The Aging Brain

Alzheimer's disease neurons with amyloid plaques

Marcus Dobson of Clemmons first recognized the cognitive decline brought on by his Parkinson's disease when he realized that he no longer wanted to play with his grandchildren or even be in the same room with them.

Bunny Fontrier wasn't having any cognition problems, but after moving to Winston-Salem to care for a mother with dementia, she thought she should look at herself, too.

Dobson, 60, and Fontrier, 63, are both participating in an exercise intervention through Wake Forest Baptist Health.

"I thought I'd find out how my mind is, and if my memory and thinking skills are going to be improved by this,'' Fontrier says.

The study got under way in March and will continue through late 2014. It is intended to help show whether high- or low-intensity exercising, or both, help improve cognition among people with early memory problems.

"There are no FDA-approved medications for mild cognitive impairment,'' says Valerie Wilson, MD, geriatrics clinic director with the Sticht Center on Aging at Wake Forest Baptist Medical Center. "We encourage people to stay physically and mentally active. It's one of those things that just makes sense.''

Richard Gottlieb is the longtime president and CEO of Senior Services, Inc., the Forsyth County agency that offers a variety of programs for older adults.

"What used to be referred to as senility or just 'old age' is now much more understood, recognized and talked about,'' Gottlieb says. "I think early intervention is a plus, but there is still a lot of anxiety and fear about dementia. And it's critical that we find some answers in terms of prevention and cures.''

Recognizing a Problem

The brain, just like other parts of the body, changes as it ages. That process can affect the functioning of neurons, the cells in the brain responsible for the way people think.

"It's a complicated metabolic pathway we still do not yet fully understand,'' Wilson says.

Although percentages have held steady, cases of dementia are up because of the rising number of elderly in the United States. It's estimated that by age 65, 5 percent of the population will have dementia. At age 80, this number jumps to 30 percent.

Memory declines with aging even in healthy people for a variety of reasons. Dementia is a general term for a significant decline in cognitive function that interferes with daily life; Alzheimer's disease is the most common form of dementia, accounting for 60 to 80 percent of dementia cases, according to the Alzheimer's Association.

One of the toughest things is for individuals and family members to recognize the first signs of a cognitive problem.

Kathy Long, director of Senior Services' Elizabeth and Tab Williams Day Center, says it is important to understand that "confusion is never normal.''

People who are older shouldn't fear disclosing a problem because confusion does not necessarily mean dementia, Long says. Urinary tract infection, pneumonia and reaction to medications are just three common issues that cause cognitive problems, and they can be easily treated.

Treating Cognitive Impairment

For more than a decade, Laura Baker, PhD, a cognitive neuroscientist and associate professor of geriatrics and gerontology with Wake Forest Baptist, has been studying the benefits of aerobic exercise in slowing cognitive decline and Alzheimer's disease.

Next year, Baker will work with the Alzheimer's Disease Cooperative Study consortium at the University of California-San Diego to help lead a $5.5 million effort funded by the National Institute of Aging. She also directs other exercise and memory studies at Wake Forest Baptist, such as those in which Fontrier and Dobson are participating.

One goal behind the studies is to show that exercise helps. Another goal, Baker says, is helping exercise become a Medicare-approved treatment in the battle against Alzheimer's and cognitive decline.

For people in the national exercise study, she says, "we hope to change their sedentary ways within 12 months. We're going to give them the needed tools and confidence to exercise on their own. One day, adults with mild cognitive impairment who are at high risk for dementia may be able to get a prescription for a specific exercise program at their local YMCA." 

Baker is one of many scientists nationwide working to prove the benefits of aerobic exercise for cognition and brain health. For example, a recent observational study published online by the Cooper Institute in Dallas showed that higher levels of cardiorespiratory fitness during middle age made people less likely to develop dementia in their senior years.

At Wake Forest Baptist, exercise trial participants such as Fontrier and Dobson complete about 90 minutes of memory and thinking tests at the Kulynych Center for Memory and Cognition Research at the Sticht Center. The tests provide a snapshot of a participant's "baseline" cognitive abilities. At the end of the study, these tests are given again for comparison.

Just weeks into their exercise programs, Fontrier and Dobson already know where they stand.

Fontrier says she has been able to do better at work, which involves reviewing numbers, since beginning her exercise program.

Dobson, a gemologist and appraiser for Schiffman's Jewelers, says exercise has helped him recapture the desire to play with his grandchildren. And it's helped him to focus.

"I can look you in the eye and have a valid conversation,'' he says. "That was something that my fellow employees said they hadn't seen in a long time.'

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Last Updated: 01-13-2014
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