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Exercise and mild cognitive impairment: How solid is the evidence? U.S. News doesn’t say

Rating

3 Star

People With Mild Cognitive Impairment Should Exercise Twice a Week, Research Says

Our Review Summary

This brief article in U.S. News & World Report discusses recently published professional guidelines for treating a condition of aging known as “mild cognitive impairment” (MCI) with regular moderate exercise.

As the article itself notes, scientists and physicians “gush” endlessly about the benefits of exercise for seemingly everything, and now for MCI. However, the story didn’t make it clear that this recommendation is based upon just two studies, both short-term. Nor did it give us a sense of the scope of the benefits. Does exercise help a little? A lot?

 

Why This Matters

The rapidly growing numbers of people diagnosed with Alzheimer’s disease and other forms of dementia are clearly causes for genuine concern and even alarm in the United States. Beyond the human costs are the financial burdens on families and the overall health care system. And the persistent failure of hoped-for benefits from clinical trials of  drugs has added to the drumbeat of worry.

As a consequence, those with symptoms of MCI (which may or may not be linked to the onset of actual AD or dementia), may turn to “alternative” interventions such as diets and dietary supplements, “brain training” with crossword puzzles, and exercise.

Because exercise has been demonstrated to have specific and non-specific physical and psychological benefits for many people, it’s no surprise at all that guidelines from a respected journal suggesting that moderate regular exercise can improve memory would be of interest.

But when the ability to summarize the precise impact of exercise is muted at best; and when the potential exists for “victim blaming” among those who fail to exercise, journalists should take great care in promoting such guidelines.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

Exercise in general is affordable, even free, for most people, though it can be challenging for some people if it requires access to a gym or non-inclement weather.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story doesn’t discuss to what extent exercise is beneficial, so readers aren’t given a sense of scope of the benefits. (If the new guidelines don’t explain the scope of the benefits, the story needs to make that clear.) The story also doesn’t explain what kind of exercise they’re talking about (weight training, running, Zumba?) or how long people need to exercise to benefit.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Since this is targeted at older adults who might have medical conditions or other factors that put them at risk of falls or other injury, the story should have at least carried a caution to consult with a doctor before initiating a new exercise routine.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story briefly explains the guidelines are based on “six-month studies.” Looking at the published paper itself, it appears they were based on a total of two short studies (both under 6 months) that showed twice-weekly exercise “is likely to improve cognitive measures.” Long-term improvements are unknown. These details were needed.

Does the story commit disease-mongering?

Satisfactory

No mongering, here. The article states the facts and estimates about the prevalence of mild cognitive impairment (MCI) and its symptoms pretty well, and duly notes the difference between MCI and dementia.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

No people were quoted or cited. Potential conflicts of interest were not discussed, though they are disclosed in the guidelines.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story acknowledged the lack of alternatives:

The guidelines note that no Food and Drug Administration-approved medications exist for mild cognitive impairment treatment, nor are high-quality, long-term studies in the works that imply drugs or dietary changes could aid people who have the condition.

Does the story establish the availability of the treatment/test/product/procedure?

Not Applicable

For the most part, exercise is widely available.

Does the story establish the true novelty of the approach?

Satisfactory

The news peg is that the Academy of Neurology updated its guidelines, which is a legitimate starting point for many health-related articles. This story makes that clear.

Does the story appear to rely solely or largely on a news release?

Satisfactory

This is a just-barely satisfactory. The story used some similar passages (though not verbatim) to a news release, and also cites an LA Times story in lieu of reporting. Stronger sourcing would have improved the story.

Total Score: 4 of 8 Satisfactory

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