Correspondence (letter to the editor): Cognitive Conscious Stimuli With Movement

Etgen et al. explicitly point out that mild cognitive impairment and dementia can be modified by protectively by physical activity (1). This again reinforces old, timeless sayings such as that from the German physician Friedrich Hoffmann (1660–1742): “Physical exercise surpasses all drugs and is the universal medicine.”Neurobiological adaptations to motion include increased cerebral blood flow, new formation of spine, nerve cells, and capillaries, and synapsis hypertrophy, as well as increased gene expression of neurotrophic factors, such as brain-derived neurotrophic factor (BDNF), insulin-like growth factor 1 (IGF-1), and nerve growth factor (NGF); these responses play key roles in structural and functional brain changes (2). It appears that people with mild to moderate dementia can benefit from a progressive strength, balance, and functional exercise training several times a week, especially if this is combined with an individual dual-task training (3). Finally, I would like to point out that there is a negative association between the well-validated “five-times-sit-to-stand test” and global cognitive performance. Using this simple stand-up muscle test in general practices as a screening tool for cognitive impairment would be desirable (4).