Alzheimer – Physical Exercise Protects the Brain
“My grandmother, she started walking five miles a day when she was sixty. She’s ninety-seven today and we don’t know where the hell she is.”
Soon after taking on a new job as CEO of a technology company, Richard W. consulted with me about his memory concerns. He always felt he had an incredible, almost photographic memory for people’s names, but now that he was 54, he was having trouble learning the names of his new staff. He’d read a lot about Alzheimer’s in the news and was worried that his memory changes might be the early symptoms of the disease.
We reviewed his medical and lifestyle background. Richard was in good health, his blood pressure and cholesterol levels were normal, and he was taking very few medicines. He had no family history of dementia, but his father had died of a heart attack at age 66. Although Richard felt some stress about his new high-level position, it wasn’t affecting his sleep or his appetite. He ate a healthy diet and maintained an active social life. He did mention that since taking on the new job, he rarely had enough time for the daily tennis, jogging, or swimming that he used to do.
Besides the memory exercises I gave him, I recommended that Richard get back into his exercise routine. Regular cardiovascular conditioning would not only protect his heart, but it would be good for his brain, potentially improving his memory and lowering his future risk for Alzheimer’s disease. A month later, Richard returned to my office and said that he had gone back to running three miles every morning and playing tennis twice a week. He felt a lift in his mood and energy level, and his memory had definitely improved—he felt like his old photographic memory for names was coming back to him. Physical activity gets us into shape, helps take off excess weight, and keeps us feeling young. I remember back in high school, the PE coach made us do hundreds of jumping jacks, sit-ups, and laps around the track. We reluctantly ran the tedious laps and moaned about it the whole time. The coach told us to stop complaining, because it was good for our hearts.
What we didn’t know then—and many people still don’t realize—is that those laps and jumping jacks were protecting not just our hearts but our brains, as well. The physical conditioning we were getting five days a week helped improve our mood and memory ability, increase our life expectancy, and reduce our risk for developing Alzheimer’s disease in the future.
Swedish scientists have found an association between cardiovascular fitness and intelligence. They reported that the fitness habits of 18-year-olds predicted their educational achievements years later in life. A 2010 report from the Framingham Longitudinal Study confirmed many earlier studies indicating that moderate physical activity protects brain health. Daily brisk walks led to a 40 percent lower risk for developing Alzheimer’s disease or any kind of dementia.
Keep Walking to Stay Sharp
Gigi’s Grandma Ollie lived in a third-floor walk-up apartment in the Upper West Side of New York City. Every day she went down those stairs several times to go to the post office or the cleaners and do a little grocery shopping, and, of course, she’d walk back up several times. She never forgot a birthday, an anniversary, or any holiday. And, boy you didn’t want to forget to send her a card or call her on her birthday. If you did forget, you’d hear about it for a long time. She lived beyond 100 (although she only admitted to being 98).
GRANDMA OLLIE: 103 years old, holding a photo of herself from her younger days.
Walking is one of the safest and most convenient ways to get an aerobic workout. How much walking or exercise each person needs depends on their baseline fitness level, age, and other health factors. However, becoming a weekend warrior who gets lots of exercise, but only on Saturday and Sunday, is not as effective as getting even short periods of cardio workouts throughout the week.
In a study of more than 18,000 older women, Harvard researchers found that a total of 90 minutes a week of brisk walking, or approximately 15 minutes a day, was all that was needed to delay cognitive decline and reduce possible risk for future Alzheimer’s disease. University of Pittsburgh scientists found that the more that older people walk, the better their cognitive abilities and the larger their brains, and larger brain size is associated with a lower risk for Alzheimer’s disease.
Many studies have demonstrated that a lower risk for Alzheimer’s disease is associated with almost any form of physical activity, whether it’s gardening, housework, swimming, or tennis. When sedentary people start a fitness program, their brains grow larger in key memory regions such as the frontal lobe and hippocampus.
Equally convincing evidence of the brain benefits of physical exercise comes from studies that have enrolled and monitored volunteers in exercise programs and compared them to sedentary control groups. Dr. Arthur Kramer and colleagues at the University of Illinois recruited volunteers aged 58 to 77 years and assigned them to either a walking group or a group that did stretching and toning. After six months the walkers had increased blood flow in brain circuits that control spatial ability and complex thinking, but the stretching and toning control group showed no such change. Although stretching and toning are important components of a comprehensive physical fitness program, Professor Kramer’s findings demonstrate the added value of cardiovascular conditioning for maintaining brain health. Other research indicates that just 20 minutes of daily aerobic exercise can improve memory ability, and these improvements were still observed a year after completion of the initial physical training even when the daily exercise regimen is not maintained.
I not only feel energized and mentally sharp after a brisk walk, swim, or workout at the gym; I can almost beat Gigi at Scrabble (even almost is hard to do). Aerobic conditioning may be improving my memory and mental acuity in several ways. Exercise gets the heart pumping more blood, not just to the muscles but also to the brain. This added blood flow in the brain appears to reverse cellular deterioration associated with aging. It also stimulates the growth of new synapses, the connection sites between neurons, and makes brain cells more responsive to external stimuli. Studies of small animals have shown that exercise increases growth of brain blood vessels that deliver oxygen, as well as brain-derived neurotrophic factor (BDNF), a protein that stimulates brain cell growth and synaptic connections, leading to a more efficient, sensitive, and adaptive brain. BDNF is also associated with reduced risk for Alzheimer’s disease.
Q: Does any kind of exercise help keep your brain healthy or do I have to do power walks, which I find boring?
A: Most of the studies showing brain health benefits from physical exercise have involved walking as the primary intervention. However, any form of cardiovascular conditioning has similar effects on increasing brain blood flow and endorphin release. Newer studies also show that strength training can improve cognitive function and brain health as well. So if walking bores you, consider swimming, cycling, competitive sports, or any form of physical exercise you enjoy. The elliptical machine or any of the machines at the gym that provide a cardiovascular workout would have the same effect on boosting your heart and brain health.
Pumping Iron Builds Brain Muscle
Most of us have seen body builders who lift huge barbells to enlarge their muscles and sculpt their bodies. They’re usually trying to build larger biceps, washboard abs, and stronger hamstrings. Neuroscientists are now finding that this same kind of strength and resistance training also boosts brain fitness.
In one recent investigation, Brazilian researchers studied three groups of laboratory rats over eight weeks: a strength-training group that had tiny weights tied to their tails while they climbed little ladders; an aerobics group that ran on miniature treadmills; and a control group that essentially sat around. Both the strength-training and aerobic groups demonstrated improved learning and memory abilities. They also had higher levels of the protein BDNF. The sitting-around group’s brains just “sat around” and showed no improvement.
Japanese researchers increased the resistance of the running wheels of laboratory animals similarly to the way we adjust the resistance on our treadmills or stationary bicycles. As a result of their increased resistance training (compared to a standard-issue running wheel exercise), the animals’ DNA switched on to produce higher levels of BDNF. Thus, physical resistance exercise may not only build muscle strength but also turn on our genes to spark neuronal activity.
In studies of older women at the University of British Columbia, Dr. Teresa Liu-Ambrose found that weight lifters have better cognitive abilities than those who stick to only stretching and toning routines. Strength training seems to improve specific brain functions involving complex reasoning and attention skills that are controlled in the frontal lobe. Pumping iron builds brain muscle by increasing the heart’s efficiency in supplying blood to the brain. The need to attend to form and technique while weight training may also provide a cognitive challenge not practiced when just stretching or running laps around the track.
Does Exercise Cure Depression?
After just a few weeks of working out and playing tennis, our technology CEO, Richard W., noticed that his mood had lifted. Anyone who has run a 10-K or done any kind of rigorous training knows firsthand the immediate sense of endorphin-induced euphoria. We feel uplifted and clearheaded, and recent research suggests that it may have a lasting effect on relieving symptoms of depression.
Depression can distract us and impair our memory ability. It can also be one of the first symptoms of the onset of Alzheimer’s disease in older adults. During our UCLA studies we have found that some symptoms of depression and even anxiety appear to correlate with the accumulation of amyloid plaques and tau tangles in the brain as Alzheimer’s disease progresses.
Colleagues from Duke University recently compared the antidepressant effects of aerobic exercise training to the antidepressant sertraline (Zoloft), as well as a placebo pill. After four months, they found that exercise was just as good as or better than the Zoloft in treating depression. Those who exercised at a moderate level—about 40 minutes three to five days each week—experienced the greatest antidepressant effect.
Exercise not only releases endorphins, the body’s own natural antidepressant, but it also releases the brain messenger serotonin, which elevates mood. Many of today’s antidepressants like Zoloft or fluoxetine (Prozac) are SSRIs (selective serotonin reuptake inhibitors) that exert their effects on the brain’s chemistry by increasing the amount of serotonin, a chemical that is decreased in depression. So the fitness component of your Alzheimer’s prevention program may not only help your memory but also give you a boost in your mood.
Getting Off the Couch
One night I set my alarm to go off early so I could get 20 minutes in on the treadmill before work. The next thing I knew, the alarm was blaring and I hit the snooze button for just a few more minutes of rest. Once I got out of bed, I figured a cup of coffee and the newspaper would be nice before my workout. The crossword puzzle looked sort of easy. I finished the puzzle and went to the closet to grab my sneakers, which I couldn’t find in the mess of shoes. I started reorganizing my shoes, and then noticed the pile of wrinkled sweaters on the shelf above, so I began refolding them. OCD? Maybe, but I suddenly looked at my watch and realized that I would be late for work if I didn’t skip the treadmill and get in the shower, asap. Maybe I’d work out tonight . . .
Now I almost always get my daily workout in. For most of us, the hardest part of an exercise program is getting started. But once we make it a habit and start seeing results, it becomes easier to stick with it. So, if we all know that exercise is good for our hearts and life expectancy, why doesn’t everybody run ten miles a week? And with new discoveries showing how exercise protects the brain and potentially guards us from Alzheimer’s disease, shouldn’t there be a stampede to the running track?
One reason that everyone doesn’t hop on the treadmill right now is that in general, most people don’t put as much value on things that are down the road in the future. Our brains are hardwired for instant gratification. We want what’s in front of us right now, especially if it looks, feels, or tastes good. The idea of having to work for something that we can get or achieve in the future—like a buffed-up body or a plumper frontal lobe—often seems theoretical and remote, even if it’s only a week or two away.
Research from economist George Loewenstein at Carnegie Mellon University has shown that most people would sooner make a quick buck than wait to grow rich later. His team offered volunteers of all ages a choice between receiving $20 right away or waiting six months and receiving $110. Most of the research subjects opted for the quick cash. When neuroscientists peer into the brains of people making such choices, it’s clear that the arousal state of the instant reward is much greater than that of waiting for a future payoff.
The good news is that physical exercise does provide instant gratification. The endorphin burst is immediate and makes us feel good. Taking a walk outside in the fresh air is usually invigorating and uplifting. Competitive sports such as basketball and tennis are exciting and fun and provide excellent aerobic workouts. The hurdle is getting ourselves to step up to the plate and take that first swing.
By integrating physical exercise seamlessly into your day, you get to feel that endorphin high without much effort. And after just a week or so, you may see other results, including a firmer body, increased energy, and possible weight loss.
Aerobic Workouts That Go to Your Head
Aerobic conditioning is an essential component of any Alzheimer’s prevention program. Whether you’re climbing stairs or swimming laps, the goal is to get your heart pumping faster so it can deliver more oxygen and nutrients to your brain.
The key is to start at your baseline conditioning level and gradually build from there. As you increase your endurance, your heart and lungs become more efficient—you can work out longer with less effort—and your brain reaps the benefits of your having a more efficient heart.
I find it helpful to set small, achievable goals for myself, perhaps adding two blocks to my morning walk or slightly increasing the incline on my treadmill by one or two clicks. Achieving these minor milestones motivates me to push forward. As a workout becomes part of your daily routine, the efficiency of your heart, lungs, and circulatory system increases. Also, you’ll lower your risk for high blood pressure, diabetes, and other age-related diseases that can damage brain neurons, and the calories you burn will help control your weight.
Your workout sessions don’t have to last for hours: Even small bursts of exertion are health promoting. Systematic studies have found that multiple periods of brief exercise—three 10-minute sessions spread throughout the day—can be as effective in controlling weight and lowering risk for heart disease as a single half-hour session.
Start with a warmup phase to raise your body temperature and loosen your joints. This will increase your pulse and prepare your heart for a more vigorous workout. After an aerobics session, take a few moments to cool down and gradually bring your body back to its resting state. Stretch your muscles to keep them limber, minimize soreness, and increase your flexibility.
The following are examples of some aerobic workouts. Which type of conditioning you choose will depend on convenience and what fits best with your current lifestyle. Since the brain craves variety, try switching up your exercise routines now and then.
TAKE A WALK. Whether you’re walking on the treadmill or the sidewalk or even at the mall, it’s good for you. It’s more difficult on the sand at the beach, but if I’m forced to walk on the beach of a beautiful tropical island, I guess I can make myself do it.
Many baby boomers have experienced their fair share of aches and pains, bad knees, and ruptured discs, making it difficult to jog or run for fitness. Today we know that walking at a brisk pace is just as good for your brain and body as running and poses minimal risk for injury.
I live in the hills, and on the weekends I like to park my car at the bottom of my hill and do my errands on foot. That way I get my afternoon walk in and take care of my tasks at the same time. Some people like to wear a pedometer so they can keep track of just how much they’ve walked and how many calories they’ve burned. I’ve tried this, but I tend to stare at the pedometer and run the risk of bumping into trees and people.
Whenever there’s enough time, my walks become a family outing that includes the dog, and I get a chance to hear my teenagers moan about the hills and ask incessantly when we are going to turn around and go home. Scaling hills can be a great way to build stamina and increase your heart rate.
CYCLING. An estimated one out of every three people age 65 or older suffers from knee or ankle pain, and those sore joints have led many of them to try cycling. The smooth, circular movement of cycling not only provides an aerobic challenge, but it can even strengthen knee joints. Outdoor cycling is a great way to get some fresh air, but it should always be done while wearing a helmet. Protecting our heads from injury is crucial for lowering our risk for Alzheimer’s disease. If weather or local terrain prevents outdoor biking, a stationary bike or elliptical machine offers a good alternative, and you can watch the news or read a book while working out. Another plus of the stationary bike is you don’t have to mess up your hair with a helmet.
SWIMMING. I love swimming because it not only offers a great cardiovascular workout, but it engages almost every major muscle group in the body. Because it is a non-weight-bearing exercise, it is ideal for people who have suffered joint injuries from higher-impact cardiovascular workouts. You can start with just a few laps and build up your stamina over time. If you have an injury, you can easily vary the strokes and kicks to avoid overworking a particular muscle group or joint.
RACQUET SPORTS. Competitive sports like tennis and racquetball are great ways to motivate us to get physical. With racquet sports, you’re not just achieving an aerobic workout, but the mental challenge strengthens three major brain areas that control hand-eye coordination, movement, and balance. Even table tennis offers these benefits. Chess provides a mental challenge as well, but you usually don’t get much of a cardiovascular burn, unless, of course, you pace a lot between turns.
GETTING FIT AND TIDY AT THE SAME TIME. I occasionally do a little work around the house (Gigi would say very occasionally). Epidemiological studies have found a link between a lower risk for Alzheimer’s disease and almost anything that picks up your breathing rate and the pace of your heart. Raking leaves in the yard, sweeping the floors, and cleaning out the attic involve lifting, bending, and other movements that can give you a pretty good workout. Chores burn calories, too: In just 10 minutes you can burn off 50 calories by hedging the bushes or about 75 calories by mowing the lawn. (Using a riding mower doesn’t count.)
CUT A RUG. Dancing combines aerobic physical activity with emotional and sensory stimulation, social interaction, and motor coordination—what scientists would call an enriched environmental condition. Brain scans of experienced dancers show strengthened neural circuits in regions involved in motor control, as well as greater neuroplasticity in their brains compared with the brains of novice dancers. Ruhr-University scientists in Germany found that people age 65 and older who had an average of nearly 17 years of amateur dancing under their belts had significantly better cognitive, motor, and perceptual abilities than a nondancing control group.
WALK THE DOG. Getting a person off the couch and on to the treadmill is one thing—keeping him off the couch is quite another. Investigators at the University of Missouri College of Veterinary Medicine found that the answer can be as simple as getting a dog. Having a dog motivates people to start walking and stick with it. After all, Rover needs his exercise, even if you don’t feel like getting any. The adherence rate to a regular walking program over a period of 50 weeks was 72 percent for dog walkers, who also experienced an average weight loss of more than 14 pounds. I have a dog. He loves to walk, and he’s already lost about 8 pounds.
SHOP TO EXERCISE YOUR BRAIN. Many people love to shop (you know who you are). Going shopping combines physical exercise like walking between stores and perhaps trying on hundreds of pairs of shoes, with brain activities ranging from searching through sale items to choosing colors and figuring out what 30 percent off equals. Although shopping may do damage to your credit cards, it can be good for your brain, since it provides exercise and activates brain centers that control memory, planning, and visual and spatial skills. And don’t forget the social interaction you get when surrounded by sales people oohing and aahing at your fabulous choices.
Strength and Resistance Training
For years I’ve known about the heart and brain benefits of aerobic conditioning. With the latest scientific evidence now also pointing to the cognitive benefits of weight-lifting and resistance training, I joined a gym and have begun building up my muscles. I’m certainly no Mr. America, but I feel stronger, and I know I’m protecting my brain. I now alternate my aerobic workouts with weight and resistance training. Taking a breather from the treadmill every other day has delighted my middle-aged knees.
Resistance and strength training not only protects brain health and builds muscle mass, but it helps make bones denser and lowers our risk for osteoporosis, which can make bones more brittle with age, so that a fall or trauma is more likely to cause a fracture. Strength training also helps stabilize blood sugar levels, which can protect us from diabetes. Most people think of weight lifting as a sport reserved for young, buffed, muscle-bound athletes, but research shows that older people, even those in their eighties, benefit from pumping iron.
At every age, it’s important to train opposing muscle groups, biceps and triceps, for instance, to reduce the risk of injuries. When beginning weight training, start out with light weight, then as your strength increases, build up both your repetitions and the amount of weight you lift. That way, you’ll avoid injury and achieve reasonable goals. As much as I’d like to be able to bench press 200 pounds today, it doesn’t happen overnight. For me, it probably won’t happen in my lifetime, but I can dream.
Strength training tears down muscle fiber, but cross training—working different muscle groups on alternate days—allows these muscle groups to rest between training sessions so they can repair and rebuild. One day you might work out your upper body muscles (arms, shoulders, back, and chest), while the following day you could focus on your lower body (thighs, calves, and hamstrings). You could also do weight training one day and switch to aerobic conditioning the next. Consider the following strength-training exercises for building up your body and your brain.
WORKING WITH WEIGHTS. Training with free weights can work out muscles from many angles in order to isolate and strengthen specific muscle groups. Working out with a trainer or someone with experience can help you learn correct form so your workout is injury-free and you develop control, balance, and coordination. If you work out in a gym, you can achieve similar benefits with weight-lifting equipment. The machines guide the weight-lifting motions and reinforce correct posture. Tips from a trainer may also increase the effectiveness of a machine workout and reduce your risk for injury.
RESISTANCE AND ISOMETRIC EXERCISES. Exercise bands, available at drugstores or sporting goods stores, come in varying degrees of resistance and can be used to work out upper- and lower-body muscle groups. If you don’t have an assortment of bands, you can wrap or double your available band to make it tighter and increase its resistance as you get stronger. Since elastic bands are light in weight, they are easy to pack and great for keeping up your exercise program when you travel. Stand on the center of your band and you can work your biceps by doing curls, or your shoulders by lifting your arms straight out laterally. If you hold the band behind your back and lift the opposite end above your head with the other hand, you can work your triceps.
Lateral arm lift with band
Without a band, you can do isometric exercises, which involve muscular contractions with resistance and no movement. Here is an example of a simple isometric exercise that will strengthen your upper body (biceps, triceps, and chest): Sit up straight and push your hands together in front of your chest. Breathe slowly and deeply and hold for five seconds, then rest between reps.
Balance and Stability
Balance and stability become increasingly important for maintaining body and brain health as we age. Older research volunteers who incorporate balance training in their exercise programs show significant improvements in memory and other cognitive abilities. Good balance and stability help prevent injuries from falls. Head trauma that causes loss of consciousness for an hour or more doubles the risk for developing Alzheimer’s disease.
Exercises that improve balance stimulate brain neural circuits to send messages from the brain to the body, making it better able to right itself if it becomes unsteady. These neural networks inform us how to react and how much tension is needed in each muscle group in order to remain upright. The brain health benefits from balance and stability exercises could result, in part, from this focused form of cognitive training.
Standing on one leg
Balance and stability training doesn’t have to involve elaborate equipment. Standing on one leg and looking in the mirror is a simple and effective training exercise. Start out for a count of 5 to 10. Once you are able to remain balanced for 30 seconds on each leg, try doing it with your eyes closed. It may be a lot harder, but with practice you can work toward that goal. Here are some other ways to improve your balance and stability.
DANCING. Dancing not only offers aerobic conditioning benefits, but it also helps people keep balanced. Investigators at Aristotle University of Thessaloniki, in Greece, assessed the effect of a ten-week traditional Greek dance program on objective measures of balance in healthy older adults. They found that the dance group showed significant improvements in balance when standing and moving compared with a control group. Other studies have found that older adults who are regular social dancers have better balance and stability when standing or walking compared with nondancers. So whether you like to cha-cha, rumba, or mambo, it can be a way to have fun while improving your balance and stability.
TAI CHI. This popular Eastern practice uses slow and smooth movements that offer several brain health benefits. The meditative component reduces stress, while the slow, deliberate movements improve cardiovascular conditioning, balance, and stability. The process of learning the exercises and maintaining proper form likely activates specialized neural circuits that provide a brain exercise.
PILATES. This exercise system was developed by Joseph Pilates as a way for people to increase strength, flexibility, and coordination. It incorporates controlled movements that strengthen the body’s core muscles, including the stomach, lower back, buttocks, and inner thighs. These muscle groups provide the body’s structural support, which maintains our balance and stability. A recent study found that middle-aged people who attended a 12-week Pilates class for an hour twice weekly showed significant improvement in objective measures of balance and posture compared with a control group. Although a full Pilates program requires the assistance of an instructor and special Pilates equipment, simpler exercises based on the same principles can be done on your own.
BALANCE BALLS. Years ago when our kids were little, I walked into my bedroom and saw a giant orange ball on the floor at the far corner of the bed. It looked like a small orange planet. I noticed my wife’s feet sticking out from behind the bed, balancing on the ball, pulling it in toward her and then pushing it away.
“What are you doing with that? Is it one of the kids’ toys?” She shushed me and said she was working on her glutes.
Today, I know lots of ways to use the balance ball for stretching, core strengthening, and balance and stability training. By introducing an element of instability into any exercise, which the balance ball does, it challenges us to strengthen muscle groups in addition to the ones the exercise was intended to work. Researchers at Bond University, in Australia, found that balance ball training led to significant improvements in lower back muscle endurance and flexibility, leg strength, and balance.
Keeping Fitness Fun and Safe
Wear and tear over the years makes our bodies more vulnerable to injuries, so we need to be more cautious and creative in achieving fitness goals and keeping our exercises safe than when we were young. Specific exercises to strengthen certain vulnerable body areas can make a big difference. Below are a few exercises and stretches that I’ve found helpful in strengthening my core muscles (which protect my back) and improving my balance and flexibility. They don’t require any equipment, so you can do them anywhere.
ABDOMINAL CRUNCH. Lie on your back with your knees bent and feet flat on the floor. As you exhale, tighten your abdomen by pulling your belly button in and pushing it toward your chin. Inhale deeply. Place your hands behind your head and as you exhale and pull your belly button in and tighten your abdominal muscles—that’s the “crunch” part—pull your torso toward the ceiling. Do not pull your neck and head up with your hands, but lift them up with the muscles of your upper body. To make it harder, try the crunches while your back is supported by a balance ball.
Abdominal crunch on balance ball
BIRD DOG. Get on your hands and knees, with your hands directly below your shoulders and your knees bent at 90 degrees. Keep your back flat, your stomach pulled up, and your head level and even with your spine. Point your right arm straight forward and your left leg straight back. Hold for 5 seconds, gradually building up to 30 seconds. Then switch sides. Repeat 5 times.
SIDE STRETCH. Stand with your feet shoulder width apart. Raise your right arm over your head and, keeping your shoulders, hips, and knees aligned, lean to the left until you feel your right-side muscles stretching. Hold for 5 seconds and then do the opposite side. Repeat for a total of 10 stretches.
PELVIC TILT. Lie on your back with your knees bent and feet flat on the floor. Lift your pelvis off the floor while tightening your buttocks for a count of five, then roll down. Repeat 10 times.
HAMSTRING STRETCH. Stand in front of a chair, table, or wall and rest your right heel on the surface. Keeping both legs straight, lean forward until you feel a stretch in your hamstring. Hold for 10 seconds. Repeat on the other side.
QUAD STRETCH. Standing with your knees parallel, lift your right foot toward your buttocks. Grab your foot with your right hand and hold for 10 seconds. Now do the other side. If you need to, hold on to a chair or table and steady yourself with your opposite hand.
These are only a few examples of the many stretches and exercises you can do to stay fit and prevent injury. As much as possible, look for opportunities throughout your day when you can add an extra pop of cardiovascular work, such as taking the stairs instead of the elevator or walking briskly to a nearby errand instead of driving the car. You can also try jumping jacks in the restroom, jogging to get your mail, or doing the twist while washing the dishes. Making their regular workout a social event motivates a lot of people to stick with their fitness programs. It doesn’t have to be a competitive sport like tennis or basketball—it can be an invigorating power walk with a friend, around the neighborhood or on tandem treadmills at the fitness center. Keeping the body healthy through exercise is an essential part of any Alzheimer’s prevention program.