Reducing risk of developing dementia

Australians at risk of developing dementia could support their brain health with increased physical activity, and a new study led by University of Melbourne researchers explores how best to encourage older people to get more active.

Published in the Journal of Alzheimer’s Disease, lead author and PhD candidate with the Academic Unit of Psychiatry of Old Age in the Department of Psychiatry, Eleanor Curran, said the research helps to develop an understanding of how to better support at-risk Australians to engage in physical activity.

Curran, who is also lead psychiatrist in the Older Adult Mental Health Program, Royal Melbourne Hospital Mental Health Services, said the research investigated the broad question of how to help people at risk of dementia to engage with physical activity, acknowledging some of the barriers that currently exist.

“We know that people who are already concerned about their memory, or other aspects of cognition, and who may also live with common mental health challenges such as depression or anxiety, tend to be less engaged with physical activity already,” Curran said.

“We need to develop tailored interventions to help address barriers and support them to both adopt and maintain physical activity.”

Curran said people in the study described experiencing difficulty with depressive or anxiety symptoms which led them to feel overwhelmed, and hindered them from doing physical activity, despite their best intentions.

She said another possible barrier was participants having only low confidence in their abilities to monitor what physical activity they are taking part in.

The research formed part of a larger project – the Exercise for Cognitive Health (EXCEL) study – that tested the benefits of interventions specifically tailored to support people experiencing mental health or cognitive challenges. The interventions supported people to both adopt and maintain the recommended daily amount of physical activity.

“This first phase of the EXCEL study aimed to better understand why people who live with cognitive concerns and symptoms of depression or anxiety do or do not engage with physical activity,” Curran said.

“We used this information to develop a model exploring ways that interventions, including the EXCEL study, could be tailored to specifically engage this group of people – making physical activity interventions more effective and efficient .”

Researchers found most of the participants in the EXCEL study had some knowledge about the benefits of exercise in reducing dementia risk – but there were gaps in their level of understanding.

“We interviewed 21 people (aged between 45 and 80) experiencing both cognitive concerns and symptoms of depression or anxiety, and also examined strategies used in previous clinical trials of physical activity for people experiencing similar challenges,” Curran said.

“We found that people who live with cognitive and mental health conditions experience different barriers to engaging with physical activity , and we need to use different strategies to support them – because we know that physical activity is important in reducing their risk of developing dementia.

Professor Nicola Lautenschlager, senior author on the report and Head of the Melbourne Medical School, said for people living with cognitive concerns or depression or anxiety, it can be challenging to modify behaviours to increase physical activity.

“There is an urgent need to learn more from ageing and older adults in this at-risk group about what new approaches can help them increase their physical activity, as this will ultimately support their wellbeing and brain health,” Professor Launtenschlager said.

“The model developed under Eleanor’s leadership contributes new understanding of the factors underpinning successful physical activity engagement for people living with cognitive concerns and symptoms of depression or anxiety.”