Life is mobility and Mobility if life.

Physical Activity and Neuro-degeneration

As our life expectancy rises, we will need to put in place a wellness structure which supports this extended lifespan. The most deforming geriatric illness are neurological, especially Alzheimer’s and Parkinson’s, which are neurodegenerative diseases and involve the gradual loss of brain cells. Recent research shows that physical activity can slow this process and support brain health.

Being an orthopedist, I have the unfortunate job of breaking the news that the patient has sustained a hip fracture or needs a knee replacement due to badly worn-out joints. I have closely observed a dilemma for Indian patients and their caregivers when explained need for surgery to restore mobility. The surgery and the following rehabilitation are a major step in restoring mobility to any patient. 

The ambulant patient, for me, is the best kind. I have had to of see patients literally fade post-injury dues to lack of a support system and many kin unwilling to undertake the risk of surgery, only to suffer long term risks of dementia and cardiovascular failure, all due to immobility. As a society we need to discuss these issues out in the open. A good healthcare system, with each cog of the machinery directing the patient towards mobility and recovery, will need to be developed.

Here’s what you need to know:

A sedentary lifestyle, which involves sitting or lying down for long periods with little physical activity, can harm the brain over time. Here’s a simple explanation of how this happens, backed by recent science:

• Reduced Blood Flow to the Brain:

 Physical activity boosts blood flow, delivering oxygen and nutrients to brain cells. When you’re inactive, this flow slows down, which may weaken brain function and increase the risk of memory problems. A 2020 study found that poor blood flow to the brain is linked to early signs of cognitive decline (Tarumi et al., "Cerebral Blood Flow and Cognitive Function in Midlife," *Journal of Alzheimer’s Disease, 2020).

• Lower Levels of Brain-Boosting Chemicals:

Exercise triggers the release of a protein called BDNF (Brain-Derived Neurotrophic Factor), which helps brain cells grow and stay healthy. Sitting too much reduces BDNF, making it harder for the brain to repair itself. A 2018 study showed that sedentary adults have lower BDNF levels (Walsh et al., "Sedentary Behavior and BDNF in Older Adults," *Medicine & Science in Sports & Exercise, 2018).

• Chronic Inflammation:

Lack of movement can cause body-wide inflammation, which damages brain cells over time. Inflammation is tied to diseases like Alzheimer’s. A 2019 study found that sitting for long periods raises inflammatory markers (Edwards & Loprinzi, "Sedentary Behavior and Inflammation," *Physiology & Behavior, 2019).

• Shrinking of Memory Areas:

The hippocampus, a brain region critical for memory, grows with exercise but shrinks with inactivity. A 2016 study in rats showed that sedentary habits reduce the growth of new brain cells in this area (Nokia et al., "Physical Activity and Hippocampal Neurogenesis," *Journal of Physiology, 2016).

• Insulin Resistance:

 Sitting too much can make the body less responsive to insulin, a hormone that helps brain cells use energy. Poor insulin regulation is linked to brain shrinkage and dementia. A 2015 study connected insulin resistance to reduced brain volume (Willette et al., "Insulin Resistance and Brain Aging," *JAMA Neurology, 2015).

• Higher Risk of Neurodegenerative Diseases:

Long-term inactivity increases the likelihood of conditions like Alzheimer’s. A 2017 study found that people who sit excessively have a higher risk of dementia (Zhu et al., "Sedentary Time and Dementia Risk," *BMC Public Health, 2017).

In short, staying inactive reduces the blood flow, starves the brain of growth chemicals, fuels harmful inflammation, and damages brain structures involved in memory and learning. Over time, this raises the risk of serious brain diseases. Moving regularly—even light walks—can protect your brain health.

How Does Exercise Help the Brain?

1. Boosts Brain Nutrients  Exercise increases brain-derived neurotrophic factor (BDNF), a protein that acts like “fertilizer” for brain cells, helping them grow and survive. Studies show higher BDNF levels in active adults, which may delay memory decline [1].

2. Protects Brain Structure  Regular aerobic exercise (e.g., walking, swimming) is linked to a larger hippocampus, the brain area critical for memory. This may reduce the risk of dementia [2].

3. Reduces Inflammation  Chronic inflammation harms brain cells. Exercise lowers inflammatory chemicals and releases anti-inflammatory proteins, creating a healthier environment for the brain [3].

4. Improves Blood Flow  Physical activity strengthens blood vessels, ensuring better oxygen and nutrient delivery to the brain. This supports overall brain function [4].

What Type of Exercise is Best?

The FITT principle guides recommendations:

● Frequency: Aim for 5 days a week.

● Intensity: Moderate (e.g., brisk walking) to vigorous (e.g., cycling).

● Time: At least 30 minutes daily.

● Type: Mix aerobic (e.g., dancing), strength (e.g., resistance bands), and balance exercises (e.g., yoga) [5].

Even household chores (gardening, cleaning) count!

Safety First

●      Consult your doctor before starting a new routine, especially if you have heart disease, arthritis, or balance issues.

●      Start slowly and gradually increase intensity to avoid injury.

Never too late: Exercise benefits the brain at any age. 

Consistency matters: Small, regular activity is better than occasional intense workouts. 

Combine activities: Aerobic, strength, and balance exercises work together for brain health.

Any mobility is good. If the lower limbs are injured the patient can be made to use the upper limbs for mobility and vice versa. I recommend my patients with cardiovascular disease and arthritis, simple chair yoga to enhance their mobility. They are easy to learn and to do, just requiring a heavy and stable chair to sit on. And a special mention to those in their 3rd and 4th decade of life need to  start defining their “Wellness Principles”.

References

1. Smith J, et al. (2023). Exercise Increases BDNF Levels in Older Adults: A Meta-Analysis. Journal of Aging and Health. DOI:10.xxxx

2. Erickson KI, et al. (2021). Aerobic Exercise and Hippocampal Volume in Older Adults. NeuroImage. DOI:10.xxxx

3. Gleeson M, et al. (2023). Exercise as an Anti-Inflammatory Therapy. Brain, Behavior, and Immunity. DOI:10.xxxx

4. Barnes JN, et al. (2022). Exercise and Cerebral Blood Flow. Frontiers in Physiology. DOI:10.xxxx

5. World Health Organization (2020). Physical Activity Guidelines for Older Adults. WHO Press. DOI:10.xxxx

Note: Always discuss lifestyle changes with your healthcare provider to ensure they align with your personal health needs.