Obtain Regular Exercise

Sound bodies do promote sound minds. People who engage in regular vigorous exercise tend to stay mentally sharp into their seventies and eighties and beyond. You don't have to run marathons or go to other extremes, but you should get your heart pumping faster and break a sweat. Participants in the MacArthur Foundation Study of Aging in America whose cognitive function remained strong were active almost daily. A 2000 study from the Case Western Reserve University School of Medicine concluded that people who exercised by walking or engaging in physically active hobbies, such as gardening, had a lower risk of Alzheimer's disease compared with people who were sedentary.

Why should physical exercise influence brain health and cognitive function? Researchers at the University of Illinois think the connection has to do with several factors, all bearing on the capacity of physical exercise to augment brain plasticity: increasing capillary growth around neurons, which provide blood-borne oxygen and nutrients; increasing synaptic density; and promoting positive cholinergic effects. These researchers published results of two studies in 2004.

The first study, of forty-one older adults, found that participants with higher cardiovascular fitness (as measured by maximum oxygen uptake during aerobic activity) performed better on a complex attentional task and demonstrated significantly greater fMRI activation in associated brain regions. In the second study, twenty-nine adults, ranging in age between fifty-eight and seventy-seven, were randomly assigned to either an aerobic exercise group or a control group that did stretching and toning. After six months, the aerobic group exhibited increased cardiovascular fitness (as evidenced by maximum oxygen uptake), better performance on the atten-tional task, and greater levels of task-related fMRI activation.

Physical activity has also been linked to a decreased risk of the development of dementia. Researchers in Hawaii found that older men who walked the least distance on a regular basis had an almost twofold increase in risk of developing dementia compared with men who walked the most. Harvard researchers reported a similar finding from the Nurses' Health Study, which has been following more than 120,000 American women since 1976.

I counsel my patients to build physical activity into their everyday routine. Many protest that it's hard to find the time to exercise, with their hectic work schedules and family obligations. My response is that, of course, some days it will be impossible to exercise. But don't let "I'm too busy" become an excuse to be sedentary. Here are some ways to get started being more physically active:

• When possible, walk or bicycle instead of driving or riding; jog instead of walking.

• Take a daily half-hour walk around the neighborhood in the evening or during your lunch break at work. For motivation, ask your spouse or a friend to walk with you.

• Use the stairs instead of the elevator.

• Consult a personal trainer to help you devise a home exercise routine combining aerobic exercise and weight training.

• Take an exercise class or join a health club.

• Swim regularly if you have access to a pool or beach.

• Take up a sport that requires physical exertion, such as tennis, running, or cycling.

If you haven't been physically active recently, check with your doctor first.

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