The World Health Organization predicts that there will be 150 million cases of Alzheimer’s disease worldwide by 2050, but Alzheimer’s is not an equal opportunity offender: Twice as many women as men have Alzheimer’s [1]. Recent research from Brazil suggests that strength and resistance training may actually play a role in treating mild cognitive impairment or the early stages of Alzheimer’s disease. If you’re a woman in your 40s to 50s, here’s what you need to know about what this research might mean for you.
What is strength training?
You’re likely already familiar with aerobic or cardio conditioning exercises, also simply called “cardio.” Biking, running, soccer, basketball, dancing, and rowing are all examples. But strength training is less familiar, and thus more scary, to many people. Strength training, also known as resistance exercise, involves pushing or pulling against a certain resistance. Free weights (like dumbbells and barbells), weight machines, and even your own body weight are a few examples of objects used in resistance exercises.
Unfortunately, many middle-aged women aren’t engaging in any form of regular exercise, let alone strength training. Less than 18% of women over 50 achieve the guidelines of the U.S. Department of Health and Human Services for physical activity per week.
Less than 18% of women over 50 achieve the guidelines of the U.S. Department of Health and Human Services for physical activity per week.
These fairly lax guidelines consist of 2.5 to 5 hours of aerobic and muscle-strengthening activities per week. That’s only about 20-40 minutes of physical activity each day!
What is Alzheimer’s disease?
Characterized by a plethora of symptoms including neuroinflammation (inflammation in the brain and spinal cord), erosion of cognitive function and emotional control, and the severing of electrical nerve pathways in the brain, Alzheimer’s Disease is a serious neurodegenerative disorder that worsens with time. These symptoms are the result of a build-up of amyloid beta peptide (Aβ; an amino acid peptide) and neurofibrillary tangles (groupings of a protein called “tau,” inside neurons). We commonly think of the memory and other cognitive problems Alzheimer’s causes, but it can also lead to muscle degeneration and loss of physical strength.
Alzheimer’s = Type 3 diabetes?
Increasingly, science is discovering the interplay between metabolic syndrome, insulin resistance, and chronic inflammation, and how these three contribute to diabetes, cardiovascular disease, depression, and more. We’ve talked about how irregular cycles as early as the teen years can be a predictor of future metabolic syndrome, and how polycystic ovary syndrome (PCOS)—which may include cardiovascular, mood, and/or metabolic issues—may predispose women to early brain aging and memory loss.
In fact, research suggests that poorly regulated blood sugar (leading to insulin resistance) may play such a significant role in at least some cases of Alzheimer’s that it’s been referred to as “diabetes of the brain” or “Type 3 diabetes” [2]. While there’s much we don’t yet know, “Importantly, type 2 diabetes and the metabolic syndrome are preventable and/or treatable conditions in many patients with lifestyle modifications that secondarily would lower your risk of Alzheimer’s” according to the University of Nebraska Medical Center. The connection between insulin resistance and Alzheimer’s is a “good thing” in that our dietary and other lifestyle practices (like exercise!) can improve insulin resistance (and potentially lower Alzheimer’s risk!).
If we can’t cure Alzheimer’s, can we slow down its progression?
Currently, no cure for Alzheimer’s Disease exists. But a 2023 literature review conducted by the Federal University of São Paulo in Brazil examined alternative therapies and non-pharmacological (non-medical) treatments for Alzheimer’s [1]. The researchers in the Department of Physiology collected and compared research studies demonstrating the relationship between resistance exercise and improving cognitive function in patients with Alzheimer’s and mild cognitive impairment.
These studies consisted of groups of animal models (rats and mice) and human patients. Of the studies with human patients, the sample sizes ranged from 8-27 people with durations ranging from 24 hours to 16 weeks. Participants were asked to complete a series of exercises (at varying frequencies) for the purpose of observing the short-term effects.
What did researchers learn about strength training and Alzheimer’s?
The Federal University of São Paulo concluded that, when combined with aerobic activity, resistance exercise improves cognitive function and can reduce Alzheimer’s pathophysiology.
The Federal University of São Paulo concluded that, when combined with aerobic activity, resistance exercise improves cognitive function and can reduce Alzheimer’s pathophysiology.
Predictably, participants with minor cognitive impairments demonstrated greater short-term improvement than those diagnosed with advanced Alzheimer’s. This difference in results may be caused by something called “the cognitive reserve.” This is the brain’s capacity to resist and recover from damage.
Resistance training plus aerobic exercise stimulates the formation of new hippocampal neurons (which are responsible for the creation of memories) and also, perhaps, the growth of the cognitive reserve. The literature review offers promising evidence that an increased frequency of physical activity in older individuals (with minor cognitive impairments or Alzheimer’s) decreases the amount of Aꞵ in the brain.
Importantly, the effectiveness of combating the quantity of Aβ in the brain through physical activity reduces with age. It seems that Aβ resists change once it reaches a certain level. Thus, resistance plus aerobic activity have a greater chance of helping in the beginning stages of developing minor cognitive impairments.
Increasing awareness around strength training as an alternative treatment
Prior to these studies collected by The Federal University of São Paulo, resistance exercise was hardly considered as an alternative or supplemental treatment for Alzheimer’s. However, the Sao Paulo review suggests that a combination of different types of exercises, including both aerobic activity and strength training, can help more than the repetition of a single type of exercise.
Certainly, more research is needed to demonstrate the effectiveness of strength training in preventing and treating Alzheimer’s Disease. However, these positive results are bringing awareness to the possibility of non-medication treatment options for Alzheimer’s.
There’s no time like the present to start exercising
If you knew it would prevent or slow down the progression of Alzheimer’s, would you start strength training (and exercising in general) now? I bet you would. You are likely already familiar with walking, jogging, or running for aerobic exercise. You may know about Zumba or other workout classes that get your heart pumping. But you might be thinking “I’m out of my league with strength training! There’s so much to know! Where should I begin?” It’s true that strength training is harder to get into with age, but it is far from impossible.
Understanding correct (and safe!) lifting techniques is so important for beginners
You’ve got options for learning how to lift weights properly and safely. Do you know anyone with experience in strength training? Having a lifting partner who holds you accountable and teaches you how to navigate the gym can help you build confidence. When I first started, there was nothing more frightening than walking into the free weight section of the gym and not knowing what to do. Going in with a plan of action and a gym buddy is a game-changer.
Maybe you need more one-on-one attention. Sign up with a personal trainer at your local gym and talk with them about your needs and goals. Together you can build a personalized workout routine that you feel comfortable and confident doing knowing that a professional is there to instruct you. And remember, you can always start at home (looking at you, workout videos on YouTube!) before joining a gym.
Additional Reading:
PCOS and memory loss in mid-life: Is there a connection?
Estrogen is a key driver of the menstrual cycle. But it impacts your brain health, too
References:
[1] Azevedo CV, Hashiguchi D, Campos HC, Figueiredo EV, Otaviano SFSD, Penitente AR, Arida RM, Longo BM. The effects of resistance exercise on cognitive function, amyloidogenesis, and neuroinflammation in Alzheimer’s disease. Front Neurosci. 2023 Mar 2;17:1131214. doi: 10.3389/fnins.2023.1131214. PMID: 36937673; PMCID: PMC10017453. [2] Nguyen TT, Ta QTH, Nguyen TKO, Nguyen TTD, Giau VV. Type 3 Diabetes and Its Role Implications in Alzheimer’s Disease. Int J Mol Sci. 2020 Apr 30;21(9):3165. doi: 10.3390/ijms21093165. PMID: 32365816; PMCID: PMC7246646.
