Hippocrates said famously, “walking is the best medicine.” New research from the University of Maryland School of Public Health has found that moderate physical activity at a “conversational pace” may improve cognitive function by improving the efficiency of brain activity associated with memory. The new study found that moderate exercise may be the best medicine for preventing Mild Cognitive Impairment (MCI) or more substantial memory loss for those at a greater risk for developing Alzheimer’s disease.
The research was led by Dr. J. Carson Smith, assistant professor in the Department of Kinesiology and is published in the Journal of Alzheimer's disease. The findings of this study provide new hope for those diagnosed with MCI. "People with MCI are on a very sharp decline in their memory function, so being able to improve their recall is a very big step in the right direction," Smith states.
For this study two groups of physically inactive older adults (ranging from 60-88 years old) were put on a 12-week exercise program that focused on regular treadmill walking and was guided by a personal trainer. One group included adults with MCI, the other group included adults with healthy brain function. Cardiovascular fitness improved by about ten percent on average for all participants. Interestingly, both groups also improved their memory performance and showed enhanced neural efficiency while engaged in memory retrieval tasks.
"We found that after 12 weeks of being on a moderate exercise program, study participants improved their neural efficiency – basically they were using fewer neural resources to perform the same memory task," says Dr. Smith. "No study has shown that a drug can do what we showed is possible with exercise."
There is currently no cure for Alzheimer’s disease. The new study is the first to show that an exercise intervention with older adults with mild cognitive impairment (average age 78) improved not only memory recall, but also brain function, as measured by functional neuroimaging (via fMRI).
Brain imaging taken after the exercise intervention showed a significant decrease in the intensity of brain activation in eleven brain regions while participants correctly identified names of celebrities and famous people. The brain regions with improved efficiency corresponded to those involved in the pathology of Alzheimer's disease, including the precuneus region, the temporal lobe, and the parahippocampal gyrus.
What is a “conversational pace”?
Lily Tomlin has jokingly advised: “For fast acting relief try slowing down.” As an Ironman triathlete I spent many years constantly pushing myself into the red zone of overexertion. Now that I am retired from competition, I prefer to work out at a ‘tonic level’ or conversational pace. Not only have researchers found that moderate exercise is more beneficial than overexerting and ‘red lining it’, but having a workout partner that you converse with creates interpersonal connectedness, which is key to well-being.
The University of Maryland study found that the best results for MCI were achieved with a dose of exercise that was in the easy to moderate range. The researchers’ guidelines urge moderate intensity exercise (activity that increases your heart rate and makes you sweat, but isn't so strenuous that you can't hold a conversation while doing it) on most days for a weekly total of 150 minutes.
Rated Perceived Exertion and Heart Rate
Most people have three basic gears when it comes to physical exertion: easy, medium, and hard. Each of these ‘zones’ would be represented by “Beats Per Minute” (BPM) of your heart and a level of “Rated Perceived Exertion” (RPE) attached to each zone.
As the name implies, RPE is a scale from 1-10 used by athletes to rate his or her level of exertion during a workout. The scale goes from 1 being perceived as “nothing at all” to 10 being “very, very heavy.” RPE is designed to be subjective—running a ten minute mile can have very different levels of RPE depending on your level of conditioning.
Walking is a terrific form of exercise to do with a friend because most of us can walk and talk at the same pace. If you are looking for a running partner, try to find someone of similar athletic ability so you can achieve a conversational pace with the same moderate level of perceived exertion.
Your inner dialogue and explanatory style changes depending on your exertion level. When you are going hard or very hard aerobically the inner dialogue often becomes scattered and is coupled with a feeling of being overwhelmed. Generally, when you’re working out at a conversational pace it feels like a tonic level that is the sweet spot between lollygagging and overexertion.
At an easy to moderate level of exertion you are able to take a wide-angle lens of your thoughts, be contemplative, and absorb the world around you. The harder you exert yourself, the smaller the aperture becomes, and you begin to be more microscopic in your focus. At a high level of exertion it’s difficutl to be contemplative or converse either through inner dialogue or with another person.
Unless you’re training for a competition, staying between the easy to medium zone of exertion is optimal for well-being. If you are interested in fine-tuning your optimal zone you can use a heart rate monitor, but the ‘Talk Test’ is an easy way to stay at a conversational pace.
Below is a simple 5-point scale for “Rated Perceived Exertion” as it relates to percentage of maximum heart rate using the “Talk Test”:
- VERY EASY: You could sing a song. (40 to 50 percent maximum heart rate).
- EASY*: You could carry on a regular conversation while moving. (50 to 60 percent).
- MODERATE*: You could speak four- to six- word sentences (60 to 80 percent).
- HARD: You could express short two- or three-word thoughts. (80 to 85 percent).
- VERY HARD: You could grunt and use sign language. (85 to 100 percent).
*Easy to moderate is the ideal “conversational pace” for optimal health benefits.
Conclusion: Conversational Pace Is Good For Body, Brain, and Social Connectedness
Something happens neurobioligically when you’re walking or jogging slowly that makes conversation more fluid and unguarded. Over the past few years I have really gotten to know my jogging partner and he’s gotten to know me. Steve Jobs was famous for holding meetings while walking ... Aristotle founded the famous Peripatetic School in ancient Greece where teaching took place while walking pathways around the Lyceum. Making conversation a part of your daily fitness routine builds stronger friendships and social connectivity which many studies are finding to be the most essential ingredient to longevity and happiness.
One of the prime benefits of working out at a conversational pace is that exercise doesn’t feel like an absolute sufferfest, and therefore the associations to physical activity become linked to pleasure and feeling good. All animals seek pleasure and avoid pain. If exercise is viewed as a disagreeable or tortorous experience you are more likely to avoid it. On the flip side, if you are exercising at a conversational pace the experience is viewed as being enjoyable and you are more likely to stick with it.
Dr. J. Carson Smith’s findings suggest that moderate exercise reduces the over-activation of the brain and may help to preserve brain function. Smith wants to do a larger study that would include more participants, including those who are healthy but have a genetic risk for Alzheimer's, and follow them for a longer time period with exercise in comparison to other types of treatments. He and his team hope to learn more about the impact of exercise on brain function and whether it could delay the onset or progression of Alzheimer's disease.