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The more physical inactivity, the more agitation in dementia

Published online by Cambridge University Press:  03 September 2010

Erik J.A. Scherder ,
Thorsten Bogen ,
Laura H.P. Eggermont ,
Jan P.H. Hamers  and
Dick F. Swaab
Erik J.A. Scherder*
Affiliation:
Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
Thorsten Bogen
Affiliation:
Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
Laura H.P. Eggermont
Affiliation:
Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands
Jan P.H. Hamers
Affiliation:
Maastricht University, School for Public Health and Primary Care, Department of Health Care and Nursing Science, Maastricht, The Netherlands
Dick F. Swaab
Affiliation:
Netherlands Institute for Neurosciences, Amsterdam, The Netherlands
*
Correspondence should be addressed to: Professor Erik J.A. Scherder, PhD, Head of the Department of Clinical Neuropsychology, VU University, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. Phone: +31-20-5988761; Fax: +31-20-5988971. Email: [email protected].
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Abstract

Epidemiological studies show a close relationship between physical activity and cognition. A causal relationship between physical activity and cognition has been observed in children, adolescents, older people without dementia, and in older people in a very early stage of dementia. Considering these positive effects, we argue that a decline in physical activity has a detrimental effect on cognition and behavior in patients with dementia. Merely living in a nursing home reduces the level of physical activity. The level of physical activity may even be reduced to a minimum when physical restraints are applied. The use of physical restraints coincides with stress, further aggravating the already existing neuropathology, which may increase stress and agitation even more. Exercise may reduce stress and agitation.

Keywords

physical activityagitationdementiacognitionbehaviorstress
Type
Focus on prevention in psychogeriatrics
Information
International Psychogeriatrics , Volume 22 , Special Issue 8: Focus on prevention in psychogeriatrics , December 2010 , pp. 1203 - 1208
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Akirav, I. and Maroun, M. (2007). The role of the medial prefrontal cortex–amygdala circuit in stress effects on the extinction of fear. Neural Plasticity, 2007, 30873.Google Scholar
Bartesaghi, R., Raffi, M. and Ciani, E. (2006). Effect of early isolation on signal transfer in the entorhinal cortex–dentate–hippocampal system. Neuroscience, 137, 875–890.Google Scholar
Bates-Jensen, B. M. et al. (2004). The Minimum Data Set bedfast quality indicator: differences among nursing homes. Nursing Research, 53, 260–272.Google Scholar
Battaglia, F. et al. (2007). Cortical plasticity in Alzheimer's disease in humans and rodents. Biological Psychiatry, 62, 1405–1412.CrossRefGoogle ScholarPubMed
Braak, H. and Braak, E. (1991). Neuropathological stageing of Alzheimer-related changes. Acta Neuropathologica, 82, 239–259.Google Scholar
Buchman, A. S., Boyle, P. A., Wilson, R. S., Fleischman, D. A., Leurgans, S. and Bennett, D. A. (2009). Association between late-life social activity and motor decline in older adults. Archives of Internal Medicine, 169, 1139–1146.Google Scholar
Budde, H., Voelcker–Rehage, C., Pietrabyk–Kendziorra, S., Ribeiro, P. and Tidow, G. (2008). Acute coordinative exercise improves attentional performance in adolescents. Neuroscience Letters, 441, 219–223.Google Scholar
Burgio, L. D., Butler, F. R., Roth, D. L., Hardin, J. M., Hsu, C–C. and Ung, K. (2000). Agitation in nursing home residents: the role of gender and social context. International Psychogeriatrics, 12, 495–511.CrossRefGoogle ScholarPubMed
Castle, N. G. (2006). Mental health outcomes and physical restraint use in nursing homes (private). Administration and Policy in Mental Health, 33, 696–704.Google Scholar
Chan, D. et al. (2001). Pattern of temporal lobe atrophy in semantic dementia and Alzheimer's disease. Annals of Neurology, 49, 433–442.Google Scholar
Coleman, E. A. (1993). Physical restraint use in nursing home patients with dementia. JAMA, 270, 2114–2115.CrossRefGoogle ScholarPubMed
Coleman, P. D. and Flood, D. G. (1987). Neuron numbers and dendritic extent in normal aging and Alzheimer's disease. Neurobiology of Aging, 8, 521–545.Google Scholar
Davies, R. R., Graham, K. S., Xuerub, J. H., Williams, G. B. and Hodges, J. R. (2004). The human perirhinal cortex and semantic memory. European Journal of Neuroscience, 20, 2441–2446.CrossRefGoogle ScholarPubMed
Dedovic, K., Duchesne, A., Andrews, J., Engert, V. and Pruessner, J. C. (2009). The brain and the stress axis: the neural correlates of cortisol regulation in response to stress. Neuroimage, 47, 864–871.CrossRefGoogle ScholarPubMed
Depp, C., Vahia, I. V. and Jeste, D. (2010). Successful aging: focus on cognitive and emotional health. Annual Review of Clinical Psychology, 6, 527–550.Google Scholar
Diaz, M., Sailor, K., Cheung, D. and Kuslansky, G. (2004). Category size effects in semantic and letter fluency in Alzheimer's patients. Brain and Language, 89, 108–114.Google Scholar
Dickerson, B. C. and Eichenbaum, H. (2010). The episodic memory system: neurocircuitry and disorders. Neuropsychopharmacology, 35, 86–104.Google Scholar
Egerton, T. and Brauer, S. G. (2009). Temporal characteristics of habitual physical activity periods among older adults. Journal of Physical Activity and Health, 6, 644–650.CrossRefGoogle ScholarPubMed
Eggermont, L., Swaab, D., Luiten, P. and Scherder, E. (2006). Exercise, cognition and Alzheimer's disease: more is not necessarily better. Neuroscience and Biobehavioral Reviews, 30, 562–575.Google Scholar
Eggermont, L. H., Swaab, D. F., Hol, E. M. and Scherder, E. J. (2009). Walking the line: a randomized trial on the effects of a short term walking programme on cognition in dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 802–804.CrossRefGoogle Scholar
Erickson, K. I. et al. (2009). Aerobic fitness is associated with hippocampal volume in elderly humans. Hippocampus, 19, 1030–1039.Google Scholar
Fratiglioni, L., Paillard–Borg, S. and Winblad, B. (2004). An active and socially integrated lifestyle in late life might protect against dementia. The Lancet Neurology, 3, 343–353.Google Scholar
Furay, A. R., Bruestle, A. E. and Herman, J. P. (2008). The role of the forebrain glucocorticoid receptor in acute and chronic stress. Endocrinology, 149, 5482–5490.CrossRefGoogle ScholarPubMed
Grady, C. L., Furey, M. L., Pietrini, P., Horwitz, B. and Rapoport, S. I. (2001). Altered brain functional connectivity and impaired short-term memory in Alzheimer's disease. Brain, 124, 739–756.Google Scholar
Hamers, J. P. H., Gulpers, M. J. M. and Strik, W. (2004). Use of physical restraints with cognitively impaired nursing home residents. Journal of Advanced Nursing, 45, 246–251.CrossRefGoogle ScholarPubMed
Hamers, J. P. H., Meyer, G., Kopke, S., Lindenmann, R., Groven, R. and Huizing, A. R. (2009). Attitudes of Dutch, German and Swiss nursing staff towards restraint use in nursing home residents. International Journal of Nursing Studies, 46, 248–255.Google Scholar
Haskell, R. M., Frankel, H. L. and Rotondo, M. F. (1997). Agitation. AACN Clinical Issues, 8, 335–350.Google Scholar
Herman, J. P., Ostrander, M. M., Mueller, N. K. and Figueiredo, H. (2005). Limbic system mechanisms of stress regulation: hypothalamo-pituitary-adrenocortical axis. Progress in Neuro-psychopharmacology and Biological Psychiatry, 29, 1201–1213.Google Scholar
Hodges, J. R. (2001). Frontotemporal dementia (Pick's disease): clinical features and assessment. Neurology, 56, S6–S10.Google Scholar
Huizing, A. R., Hamers, J. P. H., Gulpers, M. J. M. and Berger, M. P. F. (2009). A cluster-randomized trial to reduce the use of physical restraints with psychogeriatric nursing home residents. Journal of the American Geriatrics Society, 57, 1139–1148.CrossRefGoogle ScholarPubMed
Kramer, A. F. et al. (1999). Ageing, fitness and neurocognitive function. Nature, 400, 418–419.Google Scholar
Kudielka, B. M., Hellhammer, D. H. and Wüst, S. (2009). Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge. Psychoneuroendocrinology, 34, 2–18.CrossRefGoogle ScholarPubMed
Lautenschlager, N. T. et al. (2008). Effect of physical activity on cognitive function in older adults at risk for Alzheimer disease: a randomized trial. JAMA, 300, 1027–1037.Google Scholar
Lemay, M. and Landreville, P. (2010). Verbal agitation in dementia: the role of discomfort. American Journal of Alzheimer's Disease and Other Dementias, 25, 193–201.Google Scholar
Leonard, B. E. (2006). HPA and immune axes in stress: involvement of the serotonergic system. Neuroimmunomodulation, 13, 268–276.CrossRefGoogle ScholarPubMed
Lipnicki, D. M. and Gunga, H. C. (2009). Physical inactivity and cognitive functioning: results from bed rest studies. European Journal of Applied Physiology, 105, 27–35.Google Scholar
Lipnicki, D. M., Gunga, H. C., Belavý, D. L. and Felsenberg, D. (2009). Bed rest and cognition: effects on executive functioning and reaction time. Aviation, Space and Environmental Medicine, 80, 1018–1024.Google Scholar
Loucks, E. B., Berkman, L. F., Gruenewald, T. L. and Seeman, T. E. (2006). Relation of social integration to inflammatory marker concentrations in men and women 70 to 79 years. American Journal of Cardiology, 97, 1010–1016.Google Scholar
Marczinski, C. A. and Kertesz, A. (2005). Category and letter fluency in semantic dementia, primary progressive aphasia, and Alzheimer's disease. Brain and Language, 97, 258–265.Google Scholar
Melendez, R. I., Gregory, M. L., Bardo, M. T. and Kalivas, P. W. (2004). Impoverished rearing environment alters metabotropic glutamate receptor expression and function in the prefrontal cortex. Neuropsychopharmacology, 29, 1980–1987.Google Scholar
Moss, R. J. and La Puma, J. (1991). The ethics of mechanical restraints. The Hastings Center Report, 21, 22–26.CrossRefGoogle ScholarPubMed
Neugroschl, J. (2002). Agitation: how to manage behavior disturbances in the older patient with dementia. Geriatrics, 57, 33–37.Google Scholar
Nikolaev, E., Kaczmarek, L., Zhu, S. W., Winblad, W. and Mohammed, A. H. (2002). Environmental manipulation differentially alters c-Fos expression in amygdaloid nuclei following aversive conditioning. Brain Research, 957, 91–98.CrossRefGoogle ScholarPubMed
Palmer, L., Abrams, F., Carter, D. and Schluter, W. W. (1999). Reducing inappropriate restraint use in Colorado's long-term care facilities. Joint Commission Journal on Quality Improvement, 25, 78–94.Google Scholar
Pruessner, J. C. et al. (2010). Stress regulation in the central nervous system: evidence from structural and functional neuroimaging studies in human populations. Psychoneuroendocrinology, 35, 179–191.Google Scholar
Pugh, K. G. and Lipsitz, L. A. (2002). The microvascular frontal-subcortical syndrome of aging. Neurobiology of Aging, 23, 421–431.Google Scholar
Rabinovici, G. D. et al. (2007). Distinct MRI atrophy patterns in autopsy-proven Alzheimer's disease and frontotemporal lobar degeneration. American Journal of Alzheimer's Disease and Other Dementias, 22, 474–488.Google Scholar
Radley, J. J., Arias, C. M. and Sawchenko, P. E. (2006). Regional differentiation of the medial prefrontal cortex in regulating adaptive responses to acute emotional stress. Journal of Neuroscience, 26, 12967–12976.CrossRefGoogle ScholarPubMed
Rimmele, U., Seller, R., Marti, B., Wirtz, P. H., Ehlert, U. and Heinrichs, M. (2009). The level of physical activity affects adrenal and cardiovascular reactivity to psychosocial stress. Psychoneuroendocrinology, 34, 190–198.CrossRefGoogle ScholarPubMed
Román, G. C., Erkinjuntti, T., Wallin, A., Pantoni, L. and Chui, H. C. (2002). Subcortical ischaemic vascular dementia. The Lancet Neurology, 1, 426–436.Google Scholar
Rosano, C. et al. (2005). Association between physical and cognitive function in healthy elderly: the health, aging and body composition study. Neuroepidemiology, 24, 8–14.Google Scholar
Rovio, S. et al. (2005). Leisure–time physical activity at midlife and the risk of dementia and Alzheimer's disease. The Lancet Neurology, 4, 705–711.CrossRefGoogle ScholarPubMed
Sachdev, P. S., Chen, X., Joscelyne, A., Wen, W., Altendorf, A. and Brodaty, H. (2007). Hippocampal size and dementia in stroke patients: the Sydney stroke study. Journal of the Neurological Sciences, 260, 71–77.CrossRefGoogle Scholar
Strumpf, N. E. and Tomes, N. (1993). Restraining the troublesome patient: a historical perspective on a contemporary debate. Nursing History Review, 1, 3–24.Google Scholar
Sullivan–Marx, E. M., Strumpf, N. E., Evans, L. K., Baumgarten, M. and Maislin, G. (1999). Predictors of continued physical restraint use in nursing home residents following restraint reduction efforts. Journal of the American Geriatrics Society, 47, 342–348.Google Scholar
Swaab, D. F., Bao, A. M. and Lucassen, P. J. (2005). The stress system in the human brain in depression and neurodegeneration. Ageing Research Reviews, 4, 141–194.CrossRefGoogle ScholarPubMed
Tatemichi, T. K., Desmond, D. W. and Prohovnik, I. (1995). Strategic infarcts in vascular dementia: a clinical and brain imaging experience. Arzneimittelforschung, 45, 371–385.Google ScholarPubMed
Tessner, K. D., Walker, E. F., Dhruv, S. H., Hochman, K. and Hamann, S. (2007). The relation of cortisol levels with hippocampus volumes under baseline and challenge conditions. Brain Research, 1179, 70–78.CrossRefGoogle ScholarPubMed
Testad, I., Ballard, C., Brønnick, K. and Aarsland, D. (2010). The effect of staff training on agitation and use of restaint in nursing home residents with dementia: a single-blind, randomized control trial. Journal of Clinical Psychiatry, 71, 80–86.Google Scholar
Tomporowski, P. D., Davis, C. L., Miller, P. H. and Naglieri, J. A. (2008). Exercise and children's intelligence, cognition, and academic achievement. Educational Psychology Review, 20, 111–131.CrossRefGoogle ScholarPubMed
Tsoi, T., Baillon, S. and Lindesay, J. (2008). Early frontal executive impairment as a predictor of subsequent behavior disturbance in dementia. American Journal of Geriatric Psychiatry, 16, 102–108.Google Scholar
Uylings, H. B. and de Brabander, J. M. (2002). Neuronal changes in normal human aging and Alzheimer's disease. Brain and Cognition, 49, 268–276.Google Scholar
Varrone, A. et al. (2002). Voxel-based comparison of rCBF SPET images in frontotemporal dementia and Alzheimer's disease highlights the involvement of different cortical networks. European Journal of Nuclear Medicine and Molecular Imaging, 29, 1447–1454.Google Scholar
Verghese, J., Wang, C., Lipton, R. B., Holtzer, R. and Xue, X. (2007). Quantitative gait dysfunction and risk of cognitive decline and dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 929–935.Google Scholar
Volicer, L., Simard, J., Heartquist, J., Medrek, R. and Riordan, M–E. (2006). Effects of continuous activity programming on behavioral symptoms of dementia. Journal of the American Medical Directors Association, 7, 426–431.CrossRefGoogle ScholarPubMed
Wang, L. et al. (2006). Changes in hippocampal connectivity in the early stages of Alzheimer's disease: evidence from resting state fMRI. Neuroimage, 31, 496–504.Google Scholar
Werner, P., Cohen–Mansfield, J., Braun, J. and Marx, M. S. (1989). Physical restraints and agitation in nursing home residents. Journal of the American Geriatrics Society, 37, 1122–1126.Google Scholar
Wright, C. I., Feczko, E., Dickerson, B. and Williams, D. (2007). Neuroanatomical correlates of personality in the elderly. Neuroimage, 35, 263–372.Google Scholar
Zuidema, S., Koopmans, R. and Verhey, F. (2007). Prevalence and predictors of neuropsychiatric symptoms in cognitively impaired nursing home patients. Journal of Geriatric Psychiatry and Neurology, 20, 41–49.CrossRefGoogle ScholarPubMed