Study participant Donna Templeton works the weights to build bone strength and improve cognitive performance - photo by Martin Dee

UBC Reports | Vol. 53 | No. 9 | Sep. 6, 2007

Pumping Iron Aids Brains and Bones

New Study Examines Impact of Resistance Training on Cognitive Ability and Risk of Falling

By Hilary Thomson

Hitting the gym may give seniors more than muscle -- it may reduce risk of fractures by improving not only bone health but also cognitive function.

According to Teresa Liu-Ambrose, UBC assistant professor in the Faculty of Medicine’s Dept. of Physical Therapy, one-third of hip fracture hospital admissions internationally occur in seniors with cognitive impairment -- a condition that may be prevented or minimized with regular physical activity, including resistance training (RT), or exercising with weights to develop strength.

She believes RT can help reduce risk of fracture in cognitively impaired individuals in two ways: by improving bone health and by increasing levels of insulin-like growth factor 1 (IGF-1) that promotes brain cell growth and survival. RT also decreases serum homocysteine, an amino acid that in high levels is associated with impaired cognitive performance.

“The relative risk of hip fracture among those with cognitive impairment ranges from double to seven times the risk compared to those with no cognitive impairment,” says Liu-Ambrose, a member of the Centre for Hip Health, part of Vancouver Coastal Health Research Institute (VCHRI). “Although there is a large body of research about reducing falls and fractures among cognitively healthy seniors, little research has targeted bone health among those with cognitive impairment.”

More Canadian women die annually following hip fractures than from breast cancer, says Liu-Ambrose, who joined UBC in 2006. The incidence of hip fracture among Canadian men and women, mostly over 70 years, is 24,000 annually with a health-care price tag that can exceed $1.3 billion each year, she adds.

Researchers will look at the effects of RT on bone health, physiological function and cognitive function, with a focus on the brain’s executive functions or higher-order processes, such as the ability to multi-task. Falls often result from impairments in these processes. Other research has shown that cardiovascular training can benefit executive functioning but similar positive effects of RT are virtually unknown, says Liu-Ambrose.

Vancouver is the site of an initial one-year phase of her five- to six-year research program that will also reach the Vancouver suburb of Tsawwassen and Qualicum Beach on Vancouver Island. The program is unique in North America because it brings together researchers from disciplines that include psychology, geriatric medicine, orthopedics and radiology; has a large sample size of 220 participants per community; and looks at the minimum amount of RT required to make a difference.

Collaborators include Maureen Ashe, a post-doctoral Fellow at the Centre for Hip Health and UBC Asst. Prof. Todd Handy from Psychology.

The Vancouver study is being conducted at the South Slope YMCA and the Centre for Hip Health. Classes of up to 10 women aged 65-75 years are led by certified fitness instructors and focus on using weight machines and free weights to build strength. Women come to classes as a group and participate either once, twice or three times per week.

“I’ve been surprised by how difficult it can be for women in this age group to take the time to participate in physical activity, as many are caring for spouses or grandchildren,” says Liu-Ambrose. “We need to promote and enable exercise opportunities for seniors.”

Women in the study are evaluated for key factors related to hip fracture risk, such as bone health, balance, and performance of cognitive executive functions, using pen and paper tests. In addition, participants will undergo functional magnetic resonance imaging to determine if brain function changes with RT.

Participant Donna Templeton calls the program “a life-changing blessing.” Diagnosed with osteopenia -- often a precursor to the bone-thinning disease osteoporosis -- the active 68-year-old former nurse has been training twice a week for five months and feels much stronger, especially in her upper body. She won’t know about any cognitive improvements until her upcoming assessment.

A veteran of four fractures in 12 years, Templeton says the slow healing associated with osteopenia affects the whole family and can be depressing. She finds the one-on-one attention and group support helps her stick to her schedule and carefully increase the weights. An unexpected benefit has been significant reduction in pain from migraine headaches.

Her advice is have bone density tested as young as 30 to get a baseline and then hit the gym. “The sooner you start with the help of a qualified instructor, the better.”

For more information on the study, contact Liu-Ambrose at 604.875.4111, ext. 69059.

Support for this research has been provided by the Michael Smith Foundation for Health Research, the Canadian Institutes of Health Research and the Vancouver Foundation.
VCHRI is the research body of Vancouver Coastal Health Authority. In academic partnership with UBC, the institute advances health research and innovation across B.C., Canada, and beyond.

The Centre for Hip Health conducts innovative research programs to decrease the burden of hip fracture and hip osteoarthritis across B.C., Canada, and the world. It is the first international research centre to broadly focus on problems affecting the human hip across the lifespan by integrating researchers in various aspects of bone health, falls prevention, and osteoarthritis.