Skip to main content
American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2007 Feb-Mar;22(1):62–77. doi: 10.1177/1533317506295377

Language-Enriched Exercise Plus Socialization Slows Cognitive Decline in Alzheimer’s Disease

Sharon Arkin 1
PMCID: PMC10697205  PMID: 17534004

Abstract

This article reports the effects of language-enriched physical fitness interventions provided by University of Arizona undergraduate students to 24 mild-to moderate-stage Alzheimer’s disease patients (AD Rehab group). Socialization experiences consisted of supervised volunteer work and cultural/recreational activities. Changes in global functioning and neuropsychological test performance were tracked and compared to those of a similar group of untreated patients from the Consortium for the Establishment of a Registry for Alzheimer’s Disease (CERAD). Cohorts completing 4 semesters or longer showed no significant between-year changes after their first year on the Clinical Dementia Rating, a measure of global functioning, and on 5 or 6 of the cognitive and language measures. Comparisons with the CERAD sample suggested a slower rate of decline for the AD Rehab group. The stabilization of global and cognitive performance was not apparent among participants who completed only 2 semesters. Significant physical fitness and mood outcomes were previously reported in this journal.

Keywords: Alzheimer’s disease, rehabilitation, cognitive training, language training, CERAD, cognitive decline

Full Text

The Full Text of this article is available as a PDF (117.4 KB).

References

  1. McKhann G, Albert M. Keep Your Brain Young. New York, NY: John Wiley; 2002. [Google Scholar]
  2. Evans W, Rosenberg IH. Biomarkers: The Ten Determinants of Aging You Can Control. New York, NY: Simon & Schuster; 1991. [Google Scholar]
  3. Laurin D, Verreault R, Lindsay J, MacPherson K, Rockwood K. (2001). Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology. 2001; 58: 498-504 [DOI] [PubMed] [Google Scholar]
  4. Friedland RP, Smyth KA, Rowland DY. Pre-morbid activities are reduced in patients with Alzheimer’s disease as compared to age- and sex-matched controls: results of a case-control study. In: Iqbal K, Winblad B, Nishimura T, Takeda M, Wisniewski HM, eds. Alzheimer’s Disease: Biology, Diagnosis and Therapeutics. New York, NY: John Wiley; 1997. [Google Scholar]
  5. Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky KR. A prospective study of physical activity and cognitive decline in elderly women who walk. Arch Intern Med. 2001; 161: 1703-1708. [DOI] [PubMed] [Google Scholar]
  6. Weuve J, Kang JH, Manson JE, Breteler MMB, Ware JH, Grodstein F. Physical activity, including walking, and cognitive function in older women. JAMA. 2004;292: 1454-1461. [DOI] [PubMed] [Google Scholar]
  7. Abbott RD, White LR, Ross W, Masaki KH, Curb JD, Petrovitch H. Walking and dementia in physically capable elderly men. JAMA. 2004;292: 1447-1453. [DOI] [PubMed] [Google Scholar]
  8. Teri L, Gibbons LE, McCurry SM, et al. Exercise plus behavioral management in patients with Alzheimer’s disease: a randomized controlled trial. JAMA. 2003;290: 2015-2022. [DOI] [PubMed] [Google Scholar]
  9. van Praag H, Kemperman G, Gage FH. Running increases cell proliferation and neurogenesis in the adult mouse dentate gyrus. Nat Neurosci. 1999;2: 266-270. [DOI] [PubMed] [Google Scholar]
  10. Cotman C, Engesser-Cesar C. Exercise enhances and protects brain function. Exerc Sport Sci. 2002;30: 75-79. [DOI] [PubMed] [Google Scholar]
  11. Vermeer SE, den Heijer T, Prins ND, Hofman A, Koudstaal PJ, Breteler MMB. Silent brain infarcts and the risk of dementia and cognitive decline: the Rotterdam Scan Study. N Engl J Med. 2003;348: 1215-1222. [DOI] [PubMed] [Google Scholar]
  12. Adlard PA, Perreau VM, Cotman CW. Exercise-induced expression of BDNF within the hippocampus. Neurobiol Aging. 2005;26: 522-520. [DOI] [PubMed] [Google Scholar]
  13. Lazarov O, Robinson J, Tang YP, Hairston IS, Korade-Mirnics K, Sisodia SS. Environmental enrichment reduces A-beta levels and amyloid deposition in transgenic mice. Cell. 1999;120: 701-725. [DOI] [PubMed] [Google Scholar]
  14. Wilson RS, Bennett DA, Bienias JL, et al. Cognitive activity and incident AD in a population-based sample of older persons. Neurology. 2002;59: 1910-1914. [DOI] [PubMed] [Google Scholar]
  15. Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003;348: 2508-2516. [DOI] [PubMed] [Google Scholar]
  16. Podewils LJ, Guallar E, Kuller LH, et al. Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol. 2005;161: 639-651. [DOI] [PubMed] [Google Scholar]
  17. Milgram NW, Head E, Zicker S, et al. Learning ability in aged beagle dogs is preserved by behavioral enrichment and dietary fortification: a two-year longitudinal study. Neurobiol Aging. 2005;26: 77-90. [DOI] [PubMed] [Google Scholar]
  18. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease. Report of the NINCDS-ADRDA Work Group under the auspices of the Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology. 1984;34: 939-944. [DOI] [PubMed] [Google Scholar]
  19. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State,” a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12: 189-198. [DOI] [PubMed] [Google Scholar]
  20. Berg L. Clinical Dementia Rating (CDR). Psychopharmacol Bull. 1988;24: 637-663. [PubMed] [Google Scholar]
  21. Morris JC: Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1994;43: 2412-2414. [DOI] [PubMed] [Google Scholar]
  22. Yesavage J, Brink T, Rose T, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17: 37-49. [DOI] [PubMed] [Google Scholar]
  23. Wechsler D. Wechsler Memory Scale-Revised. New York, NY: Psychological Corporation; 1987. [Google Scholar]
  24. Bayles KA, Tomoeda C. Arizona Battery for Communication Disorders of Dementia (ABCD). Tucson, Ariz: Canyonlands; 1991. [DOI] [PubMed] [Google Scholar]
  25. Arkin S, Mahendra N. Discourse analysis of Alzheimer’s patients before and after intervention: methodology and outcomes. Aphasiology. 2001;15: 533-569. [Google Scholar]
  26. Mahendra N, Arkin S. Effects of four years of exercise, language, and social interventions on Alzheimer discourse. J Commun Disord. 2003;36: 395-422. [DOI] [PubMed] [Google Scholar]
  27. Tappen RM, Roach KE, Buchner D, Barry C, Edelstein J. Reliability of physical performance measures in nursing home residents with Alzheimer’s disease. J Geront Med Sci. 1997;52A: M52-M55. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Arkin S. Student-led exercise sessions yield significant fitness gains for Alzheimer’s patients. Am J Alzheimers Dis. 2003;18: 159-170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Orange JB, Purves B. Conversational discourse and cognitive impairment: implications for Alzheimer’s disease. J Speech-Lang Pathol Audiol. 1996;20: 139-150. [Google Scholar]
  30. Arkin S. Audio-assisted memory training with early Alzheimer patients: two single subject experiments. Clin Gerontol. 1992;12: 77-96. [Google Scholar]
  31. Arkin S. Alzheimer memory training: students replicate learning successes. Am J Alzheimers Dis. 2000;15: 152-162. [Google Scholar]
  32. Arkin S. Alzheimer memory training: addendum on long-term retention. Am J Alzheimers Dis. 2000;15: 314-315. [Google Scholar]
  33. Arkin S, Smith M. Language-enriched exercise for clients with Alzheimer’s disease. Correspondence continuing education course. Tucson, Ariz: Desert Southwest Fitness. Available at: www.DSWFitness.com. [Google Scholar]
  34. Havighurst RJ. Successful aging. Gerontologist. 1961; 1: 8-13. [Google Scholar]
  35. Keys LM. Former patients as volunteers in community agencies: a model work program. Hosp Community Psychiatry. 1982;33: 1017-1018. [DOI] [PubMed] [Google Scholar]
  36. Griffin R, Mouheb F. Work therapy as a treatment modality for the elderly patient with dementia. Phys Occup Ther Geriatr. 1987;5: 13-27. [Google Scholar]
  37. Hughes M. Enhancing the Self-esteem of the Nursing Home Resident. LaGrange, Tex: M and H Publishing; 1991. [Google Scholar]
  38. Mace NL. Principles of activities for persons with dementia. Phys Occup Ther Geriatr. 1987;5: 13-27. [Google Scholar]
  39. Stansell J. Volunteerism: contributions by people with dementia. In: Harris PB, ed. The Person With Alzheimer’s Disease: Understanding the Experience. Baltimore, Md: Johns Hopkins University Press; 2002. [Google Scholar]
  40. Dieckmann L, Zarit S, Gatz M. Alzheimer’s Disease Knowledge Test. Gerontologist. 1988;28: 402-406. [DOI] [PubMed] [Google Scholar]
  41. Heyman A, Fillenbaum GG: CERAD overview: clinical sites, case material, and special studies. Neurology. 1997;49(suppl 3): S2-S6. [DOI] [PubMed] [Google Scholar]
  42. Heyn P, Abreu BC, Ottenbacher KJ. The effects of exercise training on dementia: a meta-analysis. Arch Phys Med Rehabil. 2004;85:: 1694-1704. [DOI] [PubMed] [Google Scholar]
  43. Fratiglioni L, Wang HX, Maytan M, Winblad B. Influence of social networks on occurrence of dementia: a community-based longitudinal study. Lancet. 2000; 355: 1315-1319. [DOI] [PubMed] [Google Scholar]
  44. Alzheimer’s Association. African-Americans and Alzheimer’s disease: the silent epidemic. Special report, 2002. Available at: www.alz.org/Resources/Diversity/BlackAfricanAmerican.asp. [Google Scholar]
  45. Barnett E, Casper ML, Halverson, JA, et al. Men and Heart Disease: An Atlas in Racial and Ethnic Disparities in Mortality. Morgantown: Office for Social Environment and Health Research, West Virginia University; 2001. [Google Scholar]
  46. Carter JS, Pugh JA, Monterrosa A. Non-insulin dependent diabetes mellitus in the United States. Ann Intern Med. 1996;125: 237-239. [DOI] [PubMed] [Google Scholar]
  47. Arkin S, Mahendra N. Insight in Alzheimer’s patients: results of a longitudinal study using three assessment methods. Am J Alzheimers Dis. 2001;16: 211-224. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Helm-Estabrooks N. Aphasia Diagnostic Profiles. Austin, Tex: PRO-ED; 1992. [Google Scholar]
  49. Hirsch ED Jr, Kett JE, Trefil J. Dictionary of Cultural Literacy. New York, NY: Simon & Schuster; 1991. [Google Scholar]

Articles from American Journal of Alzheimer's Disease and Other Dementias are provided here courtesy of SAGE Publications

RESOURCES