In my last post, I wrote that some people with cognitive problems also have balance problems, and that many of them think these problems could be related. Recent research at Rush University seems to confirm that view: scientists there found that “impaired motor function” is increased in people with mild cognitive impairment, and is related to their risk of developing Alzheimer’s.
If you have both memory loss and balance problems, can physical therapy improve your balance? “There are fierce proponents of this postulate,” says Joseph Friedman, MD, Director of the NeuroHealth Parkinson's Disease and Movement Disorders Center in Warwick, Rhode Island and Clinical Professor at Brown University Medical School. “My own belief is that exercise of all types is useful and that therapy is therefore useful but ONLY if the exercise program is maintained.” He says his patients with dementia are more likely to stick to their exercise routine with caregiver participation and encouragement.
Anecdotal evidence about physical therapy for balance problems in people with memory loss varies widely. “I have to do some daily exercises every day, which basically has me standing on one leg at a time while being near a sturdy object in case I fall,” David Thomas, MD, a blogger and retired psychiatrist who has Lewy body dementia, says in a comment on my last post. “It has definitely helped.” Others aren’t sure whether their balance improved due to physical therapy or due to the Alzheimer’s or Parkinson’s medicines they are taking.
Physical therapy might improve your balance, but could it also improve your memory? Some memory loss patients say yes, although they don’t know why. “I am not sure if it is the therapy or the fact that it relieves the fear of falling that makes me better able to think when I am having it,” says one woman diagnosed with early onset dementia.
Dr. Friedman is equally skeptical, and thinks any improvement in memory and thinking comes from exercise in general, rather than physical therapy for balance. “I suspect that the benefits of exercise on mentation (if they are confirmed in multiple reports) are due to either increased blood flow or to some other indirect effect of repeated large muscle contractions,” he says.
There’s not yet enough scientific evidence to say whether general exercise can improve cognition in people with memory loss. In a much-publicized study by University of Kansas researchers, higher levels of fitness were associated with less shrinkage of the brain in people with early stage Alzheimer’s. This didn’t seem to make a difference on cognitive tests, though. But for people without memory loss, multiple studies link exercise to reduced risk of developing dementia or improved cognition.
If we don’t fully understand the benefits of physical therapy or exercise for people with memory loss, then why bother? “Although there is a limit to how well we can compensate for cognitive problems, it is obviously better to have a well functioning body than to have mental AND physical problems,” says Dr. Friedman. “People with dementia are at greater risk for falls and at much higher risk for complications of falls than those who are not demented. Keeping in shape reduces these risks, and may also slow cognitive decline.”