Medical Bulletin 28/ April/ 2025 - Video

A new study has found that both low and moderate-high intensity exercise could be valuable tools in the fight against Alzheimer's. The new research is published as two papers in Alzheimer's and Dementia: The Journal of the Alzheimer's Association.

EXERT (Exercise in Adults with Mild Memory Problems) included nearly 300 sedentary older adults with mild cognitive impairment who were randomly assigned to either moderate-high intensity aerobic training or lower-intensity stretching, balance and range of motion activities. Participants completed their assigned exercise 3-4 times per week for 12 months under the supervision of a YMCA trainer, and the study also included regular assessments of cognitive function and brain volume.

The researchers found:

In EXERT study participants, cognitive function remained stable over 12 months in both low and moderate-high intensity exercise groups.

Both forms of exercise were associated with significantly less cognitive decline over 12 months when compared to individuals who were not involved in the exercise study.

Both EXERT exercise groups tended to show less brain volume loss over 12 months, including in the prefrontal cortex.

Though the researchers expected to see further cognitive decline in EXERT participants, they actually found that cognitive function remained stable for both exercise groups over the course of the study. This suggests that both lower and higher intensity exercise could slow cognitive decline. Another possible explanation for the results is that participating in research itself, regardless of the treatment, may offer protection against cognitive decline due to the intellectual and social stimulation involved.

Overall, the findings of both studies taken together suggest that exercise may be a promising, safe, and feasible strategy to promote brain health and prevent continued cognitive decline for older adults with mild cognitive impairment.

"This is a critical time to intervene in this population, because they don't have dementia yet, but are at a very high risk," said Aladdin Shadyab, Ph.D., M.P.H., lead author of one of the new papers and associate professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science and School of Medicine. "Together, these findings show us that even low intensity exercise may slow cognitive decline in at-risk older adults."

Reference: https://today.ucsd.edu/story/even-light-exercise-could-help-slow-cognitive-decline-in-people-at-risk-of-alzheimers

A new peer-reviewed study, published in the Annals of Medicine (Elevate) found that smoking and other vices like drinking and lack of exercise are associated with declines in health in people as young as 36. The impact is even greater when these bad habits are indulged in over the long-term, state experts whose study tracked the mental and physical health of hundreds of people for more than 30 years.

Using a long-running longitudinal study, in which hundreds of children who were born in the Finnish city of Jyväskylä in 1959 were followed from childhood until their early 60s, the team analyzed participants’ mental and physical health via data that was collected from surveys and medicals when they were 27 years old (326 participants) and again at age 36, 42, 50 and 61 (206 participants).

Mental health was assessed via surveys. Physical health was assessed by creating a metabolic risk score. Self-health was assessed by asking the participants to rate the state of their health over the past year. Three risky behaviours were also assessed at each point in time: smoking, heavy drinking and physical inactivity. Analysis of the results showed that if an individual had all three unhealthy habits at a given point in time, their mental and physical health were poorer.

Depressive symptoms rose by 0.1 points, metabolic risk score rose by 0.53 points, psychological wellbeing fell by 0.1 point and self-rated health fell by 0.45 points. Having all three unhealthy behaviours long-term was even more strongly associated with poor health. Depressive symptoms rose by 0.38 points, metabolic risk score rose by 1.49 points, psychological wellbeing fell by 0.14 points and self-rated health fell by 0.45 points.

Lack of exercise was particularly linked to poor physical health, smoking was mainly linked to poor mental health and heavy alcohol consumption was associated with declines in both mental and physical health. Crucially, the effects were apparent by the time the participants were in their mid-30s.

“Our findings highlight the importance of tackling risky health behaviours, such as smoking, heavy drinking and physical inactivity, as early as possible to prevent the damage they do to from building up over the years, culminating in poor mental and physical health later in later life” said lead author Dr Tiia Kekäläinen, a health scientist who has a particular interest in aging.

“However, it is never too late to change to healthier habits. Adopting healthier habits in midlife also has benefits for older age.”

The authors also acknowledge that they only looked at three types of behaviour and say that other factors, such as diet, should be included in future studies.

Reference: Kekäläinen, T., Ahola, J., Reinilä, E., Savikangas, T., Kinnunen, M. L., Pitkänen, T., & Kokko, K. (2025). Cumulative associations between health behaviours, mental well-being, and health over 30 years. Annals of Medicine, 57(1). https://doi.org/10.1080/07853890.2025.2479233

A new study, published in BMC Nutrition, demonstrates that providing medically tailored meals (MTM) to patients with heart failure (HF) and malnutrition risk following hospital discharge significantly improves their nutritional status and keeps hospital readmission rates well below local and national averages.

The study compared the impact of delivering seven versus 21 medically tailored meals per week over a four-week period. The research team enrolled 46 patients discharged from the hospital with heart failure and malnutrition risk. The research team conducted telephone surveys at baseline, 30-, and 60-days post-discharge to assess changes in malnutrition risk, adherence to American Heart Association (AHA) dietary guidelines, sarcopenia risk, and 30-day readmissions.

The study revealed that patients receiving at least seven medically tailored meals per week experienced a significant reduction in malnutrition and sarcopenia risk. Notably, adherence to AHA diet goals improved over time, regardless of whether patients received seven or 21 meals. The 30-day readmission rates were significantly lower than the national average, at nine percent for those receiving 21 medically tailored meals and 12.5 percent for those receiving seven medically tailored meals.

“Our findings suggest that even a modest intervention of seven medically tailored meals per week can have a profound positive impact on the health and recovery of heart failure patients,” said Penn Nursing’s Charlene Compher, PhD, RD, LDN, FASPEN, the Shearer Chair of Healthy Community Practices, Professor of Nutrition Science, and Director of Nutrition programs in the Department of Biobehavioral Health Sciences. “This intervention not only improves nutritional outcomes and diet adherence but also keeps hospital readmissions low, which translates to better patient care and lower healthcare costs.”

The researchers concluded that the provision of at least seven medically tailored meals per week in the immediate post-discharge period is a promising strategy to improve malnutrition and sarcopenia risk, enhance diet adherence, and maintain readmission rates below national averages for patients with heart failure and malnutrition risk.

Reference: Compher, C., Henstenburg, J.A., Aloupis, M. et al. The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS). BMC Nutr 11, 56 (2025). https://doi.org/10.1186/s40795-025-01036-y