From the Guidelines
The most effective cognitive exercises for Alzheimer's dementia patients are those that combine physical activity with cognitive tasks, such as walking while performing memory exercises, which can be done in short sessions of 10-20 minutes, 3-7 days a week, as recommended by the most recent study 1. These exercises should be tailored to the individual's abilities and interests, and can include activities such as reminiscence therapy, word games, puzzles, and simple math problems. Physical exercise, including aerobic, resistance, balance, and gait exercises, is also crucial in maintaining physical function and reducing cognitive decline, with a recommended total duration of 50-60 minutes per day, distributed throughout the day to accommodate individual preferences and capabilities 1. Additionally, non-pharmacologic interventions such as cognitive training, music or art therapy, and a Mediterranean diet rich in brain-healthy foods can have a positive impact on cognition and physical function, as suggested by a recent review 1. It is essential to emphasize the importance of maintaining the exercise program over time for sustained benefits and prevention of physical and cognitive decline, and to provide additional support such as reminders or greater involvement of caregivers to improve adherence and effectiveness 1. Key aspects of these exercises include:
- Combining physical activity with cognitive tasks
- Tailoring activities to individual abilities and interests
- Incorporating aerobic, resistance, balance, and gait exercises
- Distributing exercise sessions throughout the day
- Providing additional support to improve adherence and effectiveness
- Focusing on maintaining function and improving quality of life, rather than reversing Alzheimer's progression.
From the Research
Cognitive Exercises for Alzheimer's Dementia Patients
- Cognitive training and lifestyle modifications are recognized as promising strategies for preserving or improving cognitive health in individuals at risk for Alzheimer's disease and related dementias (ADRD) 2.
- Combining physical exercise with cognitive training is a popular intervention in dementia prevention trials and guidelines, with simultaneous and sequential training showing efficacy for promoting cognitive and physical health in older adults 3.
Types of Cognitive Exercises
- Simultaneous training, which combines physical and cognitive exercises at the same time, is the most efficacious approach for cognition 3.
- Sequential training, which involves alternating between physical and cognitive exercises, is also effective for promoting cognitive and physical health 3.
- Exergaming, a type of exercise that combines physical activity with video games, ranked low for both cognitive and physical outcomes 3.
Medications and Cognitive Function
- Rivastigmine hydrogen tartrate and donepezil hydrochloride have been shown to improve cognitive function and mental behavior in patients with Alzheimer's disease, with combination therapy being more effective than monotherapy 4.
- Donepezil, rivastigmine, galantamine, and memantine are commonly used medications for the treatment of Alzheimer's disease, with galantamine being effective in treating all aspects of the disease 5.
Lifestyle Modifications
- Exercise has emerged as a key intervention for influencing cognition positively, including reducing the risk of age-related cognitive decline and dementia 6.
- Physical inactivity is a modifiable risk factor for dementia, and regular exercise can help reduce this risk 6.
- A healthy lifestyle, including regular physical activity, a balanced diet, and stress management, can help promote cognitive health and reduce the risk of dementia 2, 3, 6.