Egzersizin Nörolojik Hastalıklarda Tedavi Edici Etkisi; Alzheimer Örneği

Abstract

Alzheimer hastalığı dünya genelinde yaşlanan nüfus ile artış gösteren ve bireylerde bilişsel, fiziksel ve aynı zamanda sosyal işlevselliği olumsuz etkileyen ilerleyici bir nörodejeneratif bir hastalıktır. Farmakolojik tedavilerin sınırlı etkileri sebebi ile tamamlayıcı ve alternatif yaklaşımlar son dönemde önem kazanmakta ve egzersiz bu alternatif yöntemler arasında öne çıkan bir strateji olarak karşımıza çıkmaktadır. Bu derleme çalışması ‘’ egzersiz’’, ‘’alzheimer’’ ‘’fiziksel aktivite’’ ve ‘’tedavi’’ anahtar kelimeleri Türkçe olarak ve ’exercise’, ‘’alzheimer’’ ‘’physical activity’’ and ‘’treatment’’anahtar kelimeleri İngilizce olarak, Pubmed, Researchgate ve Google Scholar veri tabanlarında, son 5 yılın çalışmalarına ait literatür bilgisi ile sınırlandırılmıştır. Elde edilen bilgiler ışığında; Aerobik, direnç ve denge egzersizlerinin yanında yüksek yoğunluklu ve aralıklı egzersiz yöntemleri de son yıllarda nörobiyolojik etkileri ile dikkat çektiği tespit edilmiştir. Egzersiz; BDNF artışına destek vererek nörovasküler bütünlüğün korunmasına destek sağlar, inflamasyon süreçlerini azaltarak insülin duyarlılığının iyileştirilmesi gibi birçok mekanizma aracılığı ile hastalığın seyrini değiştirebilme yetisine sahip olabilir. Egzersiz tedavisinin etkinliğini arttırmak amacı ile yapılandırılmış bazı programlar, teknolojik destekler ve hasta merkezli yaklaşımlarla bütünsel çalışmaların gerçekleştirilmesi önerilmektedir. Bu bağlamda multidisipliner bakış açısı ile uzun dönemli ve biyobelirteç odaklı araştırmaların Alzheimer hastalığı da ile ilgili mücadele de egzersizin potansiyelini daha net bir şekilde ortaya koyacaktır.

Keywords

• Egzersiz
• Alzheimer
• Fiziksel Aktivite
• Tedavi

The Therapeutic Effect of Exercise in Neurological Diseases: The Case of Alzheimer’s Disease

Abstract

Alzheimer's disease is a progressive neurodegenerative disease that is increasing worldwide with the aging population and negatively affects cognitive, physical, and social functioning in individuals. Due to the limited effects of pharmacological treatments, complementary and alternative approaches have gained importance in recent years, and exercise has emerged as a prominent strategy. This review study was conducted using the keywords “exercise,” “Alzheimer's,” “physical activity,” and ‘treatment’ in Turkish and “exercise,” “Alzheimer's,” "physical activity,“ and ”treatment" in English in the PubMed, Researchgate, and Google Scholar databases, limited to literature from the last 5 years. Based on the information obtained, it was determined that aerobic, resistance and balance exercises, as well as high-intensity and interval training methods, have attracted attention in recent years due to their neurobiological effects. Exercise supports the maintenance of neurovascular integrity by promoting BDNF increase, and it may have the ability to alter the course of the disease through various mechanisms, such as reducing inflammation processes and improving insulin sensitivity, exercise may have the ability to alter the course of the disease through various mechanisms. To enhance the effectiveness of exercise therapy, it is recommended to conduct comprehensive studies using structured programs, technological support, and patient-centered approaches. In this context, long-term, biomarker-focused research with a multidisciplinary perspective will more clearly reveal the potential of exercise in the fight against Alzheimer's disease.

Keywords

• Exercise
• Alzheimer
• Physical Activity
• Treatment

References

1. Alani, Z. (2024). Exercise, Episodic Memory, and Age: A Systematic Review. International Journal of High School Research, 6(9).
2. Anitha, K., Singh, M. K., Kohat, K., Chenchula, S., Padmavathi, R., Amerneni, L. S., ... & Bhatt, S. (2025). Recent insights into the neurobiology of Alzheimer’s disease and advanced treatment strategies. Molecular Neurobiology, 62(2), 2314-2332.
3. Baek, J. E., Hyeon, S. J., Kim, M., Cho, H. Y., & Hahm, S. C. (2024). Effects of dual-task resistance exercise on cognition, mood, depression, functional fitness, and activities of daily living in older adults with cognitive impairment: a single-blinded, randomized controlled trial. BMC geriatrics, 24(1), 369.
4. Barha, C. K., Best, J. R., Rosano, C., Yaffe, K., Catov, J. M., & Liu-Ambrose, T. (2020). Sex-specific relationship between long-term maintenance of physical activity and cognition in the health ABC study: potential role of hippocampal and dorsolateral prefrontal cortex volume. The Journals of Gerontology: Series A, 75(4), 764-770.
5. Brodaty, H., Chau, T., Heffernan, M., Ginige, J. A., Andrews, G., Millard, M., ... & Valenzuela, M. (2025). An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial. Nature Medicine, 1-9.
6. Cheung, C. L. K. (2024). Association Between the Pattern of Participation in Intellectual Activities and Cognitive Functioning in Older Adults Without Clinical Dementia (Master's thesis, The Chinese University of Hong Kong (Hong Kong)).
7. Cummings, J., Lee, G., Zhong, K., Fonseca, J., & Taghva, K. (2021). Alzheimer's disease drug development pipeline: 2021. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 7(1), e12179.
8. De la Rosa, A., Olaso-Gonzalez, G., Arc-Chagnaud, C., Millan, F., Salvador-Pascual, A., García-Lucerga, C., ... & Gomez-Cabrera, M. C. (2020). Physical exercise in the prevention and treatment of Alzheimer's disease. Journal of sport and health science, 9(5), 394-404.

9. Festa, F., Medori, S., & Macrì, M. (2023). Move your body, boost your brain: the positive impact of physical activity on cognition across all age groups. Biomedicines, 11(6), 1765.
10. Frederiksen KS, Gjerum L, Waldemar G, Hasselbalch SG. Effects of Physical Exercise on Alzheimer's Disease Biomarkers: A Systematic Review of Intervention Studies. J Alzheimers Dis. 2018;61(1):359-372.
11. Gallardo-Gomez, D., del Pozo-Cruz, J., Noetel, M., Alvarez-Barbosa, F., Alfonso-Rosa, R. M., & del Pozo Cruz, B. (2022). Optimal dose and type of exercise to improve cognitive function in older adults: A systematic review and bayesian model-based network meta-analysis of RCTs. Ageing research reviews, 76, 101591.
12. Gao, Y., Syed, M., & Zhao, X. (2023). Mechanisms underlying the effect of voluntary running on adult hippocampal neurogenesis. Hippocampus, 33(4), 373-390.
13. Gholipour, P., Komaki, A., Ramezani, M., & Parsa, H. (2022). Effects of the combination of high-intensity interval training and Ecdysterone on learning and memory abilities, antioxidant enzyme activities, and neuronal population in an Amyloid-beta-induced rat model of Alzheimer's disease. Physiology & Behavior, 251, 113817.
14. Hampel, H., Cummings, J., Blennow, K., Gao, P., Jack Jr, C. R., & Vergallo, A. (2021). Developing the ATX (N) classification for use across the Alzheimer disease continuum. Nature Reviews Neurology, 17(9), 580-589.
15. Hu, J., Huang, B., & Chen, K. (2024). The impact of physical exercise on neuroinflammation mechanism in Alzheimer’s disease. Frontiers in Aging Neuroscience, 16, 1444716.
16. Hu, Y., Zhou, Y., Zhang, M., Ge, W., Li, Y., Yang, L., ... & Huang, H. (2021). CRISPR/Cas9-engineered universal CD19/CD22 dual-targeted CAR-T cell therapy for relapsed/refractory B-cell acute lymphoblastic leukemia. Clinical Cancer Research, 27(10), 2764-2772.
17. Jack Jr, C. R., Andrews, J. S., Plaj, T. G., Buracchio, T., Dunn, B., Graf, A., ... ve Carrillo, M. C. (2024). Revised criteria for the diagnosis and staging of Alzheimer's disease: Alzheimer's Association Working Group. Alzheimer ve Demans, 20(8), 5143-5169.
18. Karssemeijer, E. E., Aaronson, J. J., Bossers, W. W., Smits, T. T., & Kessels, R. R. (2017). Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia: A meta-analysis. Ageing research reviews, 40, 75-83.
19. Knopman, D. S., Amieva, H., Petersen, R. C., Chételat, G., Holtzman, D. M., Hyman, B. T., ... & Jones, D. T. (2021). Alzheimer disease. Nature reviews Disease primers, 7(1), 33.
20. Kovacevic, A., Fenesi, B., Paolucci, E., & Heisz, J. J. (2020). The effects of aerobic exercise intensity on memory in older adults. Applied physiology, nutrition, and metabolism, 45(6), 591-600.
21. Law CK, Lam FM, Chung RC, Pang MY. Physical exercise attenuates cognitive decline and reduces behavioural problems in people with mild cognitive impairment and dementia: a systematic review. J Physiother. 2020 Jan;66(1):9-18.
22. Lee, D. C. A., Callisaya, M., Meyer, C., Taylor, M. E., Lawler, K., Levinger, P., ... & Hill, K. D. (2024). Changing the focus: Facilitating engagement in physical activity for people living with mild dementia in a local community—Protocol for a pre-post mixed methods feasibility study. Plos one, 19(9), e0307018.
23. Leng, F., & Edison, P. (2021). Neuroinflammation and microglial activation in Alzheimer disease: where do we go from here?. Nature Reviews Neurology, 17(3), 157-172.
24. Maaß, A., Düzel, S., Goerke, M., Becke, A., Sobieray, U., Neumann, K., ... & Düzel, E. (2015).Vascular hippocampal plasticity after aerobic exercise in older adults. Molecular psychiatry, 20(5), 585-593.
25. Nogueira Godinho, W. D., Vasconcelos Filho, F. S. L., Pinto, D. V., Alves, J. O., de Souza Nascimento, T., de Aguiar, I. D., ... & Soares, P. M. (2022). High-Intense Interval Training Prevents Cognitive Impairment and Increases the Expression of Muscle Genes FNDC5 and PPARGC1A in a Rat Model of Alzheimer's Disease. Current Alzheimer Research, 19(12), 830-840.
26. Palmdorf, S., Stark, A. L., Nadolny, S., Eliaß, G., Karlheim, C., Kreisel, S. H., ... & Dockweiler, C. (2021). Technology-assisted home care for people with dementia and their relatives: scoping review. JMIR aging, 4(1), e25307.
27. Rieker, J. A., Reales, J. M., Muiños, M., & Ballesteros, S. (2022). The effects of combined cognitive-physical interventions on cognitive functioning in healthy older adults: a systematic review and multilevel meta-analysis. Frontiers in human neuroscience, 16, 838968.
28. Sortino, M., Amato, A., & Musumeci, G. (2024). Advanced technologies applied to physical exercise for dementia and Alzheimer’s disease management: a narrative review. Advanced Technology in Neuroscience, 1(1), 72-85.
29. Supruniuk, E., Górski, J., & Chabowski, A. (2023). Endogenous and exogenous antioxidants in skeletal muscle fatigue development during exercise. Antioxidants, 12(2), 501.
30. Van Dyck, C. H., Swanson, C. J., Aisen, P., Bateman, R. J., Chen, C., Gee, M., ... & Iwatsubo, T. (2023). Lecanemab in early Alzheimer’s disease. New England Journal of Medicine, 388(1), 9-21.
31. World Health Organization. (2023).Dementia. Retrived From: https://www.who.int/news-room/fact-sheets/details/dementia E.T : 19.03.2025
32. World Helath Organization. (2020). WHO guidelines on physical activity and sedantary behaviour. https://www.who.int/publication/i/item/9789240015128 E.T: 12.03.2025
33. Yu F, Vock DM, Zhang L, Salisbury D, Nelson NW, Chow LS, Smith G, Barclay TR, Dysken M, Wyman JF. Cognitive Effects of Aerobic Exercise in Alzheimer's Disease: A Pilot Randomized Controlled Trial. J Alzheimers Dis. 2021;80(1):233-244.
34. Zeng, Y., Wang, J., Cai, X., Zhang, X., Zhang, J., Peng, M., ... & Yan, F. (2023). Effects of physical activity interventions on executive function in older adults with dementia: A meta-analysis of randomized controlled trials. Geriatric Nursing, 51, 369-377.
35. Zhang, H. W., Zhang, H. B., Liu, X. L., Deng, H. Z., Zhang, Y. Z., Tang, X. M., ... & Huang, B. (2024). Clinical assessment of magnetic resonance spectroscopy and diffusion-weighted imaging in diffuse glioma: insights into histological grading and IDH classification. Canadian Association of Radiologists Journal, 75(4), 868-877.