The Importance of Maintaining Mobility in Ageing and Dementia
Sunday 15th May 2016
Dementia has become a major challenge for our society. We have an increasing population of adults aged over 65 years and the number of people living with dementia in the UK set to rise from the current estimate of 850,000 to 2 million by 2051.
To mark Dementia Awareness Week 2016, Naiara Demnitz, Poppy Seager and Claire Sexton from the FMRIB Centre at the, Nuffield Department of Clinical Neurosciences, University of Oxford explain how important it is to keep mobile as you grow older and if you have dementia.
Although the major hallmark of dementia is a progressive decline in mental abilities, mobility difficulties are one of many symptoms also associated with the disease. Adults with dementia tend to walk slower, have greater variability between steps, and have poorer balance, compared to adults of a similar age who do not have dementia. Detrimental changes to gait and balance may lead to an increased number of falls and a reduced ability to move around safely and independently, which can make even simple activities of daily living difficult. Such changes will impact upon both the individual and their caregivers and, ultimately, have a large effect on quality of life.
Mobility problems do not just affect people living with dementia though, they are also extremely common in older adults. In a survey by the Office for National Statistics, 56% of adults over the age of 65 reported having impaired mobility. Recently, research has shown that mobility is linked to cognition and brain measures in general populations of older adults. For example, it has been shown that older adults with good physical balance and walking speed perform better on tests of memory and reasoning. Further, individual studies have shown that a lower level of physical function (e.g. a slower walk) is a risk factor for a more rapid rate of cognitive decline and an increased risk of dementia, although further research is required to confirm this. Similar effects have also been observed using magnetic resonance imaging (MRI) brain scans. For instance, more mobile adults have, on average, greater medial temporal volumes, a brain region associated with memory, than their mobility-impaired counterparts.
Importantly, a range of strategies have been suggested to help to promote or maintain mobility for older adults and people living with dementia, including physical activity programmes. Encouragingly, studies involving adults living with dementia have shown that exercise interventions improve not only mobility, but also activities of daily living like bathing and getting dressed. This is also the case for older adults who are not living with dementia. In the United States, for example, the Lifestyle Interventions and Independence for Elders (LIFE) study found that a 2 year physical activity program reduced the incidence of major mobility disability among sedentary older adults. Inspired by the results of the LIFE study, researchers in Bath, Birmingham, Exeter and Oxford have come together to roll-out a physical activity intervention study for older adults in the UK. This study, called the Retirement in Action or REACT study, is recruiting adults aged 65 or older who are starting to have difficulties with everyday activities such as walking, climbing stairs and getting up from a chair. Through a cost-effective 12-month physical activity intervention, the REACT study aims to improve the mobility and cognitive outcomes of its participants. In future, we hope that studies like these might also inform public health policies on how physical activity may play a role in improving mobility and quality of life of older adults.
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