Exercise as medicine: Can working out help protect us from dementia?

Leanne Kaufman:

We all know exercise is good for our health and wellbeing, but what if it could be used as a medical intervention in the fight against Alzheimer’s disease? If current trends continue, the economic burden of dementia in Canada could reach $150 billion by 2050, meaning the potential savings of delaying the onset of dementia are so substantial and Canada could reap significant health and economic benefits. That’s where exercise as medicine could play a crucial role.

Hello, I’m Leanne Kaufman and welcome to RBC Wealth Management’s Matters Beyond Wealth. With me today is Dr. Cindy Barha, Canada Research Chair in Neuroscience, Brain Health and Exercise at the University of Calgary. I had the pleasure of meeting Dr. Barha at an event with our friends at Women’s Brain Health Initiative where she spoke about healthy brain aging and the connection with exercise. Dr. Barha, thank you for joining me. I’m looking forward to chatting with you about this topic of brain health and exercise and why it matters beyond wealth.

Cindy Barha:

Thank you for having me.

Leanne Kaufman:

So can you start by telling us about your own background and your interest in this space?

Cindy Barha:

So currently I’m an assistant professor in the Faculty of Kinesiology at the University of Calgary. But actually by training, I’m a behavioral neuroscientist. So I actually did my PhD looking at the effects of different types of menopause hormone therapy on brain function, as well as brain plasticity using a rodent model of menopause. And also looking at the role of pregnancy history and mothering and how that could also influence brain aging.

And so I was looking at this in my PhD and then I became interested in how exercise and actually physical activity could be used as lifestyle interventions to help promote brain health as we age, particularly in those at higher risk of dementia. And so I did my postdoctoral training in this area and I’ve been interested in it ever since.

Leanne Kaufman:

So what can you tell us about your findings so far?

Cindy Barha:

Well, so we’ve been really focusing on trying to understand for whom exercise is most effective at protecting the brain. And we’ve also been trying to understand how exercise is actually influencing the brain and not just the body itself. So some of our more interesting things that we found are that different types of exercise. So specifically we’re looking at aerobic training. So that’s things like walking and jogging and running and resistance training, so lifting weights to increase muscle mass, we found that both of those types of exercise are beneficial for the brain in terms of how we can think and how we remember things. And we found this in older adults, adults older than 65. And we found that this was particularly true for those at a greater risk of developing Alzheimer’s disease later in life. So for example, we found that we found this effect in those living with mild cognitive impairment or MCI. MCI is actually a condition where memory and thinking skills are declining at a greater rate than would be expected for an individual’s age. But they’re not severe enough to be considered dementia yet. So while not all of individuals with MCI are going to go on to develop dementia, it does significantly increase your risk for dementia. And so we’ve been looking at exercise and how we can use that to sort of promote and protect brain health in these individuals with MCI. And we’ve found that both aerobic training and resistance training are effective. And we’ve also found that walking, so aerobic training, seems to be more beneficial for people that carry a genetic predisposition for Alzheimer’s disease.

Leanne Kaufman:

Well, that’s good. It means all those reels I see on my Instagram feed seem to have merit about these benefits. It’s good to hear an actual doctor say it. You were talking about how you focus in on different age groups and I’m wondering if you can expand a little bit on whether those different types of exercise like you were mentioning are different or is there more benefit to one versus another depending on your age group, say a 40 year old versus a 70 year old.

Cindy Barha:

Yeah, absolutely. So in terms of the brain, as I said, we focus on aerobic training and resistance training, the two main forms of exercise. And so we don’t actually know which form is actually best for the brain at either of those ages. So in midlife or an older age. But overall, it does seem like there are good for linking a memory in individuals that are in older age, so over 65. And we’re actually starting to look, we’re just finishing up a study at the University of British Columbia that’s actually going to directly pair both of those types of exercises in older adults. So hopefully in a few months I can actually give you more information about which type of exercise is best for older adults.

In terms of middle age, so more like 40 to 60 years of age, there’s actually not been a lot of studies done looking at this age group in terms of exercise and brain function. So we did a small study at UBC with Dr. Theresa Liu-Ambrose, looking at high intensity interval training, so HIIT, in perimenopausal women. So they’re in that age group of about 42 to 55. And we actually found that HIIT seemed to be beneficial for some tasks that you looked at memory. But it was a small pilot study and we’re going to build on that looking at a larger sample size. And we also just recently finished a study here, a pilot study here at the University of Calgary with high intensity resistance training, so lifting weights.

And this was in perimenopausal women, so the same sort of age group that I talked about, but also early postmenopausal women. So these are women that are within about five years of menopause onset. And we just finished it and we actually found a small benefit of resistance training on some tasks that required thinking and multitasking, but only in the perimenopausal women. The benefit of resistance,

Leanne Kaufman:

Whoa.

Cindy Barha:

yeah. And then what we found in the early post-menopausal women was something a little bit different. We found that resistance training was actually good for memory function in that group, but didn’t have an effect on their thinking abilities.

Leanne Kaufman:

Okay, so there goes all my Instagram reels.

Cindy Barha:

Well, we’ll see.

Leanne Kaufman:

What about this concept, this is another thing I keep seeing show, I should stop quoting pop culture because it seems ridiculous, this lift heavy and fewer reps when you’re talking resistance versus light and multiple reps, is there any merit to that or is that not something you’ve studied yet?

Cindy Barha:

Well, that’s a great question. I haven’t, in terms of brain function, I haven’t looked at that yet, right? So we’ve only started looking at this in middle-aged and perimenopausal women with this high intensity interval training. And it was actually a sub-study of a larger study done by my colleague, Leigh Gabel, who was looking at it in terms of bone density. And so this was high intensity, but we are going to start looking as well as she’s going to look at more modern intensity, lighter weights and how that could be effective. But you know, I wouldn’t say that. For brain function, we don’t know in terms of other systems. I see the same thing that you’re talking about, but I would say that it more reps with lighter weights. I’ve also heard it’s really good for muscle mass in women too. So I think that there’s evidence for both.

Leanne Kaufman:

I guess it depends on what we’re trying to achieve. We can probably agree that anything is better than nothing. In fact, we know that Health Canada recommends 150 minutes of exercise per week, but just like medications impact each of us as individuals in very different ways, exercise probably does look different and what benefits one person may not be exactly the same as what benefits another. So, you know, I mentioned that you and I met at a women’s brain health event. So have you studied the difference in gender and looking at whether, you know, sex and gender has an impact in the research you’re doing as well, the difference in men and women.

Cindy Barha:

Yeah, absolutely. So my work actually has been focusing on looking at sex differences, so biological sex, in the effect of exercise on brain health in older age. That’s what most of my work so far has been looking at. And so we found some really interesting things a few years ago when I was doing my postdoc at UBC with Dr. Teresa Liu-Ambrose. So we found that older postmenopausal women over the age of 65, they seem to actually gain greater benefits in terms of thinking and memory from aerobic training compared to age-matched males.

And it seemed that this was related to a greater effect of aerobic training on increasing the levels of this protein in our bodies called brain-derived neurotrophic factor or BDNF. And so we found that aerobic training was increasing BDNF more in the post-menopausal women than in the age-matched men. And so what is BDNF? Well, we know it’s really, really important for keeping our brain cells alive and keeping them healthy. I like to think of it as kind of like a super vitamin for your brain. And so, yeah, we found that aerobic training increased levels of this super vitamin in our older females more so than our older males.

Leanne Kaufman:

Hmm, good to know. Okay, another one to tuck away.

Cindy Barha:

Yeah, and in terms of like middle age, because we talked about the different age life stages, we actually are starting to look at a, we’re starting to study that’s going to look at sex differences in the effect of exercise on brain function in middle aged males and middle-aged females here at the University of Calgary in the next few months.

Leanne Kaufman:

sure that’ll be fascinating too because one of the other things I’ve learned from our mutual friends at Women’s Brain Health is that brain health is actually kind of a middle-aged disease, right? It doesn’t show up until later in life, but it’s some of the activities and lifestyle choices that we’re making in our middle-age that have an impact. So that’ll be fascinating to hear what your work shows there.

Leanne Kaufman:

So, what is it that’s next for you in your research journey and maybe on a broader basis? What is it that you’re hoping that all of this work will lead to and achieve?

Cindy Barha:

Well, I think like any researcher, I think my hope is to help everyone, every individual live longer with a healthier brain. And so we’re doing this by trying to help make exercise sort of more effective at protecting the brain by looking at how we can personalize these interventions and tailor them to things like biological sex, to our genetics, and even to our reproductive histories or our life stages. And so one thing I didn’t speak about is some of our findings that we found a few years ago that found that the number of pregnancies, previous pregnancies an individual has had actually impacts the way the brain ages later in life. And we found also that exercise itself, so in this case it was self-reported walking, it seemed to impact the brain differently depending on the number of previous pregnancies. And it seemed that walking was most effective for protecting the brain in women that had zero complete pregnancies or those that had five or more complete pregnancies.

So why we thought that was really interesting that we found this greater effect of physical activity in the null at-risk, so the women with zero complete pregnancies and those with five or more complete pregnancies, is that studies suggest that those are the two groups that are more at risk for dementia in women.

So the answer to your question, what’s next in the research journey, that’s where I was starting to go for that. So we can put these together. so in our future studies, what we really want to start to look at is not only looking at sex differences in exercise effects in middle age, we also want to start looking at how number of pregnancies may influence brain health and how exercise can be used to protect the brain. But we also want to look at women with a history of hypertensive pregnancies because that’s another factor that seems to be a risk factor for dementia. And then we want to see how exercise in middle age and older age can be used to help protect their brain health.

Leanne Kaufman:

Yeah, it’s amazing work. It’s one of those things that is like really within our control, isn’t it? Because I think so many of us think that the brain health is a predetermined, it’s kind of a luck of the draw. And we just need to, we need so much more research like what you’re doing to be able to help us understand what we can be doing to really change those, change that risk profile for each of us.

I’m just so fascinated by the work that you and your colleagues are doing as it relates to all these things that try to help us not just live healthier for longer, with our best lives, which is I think really what we’re all trying to achieve. We know we’re going to probably live longer, but it’s work like yours that’s helping us understand how we can make the most of all of those years, not just the early ones.

Dr. Barha, if you hope listeners remember just one thing from our conversation that we’ve had today, what would that one thing be?

Cindy Barha:

I guess it would be just keep moving and try to reduce your sedentary time whenever possible. And I really think that in order for exercise to become forever, we really need it to be fun and feasible. And as you alluded to before, of course, some is better than none, but more is better than some.

Leanne Kaufman:

Great, yeah, but it doesn’t all have to be HIIT, does it? Okay, asking for a friend.

Cindy Barha:

No, absolutely not. And you know, like we talked about middle age. Yeah, no, it doesn’t have to be HIIT. It could be walking even like high intensity walking. We’ve been looking at that as well. And I think we talked a little bit about middle age and how that’s such a critical window for brain health. And so some other things that we’re looking at are we’re really starting to focus now on females during the perimenopausal period with exercise.

And we want to see if it can be utilized to improve brain fog, which is a symptom that many women suffer during menopause. And we want to look at how genetics can actually be playing a role in this and how even something like menopause hormone therapy, how that could be interacting with exercise to sort of further influence our brain function.

I’ll repeat how pleased I am that you’re all doing this work because you’re speaking my language right now, just as a sample size of one. So thank you so much, Dr. Barha for joining me today and delving inside the brain and helping us understand the important connection to exercise and

brain health and why all of this matters beyond wealth.

Cindy Barha:

Thank you so much for having me and giving me this opportunity to share our research.

Leanne Kaufman:

You can find out more about Dr. Cindy Barha and her research on the University of Calgary’s website. And you can learn more about our friends at Women’s Brain Health initiative, whom we have again to thank for the introduction to Dr. Barha, at womensbrainhealth.org. If you enjoyed this episode and you’d like to help support the podcast, please share it with others, post about it on social media, or leave a rating and review. Until next time, I’m Leanne Kaufmann. Thank you for joining us.

Outro speaker:

Whether you are planning for your own estate, the needs of your family or business, or you are an executor for a loved one’s estate, we can help guide you, simplify the complex, and support your life’s vision. Partner with RBC Royal Trust and ensure your legacy will thrive for generations to come. Leave a legacy, not a burden™. Visit rbc.com/royaltrust.

Thank you for joining us on this episode of Matters Beyond Wealth. If you would like more information about RBC Royal Trust, please visit our website at rbc.com/royaltrust.

---

Other episodes in this series