An older man who has Alzheimer's Disease is exercising with a staff person

Beginning aerobic fitness can be assessed by measuring the distance (in feet) a person can walk in 6 minutes. This is a commonly used and reliable measure of fitness in the elderly and persons with disabilities (Tappen, Roach, Buchnor, Barry, & Edelstein, 1997).

Upper- and lower-body strength can be assessed by recording the amount of weight a person can press or lift 10 times on a chest press and a leg press machine, respectively.

If machines aren't available, dumbbells can be used for an upper-body test. For another test of lower-body fitness, count the number of seconds it takes the person to rise from a chair and sit down again 10 times. Persons using any kind of free weights must be closely monitored and should wear sturdy, closed shoes to minimize the risk of injury should a dumbbell be dropped. Balance can be assessed by having the person stand first on one foot and then on the other and recording how many seconds balance can be maintained (Netz & Argov, 1997). It's a good idea to give three trials for each foot and to record the best trial for each. Progress can be measured by retesting and comparing scores after an interval of training, i.e., three and four months.

A 'Tried-and-True' Fitness Protocol for Persons with Alzheimer's Disease

An older woman who has Alzheimer's Disease is exercising with a staff person

The protocol described below has been successfully used with persons with Alzheimer's Disease for four years at the University of Arizona Medical Center's cardio-rehab/employee wellness center. Four participants, the oldest whom is 90 years old, have been following this program for all four years the program has been in operation. Others currently in the program have been following it from one to three and a half years. Their schedule has been twice-weekly workouts for 10 weeks during each academic semester and, for some participants with committed caregivers, once weekly during university vacation periods.

Each workout consists of stretching and balance exercises, 20 to 30 minutes of aerobics (usually achieved by the end of one semester of participation) and 20 to 30 minutes of upper- and lower-body strength training. One of the two weekly workout sessions is supervised by a student, who also administers a variety of memory- and conversation-stimulation activities during and between the various exercises. (Examples of all the activities administered follow this section.) Students are undergraduates and were originally recruited from among speech and hearing, psychology, and exercise physiology students; later, health science majors and honors students from all disciplines were also recruited via mass e-mails (listservs). They are given small-group training on safety procedures and use of the exercise equipment, as well as individual supervision during their first few sessions with their rehab partner.

There are several purposes for these activities. First, they provide practice in memory and language skills that typically deteriorate in Alzheimer's Disease; second, they help pass the time during lengthy sessions on the treadmill and stationary bike; third, they provide a starting place for conversation between the exerciser and the exercise assistant. Persons with Alzheimer's Disease tend to get in a 'rut' conversationally, limiting their discourse to safe, familiar topics and anecdotes, and repeating themselves a great deal. Family members who care for someone with Alzheimer's Disease, often misjudge their ability to discuss complex or controversial issues, and limit their conversation to topics related to care-giving, such as meal preferences, appointment reminders, instructions, and admonitions. Introducing novel, provocative topics in the course of an exercise session stimulates the person's mental 'lexicon' and improves conversational ability. (See Arkin & Mahendra, 2001 for a detailed description of Alzheimer's discourse analysis and outcomes after one year of exercise plus language interventions).

The second weekly workout is supervised by a family member. There is also one session per week of brisk walking, which is incorporated into some other type of community activity that is supervised by the student assistant. (The student assistants receive university credit for their work as 'rehab partners'). The full workout sessions are scheduled so that there is at least one day of rest between sessions to allow for recovery.