Exercise for Neurological and Neuromuscular Conditions: Dementia and Alzheimer's Disease

Vocabulary practice flashcards covering the pathophysiology, clinical stages, diagnostics, pharmacology, and exercise prescription principles for dementia and Alzheimer's disease.

Dementia

An umbrella term describing a syndrome associated with the progressive and irreversible loss of cognitive function caused by diffuse brain disease primarily affecting the cerebral cortex and hippocampus.

Alzheimer's Disease

The most common form of dementia (accounting for $50\text{--}75\%$ of cases), characterized by a gradual onset, predictable progressive decline, short-term memory loss, apathy, and depression.

Vascular Dementia

The second most common cause of dementia ($20\text{--}30\%$ of cases), resulting from cerebrovascular events such as stroke, frequently marked by sudden onset, physical frailty, and pronounced mood fluctuations with less severe memory impairment than Alzheimer's disease.

Frontotemporal Dementia

A subtype of dementia comprising $5\text{--}10\%$ of cases, observed more frequently in males at a younger age of onset, with early clinical manifestations including alterations in personality, mood changes, disinhibition, and language impairment.

Dementia with Lewy Bodies

A dementia variant accounting for $<5\%$ of cases, characterized by abnormal intracellular inclusions in neurons, marked fluctuations in cognitive function, visual hallucinations, and Parkinsonian motor symptoms such as rigidity and tremor.

Microscopic Hallmarks of Alzheimer's Disease

Histopathological features including extracellular beta-amyloid plaques that aggregate to impede synaptic communication, and hyperphosphorylated Tau proteins that detach from axonal microtubules, precipitating tubular collapse and neuronal death.

Transaxial PET Hypometabolism in AD

Neuroimaging pattern in Alzheimer's disease showing significant regional reduction in metabolic activity (indicated by yellow and blue regions) predominantly across the association and limbic cortices.

Morphological Brain Alterations in Alzheimer's Disease

Gross structural changes that include marked shrinkage of the cerebral cortex, severe atrophy of the hippocampus, and compensatory enlargement of the cerebral ventricles.

Mini-Mental State Examination (MMSE)

A 30-item screening assessment used to detect cognitive impairment: a score of $\ge 25$ is classed as normal, $21\text{--}24$ indicates mild impairment, $10\text{--}20$ denotes moderate impairment, and $<10$ represents severe cognitive impairment.

Mild Stage Alzheimer's Disease

Initial stage lasting $2\text{--}4\text{ years}$, defined by minor short-term memory lapses and difficulty learning new information, while long-term memory, reason, and social awareness remain relatively intact.

Moderate Stage Alzheimer's Disease

Intermediate stage lasting $2\text{--}10\text{ years}$, marked by withdrawal, confusion, difficulties executing activities of daily living (ADLs), impaired judgment, communication deficits, and behavioral disturbances such as anxiety and restlessness.

Severe Stage Alzheimer's Disease

Advanced stage typically lasting $1\text{--}3\text{ years}$, characterized by complete incapacitation, non-verbal state, inability to recognize family members, loss of bowel/bladder control, and dependence on assisted feeding.

Cholinergic Medications

Pharmaceutical agents (such as tacrine, donepezil, and galantamine) that inhibit the enzyme acetylcholinesterase, thereby elevating acetylcholine bioavailability to facilitate memory processes.

Memantine

An Alzheimer's pharmacotherapy that blocks glutamate receptors to prevent neurotoxic calcium influx into brain cells.

Acute Cardiovascular Response in AD

Hemodynamic profile where resting and submaximal responses are comparable to healthy controls, but abnormalities emerge at peak workload alongside elevated heart rate variability and delayed postural circulatory adjustments.

Heyn et al. (2004) Meta-Analysis

A systemic review of $30\text{ trials}$ ($n = 2020$) showing exercise yields an overall effect size of $\text{ES} = 0.62$, with notable improvements in cardiovascular fitness ($\text{ES} = 0.62$), strength ($\text{ES} = 0.75$), flexibility ($\text{ES} = 0.91$), and cognition ($\text{ES} = 0.57$).

2:1:2 Cadence

A controlled movement tempo recommended during resistance training for individuals with Alzheimer's disease to optimize muscle contraction and prevent the Valsalva maneuver.

Sundowning Effect on Exercise Timing

The exacerbation of agitation, restlessness, and cognitive fatigue in individuals with Alzheimer's disease during late afternoon or evening, making morning sessions optimal for exercise programming.

Base of Support (BOS)

The foundation area under an individual defined by contact points with the surface; systematically manipulated in balance exercises (e.g., tandem stance, single-limb stance, foam pads) to improve postural stability.

Center of Gravity (COG)

The point where the body's mass is centered; challenged dynamically during reaching, turning, and relay gait tasks to train anticipatory and reactive postural adjustments.