Skip to main contentSkip to navigationSkip to navigation
Researchers hoped to prove that rigorous exercise could help people with dementia, but sadly it appears that the opposite is true.
Researchers hoped to prove that rigorous exercise could help people with dementia, but sadly it appears that the opposite is true. Photograph: Alamy Stock Photo
Researchers hoped to prove that rigorous exercise could help people with dementia, but sadly it appears that the opposite is true. Photograph: Alamy Stock Photo

Rigorous exercise does not halt dementia decline, study concludes

This article is more than 5 years old

Keeping active helps prevent the onset of dementia, but once the disease has taken hold, working out more does nothing to slow its progress

Moderate to more intense exercise does not help people with dementia and may even make it worse, according to a major study which had hoped to find it slowed down the progress of the disease so that gym sessions could be offered as treatment by the NHS.

Regular exercise and an active life are thought to help prevent or delay dementia, and some small studies have been done in dementia patients with positive results.

But a trial found that gym exercise did nothing to slow down the progress of the disease.

“I was disappointed by the results, although I probably wasn’t completely surprised,” said Prof Sarah Lamb, lead author of a paper in the British Medical Journal.

“I think it would be fair to say that dementia is a difficult problem to fix,” said Lamb, who works at the Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences at Oxford University.

Nearly 500 people with dementia volunteered to join the trial, and of those 329 were assigned to a serious physical fitness regime, while 165 had usual care. Those allocated to four months of physical exercise, which was personalised according to their fitness, did two gym sessions a week lasting 60 to 90 minutes, involving exercise such as cycling on static bikes and using dumb bells and weight belts. They were also asked to do a further hour a week at home.

The study was approved and funded by the National Institute for Health Research, which tests interventions that might be of use to the NHS. But the researchers found that “this level of specialist exercise doesn’t work”, Lamb said.

The results showed, in fact, that those who carried out the exercise programme had worse cognitive scores – a measurement of their thinking and rationalising abilities – than those who did not. It made them physically fitter, which was helpful in their daily life, but it did not slow down the progress of the disease.

That should not stop people with dementia going for walks, swimming or doing other sorts of gentle activities, said Lamb. “We don’t want to alarm members of the public with dementia and their families. We used a very specialised exercise programme. We know that gentle exercise is good for you. We don’t want people to stop what they are doing,” she said.

“But if you think of exercise as a drug, it is certainly not worth the NHS investing in that type of treatment for people.”

Dr Brendon Stubbs, research physiotherapist at King’s College London, said the results are enormously important for people with dementia and the NHS. “The search for effective lifestyle interventions that can delay cognitive decline in dementia must continue,” he said.

Rob Howard, professor of old age psychiatry at UCL, said the negative results were also important. “Although this was only a tiny worsening in cognitive functioning that wouldn’t have been noticeable in an individual patient, it was statistically significantly different from the outcome seen in those who didn’t exercise.

“Despite its small size, I am sure that – had this been instead an improvement in cognitive functioning with exercise – we would all have been excited about finding something positive in the, so far, depressing fight against dementia. On this basis, I don’t think we should ignore the possibility that exercise might actually be slightly harmful to people with dementia.”

A second study, published in the JAMA Psychiatry journal, showed that people with lower incomes have a higher risk of dementia than those who are well off. Researchers from University College London looked at data on 6,000 adults born between 1902 and 1943 and found that the 20% most deprived adults were 50% more likely to develop dementia than the 20% least deprived adults.

“Our study confirms that the risk of dementia is reduced among well-off older people compared with those who have fewer economic resources,” said Professor Andrew Steptoe, senior author of the study.

“Many factors could be involved. Differences in healthy lifestyle and medical risk factors are relevant. It may also be that better off people have greater social and cultural opportunities that allow them to remain actively engaged with the world.”

Neither education nor physical health accounted for the results, said Dr Sara Imarisio, Head of Research at Alzheimer’s Research UK. “Socioeconomic status is closely intertwined with many different aspects of lifestyle, so unpicking the underlying cause of the relationship highlighted by this research is extremely difficult,” she said.

“The findings suggest that people from economically disadvantaged backgrounds may benefit most from advice about how to reduce dementia risk, and this is something that the health service, charities, and government agencies should consider in future public health campaigns.”

Most viewed

Most viewed