Exercise as an Intervention for Dementia in Linguistic Relation to the Activity Theory

1. Exercise as an Intervention for Dementia in Linguistic Relation to the Activity Theory Meagan Driggers Final Exam May 8, 2006 Language, Aging, & Health GRNT 5050 ~ Spring 2006

2. Facts about Dementia • Dementia is a degenerative brain ailment leading to neurological cell death • Disease duration is 5-17 years with an average lifespan of 8 years after initial diagnosis • Causes are immeasurable, but may include: age, gender, genetics, lifestyle, etc. • No cure is available at this time • Available treatments include: medications, thinking & memory activities, assisted living facilities, caregivers, & exercise

3. The Basics of Exercise • Classified as an activity having a specified aspect & requiring physical, mental, & emotional exertion • Types include: aerobic, anaerobic, strength training, resistance training, stretching, cardiovascular training, etc. • Professionals are taught how to implement tailored exercise prescriptions based upon lifestyle, goals, chronic diseases, & medical conditions • “A good activity program restores a sense of purpose, identity, & control.”

4. Why Exercise Works • Exercise is a structured & intensely monitored form of activity • Patients with Alzheimer’s disease or Dementia will continue on the same exercise prescription in an effort to increase functional fitness • Exercise provides constant physical, mental, & emotional contact • Exercise requires high amounts of listening, recall, recognition, communication, & remembrance

5. Exercise as an Intervention for Dementia • Any element from everyday existence can be turned into an activity • Exercise is flexible & accommodates any physical limitations brought about by cognitive decline • Exercise increases the speed & pathway through which neurological cells travel • Those who work with & participate in activity are advocating contemplative, as well as physical forms of stimulation

6. The Cognitive Effects of Exercise on Patients with Dementia • A recent study analyzed the long-term effects of exercise on the cognitive performance of patients clinically diagnosed with Dementia • The study included 15 male participants with a mean age of 74 years • Patients had clinically diagnosed Dementia of the Alzheimer type with no other contraindications • Exercise training consisted of using a cycloergometer 3 days/week for 3 months with assessments taken initially & after 3 months • Heart rate was maintained at 70% of max

7. The Cognitive Effects of Exercise on Patients with Dementia (cont.) • The results & conclusions of the study were as follows: • Exercise training significantly improves the cognitive function of elderly individuals with clinically diagnosed Dementia of the Alzheimer type • Physical activity helps to retain & partially restore compromised cognitive function • Increased cognitive decline leads to immobility & isolation which further exacerbates the already diminished mental performance…long-term exercise prescription breaks this cycle

8. My Personal Experience at a Senior Center • One cognitively impaired woman could no longer remember how to perform many common activities, such as opening the mail • Initially, she was frustrated with the exercise plan due to frequent memory impairments • With time & persistence, she can now remember, recall, & recognize her exercise plan, along with many more daily activities • With no other lifestyle changes, my wonderfully inspiring lady attributes the changes in her mental acuity to exercise

9. Activity in Old Age • Activity is defined in the following terms: • As physical movement • As the pursuit of everyday interests • As social participation • Activity makes growing older a lively, creative, & learning experience • Idleness, not the process of aging, hastens illness & enfeeblement • The commonality & acceptance of activity’s positive role in an elderly individual’s life led to the development of the Activity Theory

10. Activity Theory • Predates the Disengagement Theory • Accepted by Gerontologists in the 1950s • Regarded through the following approaches: • Activity is crucial for a healthy transition into old age • Successful aging is linked to an active social life • Elderly individuals have greater life satisfaction & higher levels of social interaction with increase in daily activity • Close, stable relationships are key • Retirement & growing older should be a time of health, activity, & mobility

11. Stages of the Activity Theory • There are three stages of the Activity Theory • Each stage must transpire successfully in order for an elderly individual to efficiently communicate & grow into the process of aging • The engaged upon interactions must be frequent & regular • The acquired relationships should be characterized through intimacy & closeness during the process of aging • The degree & type of activity with each developed relationship should be evident through the communicative acts

12. Stages of Activity Theory (cont.) • The engaged upon interactions must be frequent & regular • Exercise Specialists recommend that patients with Dementia engage in mild to moderate exercise for 30 minutes ~ 3 days per week • Senior specific exercise facilities & classes maintain regular operating hours to allow for the adaptation to a consistent exercise schedule • Patients with Dementia who follow a frequent & regular exercise schedule will dramatically stimulate the neural pathways, thus significantly decreasing the signs & symptoms associated with this degenerative disease

13. Stages of Activity Theory (cont.) • The acquired relationships should be characterized through intimacy & closeness during the process of aging • Patients with Dementia require communicative stimulation & participating in exercise affords an instant connection with those surrounding them in similar environment & activity • Intimacy & closeness arrives as patients experience the aging process at the same rate through exercise • Shared situations & life experiences stimulate long-term memories & spark meaningful conversation crucial to patients with Dementia • War stories, the Depression, music, specific eras, family, births, deaths, weddings, widowhood, etc.

14. Stages of Activity Theory (cont.) • The degree & type of activity with each developed relationship should be evident through the communicative acts • Exercise provides instant connection & conversation • Walking next to someone else on a treadmill or taking part in a strength training class • Exercise physiologists communicate the frequency, time, & type of activity to the participant on a constant basis & work with clients during each visit • Communication & exercise stimulate neural activity • Other members can help patients with Dementia in regards to exercise, due to their frequent loss of short-term memory, which further strengthens communications skills & intimate relationships

15. The Perspective from the Field of Clinical Exercise Physiology • Exercise & activity are the heart & soul of Clinical Exercise Physiology, requiring unlimited amounts & types of communication • Without communication, the relationship between the Clinical Exercise Physiologist & the patient would quickly deteriorate • “In short, activity expands the social terrain upon which gerontologists and related professionals who work with the elderly can intervene while addressing the problematization of adjustment from multiple vantage points.”

16. Mental Stimulation & Exercise “Mental stimulation is the most important measure in the hygiene of the aged. A walk through an unfamiliar forest path will not alone give physical exercise but will stimulate the brain & cause continual mental exhilaration.” ~Ignatius Nascher~ Geriatrics: The Diseases of Old Age & Their Treatment

17. Works Cited • "Dementia.com: Round-the-Clock Resources for Dementia." 03 March 2006. Janssen-Cilag. 22 April 2006 <http://www.dementia.com>. • Heyn, PhD, Patricia, Beatriz Abreu, PhD, OTR, & Kenneth J. Ottenbacher, PhD, OTR. "The Effects of Exercise Training on Elderly Persons With Cognitive Impairment & Dementia: A Meta-Analysis." The Archives of Physical & Medical Rehabilitation 85(2004): 1694-1704. • Katz, Stephen. "BUSY BODIES: Activity, Aging,& the Management of Everyday Life." Journal of Aging Studies 14(2000): 135-152. • Mahendra, Nidhi & Sharon Arkin. "Effects of four years of exercise, language, & social interventions on Alzheimer discourse." Journal of Communication Disorders 36(2003): 395-422. • Nussbaum, Jon F., Loretta L. Pecchioni, James D. Robinson, & Teresa L. Thompson. Communication & Aging.2nd ed. Muhwah, New Jersey: Lawrence Erlbaum Associates, Publishers, 2000. • Palleschi, L., F. Vetta, E. De Gennaro, G. Idone, G. Sottosanti, W. Gianni, & V. Marigliano. "Effect or Aerobic Training on the Cognitive Performance of Elderly Patients with Senile Dementia of Alzheimer Type." The Archives of Gerontologtical Geriatric Suppl. 5(1996): 47-50.