Muscle mass and strength: How Building Muscle Can Safeguard Against Dementia

What is cognitive decline and dementia?

As we age, our brain changes. Some change is normal (like the decreased speed of our thinking), but cognitive impairment and dementia are not a normal part of ageing. Cognitive decline is when we first start to notice a difficulty in our thinking, planning, memory, concentration or any other of the brain’s functions. Dementia is when these difficulties become severe enough to interfere with our independent daily living. Currently, there is no cure for dementia.

The good news is about 40% of all dementia cases could be preventable (https://doi.org/10.1016/S0140-6736(20)30367-6). Increasing our muscle mass and strength is one way we may be able to prevent or lower our risk of developing dementia in later life.

What does the latest research say about muscle mass, muscle strength, and dementia?

A new study (https://doi.org/10.1007/s12603-023-2007-9) has shown that males with a decline in muscle mass over four years also had a decline in cognitive function. Males who did not lose mass over this time, did not have this same decline in cognitive function. This association was not found in females. Sex hormones may play a role in the difference between males and females, but it is too early to draw definitive conclusions.
Another 2023 study found that those adults (males and females) with a diagnosis of sarcopenia (diagnosed by low muscle strength, requiring assistance with walking, the inability to rise from a chair, difficulty with climb stairs, or having previously fallen) had a 2.4 times greater risk of dementia when compared to people who did not have sarcopenia (https://doi.org/10.1007/s12603-023-2006-x).

It may be that increasing your strength is even more important than increasing your muscle mass for preventing dementia. This may be because muscle mass can accumulate with both healthy (resistance training) and unhealthy behaviours, like a caloric surplus (overeating). On the other hand, strength typically accumulates with healthy behaviours only (resistance exercise).

In this UK Biobank study, weak grip strength at baseline predicted dementia diagnosis and death (https://doi.org/10.1002/jcsm.12857). People with the lowest hand grip strength had a 72% higher risk of dementia diagnosis during a nine-year follow-up period, and a 87% higher risk of dying from dementia, when compared to people with the highest hand grip strength.

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Why might muscle mass and strength play a role in dementia?

We are only beginning to understand why muscle mass and muscle strength are important for maintaining cognitive health in later life. Some reasons might be:

• A loss of muscle mass and strength is associated with inflammation. Inflammation is associated with cognitive decline. On the other hand, exercise has been shown to decrease inflammation, and therefore, exercise may have a protective effect.
• A lack of exercise is associated with neuromuscular decline and vascular dysfunction. Vascular dysfunction is also associated with cognitive decline.
• If you’re not participating in activities like group exercise, you may be at risk for social isolation. Social isolation has also been shown to be associated with cognitive decline.

What can I do to lower my risk for cognitive decline and dementia?

Participate in resistance training at least twice per week. Follow the UK’s Chief Medical Officers’ Physical Activity Guidelines (https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report).

At least 2 days per week, perform strength exercises for all major muscle groups in the upper and lower body. Resistance can be provided by machines, dumbbells, resistance bands, or body weight. Beginners can start with as little as 1 set of 12 repetitions with good form. Be sure to progress to fewer repetitions (6-8 repetitions) with greater resistance (weight or load) over time for strength gain. By the third week, the last repetition you perform should feel difficult to complete. If the last repetition was easy to complete, or you felt that you could have performed more than two more repetitions, the resistance is too low and should be increased.

For muscle hypertrophy (building muscle mass), try taking one of your sets to failure. Failure is when you cannot perform your last repetition with good form because your muscles are exhausted.

Other potential ways we can attempt to prevent or delay the onset of dementia include:

• Increasing educational attainment
• Keeping a normal blood pressure
• Avoid hearing impairment (that is, using a hearing aid when needed)
• Avoid smoking
• Keeping a normal weight; avoiding obesity
• Avoiding depression
• Avoiding Diabetes
• Increasing social contact/connectedness
• Avoiding excessive alcohol consumption
• Avoiding traumatic brain injury
• Avoiding air pollution

Goldster offers a range of resistance exercise classes for both beginners and more active adults. These classes are always supervised by expert trainers who are able to modify exercises for those with goals of increasing their strength and muscle mass to lower their risk of developing dementia.
Stay strong my friends,

Dr. Ashley Gluchowski, CSEP-CEP, CSPS

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