 8.2% in 2021.”

That 2021 decline in dementia is itself a reflection of a long, slow decline in Alzheimer’s dand dementia in older Americans that has been underway for decades. That is good, but there is an ironic and troubling complication in the rise of this disease among the middle age and younger.

The Blue Cross and Blue Shield insurance companies in 2020 reported detecting a 373 percent spike in the diagnosis of early-onset dementia and Alzheimer’s among Gen-X and Millenials.

“The increase in early-onset dementia and Alzheimer’s diagnoses among a generation who typically wouldn’t expect to encounter these conditions for several decades is concerning, especially since there is no cure for Alzheimer’s disease,” Dr. Vincent Nelson, vice president of medical affairs for the company said in a statement. “Further education and research is needed to learn more about early-onset dementia and Alzheimer’s, how to treat these conditions and what can be done to better prevent diagnoses.”

Obviously, the latest research would indicate one easy way prevent them would be to get younger Americans up and moving more. It is hard to imagine that some of currest spike isn’t related to the American slothdemic and the epidemic of obesity among American children that began in the 1970s and accelerated into the 21st Century.

Childhood obesity was rather rare in this country before then. An Environmental Protection Agency study of children’s health notes that  “in 1976-1980, 5 percent of children ages two to 17 years were obese. This percentage reached a high of 18 percent in 2015-2016” after which it leveled off for a time.

The plateau didn’t last.

“Obesity in U.S. children increased at an unprecedented rate during the pandemic,” the BMJ,  once known as the British Medical Journal, headlined in 2021. 

By August of that year, 22 percent of U.S. children and teens – more than in every five Americans under the age of 18 – were obese.

“The national weight gain will surprise few pediatricians, who have been warning since the pandemic began of the likely effects of reduced physical activity and increased screen time,” The BMJ added. “But the rate of change is striking. The monthly rate of body mass index (BMI) increase nearly doubled to 1.93 times its pre-pandemic rate. The proportion of US children who are obese was rising by 0.07 percent a month before the pandemic, but by 0.37 per month – five times faster – after the virus appeared.”

Predictable

In hindsight, this was largely predictable given the countries twins addiction to motor vehicles and high-speed roads, which almost put an end to kids walking or pedal biking school; and screens, be they TV or computer, which have us all sitting on our asses more than ever.

Couple that to the normalization of fatness in American society, and it’s pretty much the perfect physiological storm.

‘The U.S. is the world’s most overweight large country…,” The BMJ observed. “Its proportion of obese citizens is exceeded only by 10 small Pacific states and by Kuwait.”

Given the still-rising numbers for both childhood and adult obesity in this country, one would have to conclude that Americans have generally accepted this newfound largeness even it is killing them.

And they were warned.

After looking at data for the first ten months into the start of the Covid-19 pandemic, the U.S. Centers for Disease Control in 2021 reported that among a sample of more than 3.2 million Americans – a huge sample size – “obesity was (found to be) a risk factor for both hospitalization and death, exhibiting a dose-response relationship with increasing body mass.”

That study found, as have others, a “J-shaped relationship” between body size and death from Covid. This is likely to due to some number of thin people being thin as reflection of poor health. They – the like the mildly obese – had a higher risk of hospitalization, severe Covid-19 and death than Americans of normal weight or slightly more.

Once body size increased beyond that point,however,  the relationship between body size and Covid-19 hospitalization and/or death became clearly linear – the more someone weighed, the greater their risks.

“Consistent with previous studies, the dose-response relationship between risk for hospitalization or death and higher body mass index was particularly pronounced among patients aged less than 65 years,” the researchers added.

As of yet, no one appears to have studied exactly how many of those under age 65 dead of Covid were in the cohorts of obese children that began to grow in the U.S. in the ’80s and has only increased since. But it is likely a significant number of them were overweight kids who never escaped their obesity given the research indicating the size of the difficulty in overcoming childhood obesity.

A meta-analysis of obesity studies reported in Obesity Review almost a decade ago warned that “around 55 percent of obese children go on to be obese in adolescence, around 80 percent of obese adolescents will still be obese in adulthood and around 70 percent will be obese over age 30. Therefore, action to reduce and prevent obesity in these adolescents is needed.”

Nothing happened despite the warning. The number of obese adolescents and adults in the U.S. just kept growing, and a pandemic that primarily killed the fat and unfit doesn’t seem to have gotten the message out either.

How long can this go on?

The message that came out of the pandemic,  in fact, seems to be almost the opposite of a warning for American to work on their fitness or die. The message has been so heavily focused on vaccination that it would be easy to come to this conclusion:

Why slim down and get fit – neither of which are particularly easy – when it’s easier to just get vaccinated?

This despite a variety of studies showing that “physical activity enhances vaccine effectiveness against severe COVID-19,” and the fact that unfit people vaccinated against Covid-19 are continuing to die. By August 2022, the CDC was reporting about six in 10 of all Covid-19 deaths were among the vaccinated.

The current rates are unreported, but Americans are continuing to die of Covid at a Western-world-leading rate, according to the latest World Health Organization (WHO). Some of this may be due to the failure of Americans, especially the most vulnerable Americans, to get Covid-19 booster shots given that the effectiveness of the vaccines, unlike exercise, have been shown to wane rather rapidly.

The CDC is now recommending people 65 years and older and those who are moderately or severely immunocompromised get a booster every six months. It is continuing to recommend annual boosters for everyone else over the age of six months. 

The federal agency also promotes physical activity as a general health benefit, too, but not nearly as aggressively. The agency’s Covid-19 advice focuses on vaccines. Its dementia advice preaches “healthy lifestyles” but soft-pedals exercise amid warnings about diabetes, high-blood pressure, hearing loss, and the use of tobacco and alcohol.

“Physical activity is important to keeping your heart, body and brain healthy. What is good for your body is good for your mind,” the CDC website says, but then instead of telling readers of the documented and vital importance of at least 150 minutes of exercises every week says that “experts recommend” this as if it is just a suggestion. 

Obesity is the most obvious visual indicator of the country’s epidemic of “metabolic syndrome” that has been linked to lack of physical activity, and metabolic syndrome has now been tied to worsening brain health in general.

University of Oxford researchers his summer published the largest study to date on metabolic syndrome and brain health. They therein reported metabolic syndrome reduced brain volume; lessened grey matter responsible for information processing; increased white matter hyperintensities, a sign of damagethat has been associated with to dementia; fueled memory loss, and drove declines  in cognitive processing speeds, verbal and numerical reasoning, nonverbal reasoning and of executive function.

Their peer-reviewed study was published in the journal of Diabetes Care where they did note some “promising findings (that) come from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial, a multidomain intervention involving a diet, exercise, cognitive training, and vascular risk monitoring program in older adults with high rates of MetS-related components.”

In the cold, dark north of Europe, the Finns have over the past several decades gone from one of the sickliest societies in the world to one of the fittest. The WHO now ranks them number two in the world behind Uganda – a poor, African nation where human muscle power remains a main form of transportation. 

How did Finland turn things around?

Most of the credit is given to the “North Karelia Project,” an experiment begun in the 1970s to try to reduce the countries staggering rate of heart disease. It focused first on weaning Finns off cigarettes and fat, and then moved into encouraging them to exercise more.

The Finnish Institute for Health and Welfare now reports that almost half of the adults in that country get in the weekly ecommended two and a half hours of moderate intensity endurance exercise, about 20 minutes per day, or “an hour and 15 minutes of vigorous intensity aerobic physical activity.”

In the U.S., the latest report from the CDC is that “among all adults aged 18 and over, 24.2 meet met the guidelines for both aerobic and muscle-strengthening activities (and) 22.7 percent met only the guidelines for aerobic activity.”

These rates are less than half those of Finland. The Finns get in a lot of their physical activity by walking. A tracking study of steps taken by Finns in 2020 showed women averaging 8,525 per day with men just behind at 8,517.

Ameircans hardly walk anywhere anymore as is reflected in the Mayo Clinic reporting an average American step count of 3,000 to 4,000 per day, or less than half the number of steps per day in Finland. Very Well Health puts its estimate of steps higher at 4,000 to 5,000, but suggests that “adults under age 60 should aim for 8,000 to 10,000 steps per day, and those older than age 60 should aim for 6,000 to 8,000 steps per day.”

The later publication noted that “for adults younger than 60, 8,000 and 10,000 steps per day were associated with a decreased risk of death.” Given what the new research is showing about activity and brain health, that number of steps is likely also good for the brain.

Researchers have suggested children and adolescents should be getting in 11,000 to 15,000 steps per day. The recommendation for children to get 60 minutes of exercise per day is based on the idea that in that time they will get in that number of steps although how many steps they do get in has been shown to very greatly.

Actual step counts of U.S. children and adolescents are hard to find, but a Univeresity of Utah undergraduate student who put trackers on 70 middle school students in that state in 2022 found boys were exceeding the lower range of recommended goal with an average of 12,607 steps on weekdays but failing miserably on weekends when step counts fell to 7,502 on average.

Girls fell short on weekdays with only 8,237 steps per day on average and plummeted to 5,329 on weekends.

The CDC in 2020 also reported Utah among the nation’s four most active states with less than 20 percent of people doing nothing but sitting around during their free time from work. Given that the activity levels of children tend to reflect that of their parents, Utah is probably not representative of most of the rest of the country.

In seven states, the CDC reported 30 percent or more of the population was barely moving when not at work and working in America isn’t the physical task it once was. A lot of jobs now involving hours upon hour of sitting.

As for children, a 2021, peer-reviewed study published in the Journal of Sport and Health Science found that “only 15 percent, 9 percent, and 6 percent of students in elementary, middle, and high schools, respectively, are required to take physical education (PE) classes on three or more days a week during the entire academic year. (And) s surveillance data indicate that children in all grades, on average, may spend less than half (45 percent) of their PE time engaging in moderate to vigorous physical activity.”

American politicians, government officials and parents these days seem to spend a goodly amount of time trying to protect the heads of children from bumps and bangs that might cause brain injuries but pay precious little attention to seeing to it that children get enough exercise to prevent now demonstrable brain decay.

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