title: The Link Between Physical Activity and Cognitive Dysfunction in Alzheimer Disease.
abstract: Alzheimer disease (AD) is a primary cause of cognitive dysfunction in the elderly population worldwide. Despite the allocation of enormous amounts of funding and resources to studying this brain disorder, there are no effective pharmacological treatments for reducing the severity of pathology and restoring cognitive function in affected people. Recent reports on the failure of multiple clinical trials for AD have highlighted the need to diversify further the search for new therapeutic strategies for cognitive dysfunction. Thus, studies detailing the neuroprotective effects of physical activity (PA) on the brain in AD were reviewed, and mechanisms by which PA might mitigate AD-related cognitive decline were explored. A MEDLINE database search was used to generate a list of studies conducted between January 2007 and September 2014 (n=394). These studies, along with key references, were screened to identify those that assessed the effects of PA on AD-related biomarkers and cognitive function. The search was not limited on the basis of intensity, frequency, duration, or mode of activity. However, studies in which PA was combined with another intervention (eg, diet, pharmacotherapeutics, ovariectomy, cognitive training, behavioral therapy), and studies not written in English were excluded. Thirty-eight animal and human studies met entry criteria. Most of the studies suggested that PA attenuates neuropathology and positively affects cognitive function in AD. Although the literature lacked sufficient evidence to support precise PA guidelines, convergent evidence does suggest that the incorporation of regular PA into daily routines mitigates AD-related symptoms, especially when deployed earlier in the disease process. Here the protocols used to alter the progression of AD-related neuropathology and cognitive decline are highlighted, and the implications for physical therapist practice are discussed.
authors.affiliation: C. Phillips, PT, EdD, Department of Physical Therapy, Arkansas State University, PO Box 910, Jonesboro, AR 72467 (USA). cphillips@astate.edu.
authors.forename: Cristy
authors.initials: C
authors.lastname: Phillips
authors.affiliation: M. Akif Baktir, MD, Department of Physiology, School of Medicine, Erciyes University, Kayseri, Turkey; VA Palo Alto Health Care System, Palo Alto, California; and Cardiovascular Medicine, Department of Medicine, School of Medicine, Stanford University, Palo Alto, California.
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Baktir
authors.affiliation: D. Das, MD, MPH, VA Palo Alto Health Care System and Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University.
authors.forename: Devsmita
authors.initials: D
authors.lastname: Das
authors.affiliation: B. Lin, BS, VA Palo Alto Health Care System.
authors.forename: Bill
authors.initials: B
authors.lastname: Lin
authors.affiliation: A. Salehi, MD, PhD, VA Palo Alto Health Care System and Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Salehi
mesh_terms: D000544:Alzheimer Disease / Q000473:pathology* / Q000523:psychology* / Q000628:therapy; D003072:Cognition Disorders / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D009043:Motor Activity / Q000502:physiology*; D026741:Physical Therapy Modalities