Member has chosen to not make this information public.

Posts (6)

Tue, Mar 31 8:43am · Staying Physically Active During a Time Of Social Distancing in Living with Mild Cognitive Impairment (MCI)


Right now, when we are encouraged to avoid physical closeness with people besides those living with us, your regular workout routine may have been disrupted. Perhaps your main activity was a regular group exercise class or being part of a pickle ball team, and now with gym closures and other recommended practices of social distancing, these options are not currently available.

Although it might seem like a good plan to just postpone exercise for a while, we strongly discourage you from stopping physical activity, unless you are ill. There are many scientifically proven benefits to exercise including stress reduction, improved mood, better sleep, better immune function, and stronger bones and muscles to name a few.  Especially during times like these, we urge you to get creative with ways to stay active, and check out the resources listed in this blog.

The American College of Sports Medicine (ACSM) has the following exercise recommendations for adults: at least 150 minutes of moderate cardio-vascular exercise per week, twice a week strengthening most major muscle groups, stretching, and balance exercises. For older adults with limitations or chronic conditions, the recommendation would be: do what you can safely do, even if it doesn’t quite meet the recommendation.

Ideas for exercise:

  • Walk: Walking is an ideal form of exercise. If you can walk outside and maintain social distancing, that would be best; otherwise, you might consider walking in your home. This can be walking in place (to the beat of your favorite music), walking the length of your home, or walking along with a free YouTube video like this one 1 mile walk or 3 mile walk. Make sure to find your own best pace.
  • Cardio-equipment: If you are fortunate to have cardio equipment in your home, make sure to use it most or all days of the week.
  • Dance: Turn on some music and dance in the living room. Invite your partner if you share your living space with them.
  • Yoga: yoga has the benefit of not only providing you with physical exercise, but has the additional advantage of providing you with skills to calm your mind. Try this Gentle Yoga example from Mayo Clinic.

Also consider some of these reputable websites with additional information on staying active during this time:

https://www.exerciseismedicine.org/assets/page_documents/EIM_Rx%20for%20Health_Coronavirus.pdf  (Staying active during the corona virus pandemic)

https://www.ncoa.org/blog/encouraging-older-adults-to-stay-active-and-safe-during-the-coronavirus-pandemic/ Advice from the National Council on Aging-for older adults.

https://www.youtube.com/playlist?list=PLmk21KJuZUM7kDgg7EOsXqPKAoOnD5Q8N 4 exercise videos ranging from 10-60 minutes, specifically geared to older adults (National Council on Aging)

Join Mayo Clinic Connect’s virtual walking group: Let’s Go Walking! Join me for a virtual walking support group


Nov 4, 2019 · Exercise Part 2: Does Exercise Change the Brain in People with MCI? in Living with Mild Cognitive Impairment (MCI)

Exercising Couple

There are many great health reasons to stay physically active throughout life. Because of these benefits, the limited risks, and the low to no cost options for getting moving, it has been said that if we could package exercise as a pill, everyone would take it. Besides all the scientific evidence for the physical benefits like weight management, improved heart function, increased muscle strength and flexibility, better sleep and improved digestion and elimination, there are also significant brain health benefits.

Last week, Dr. Shandera outlined strategies to start a new exercise program gradually. This week, I’d like to highlight an example of a recent study that outlines the brain health benefits of exercise for those living with Mild Cognitive Impairment (MCI).


This recent study published in the Journal of Alzheimer’s’ disease examined the effect of a year-long program of aerobic exercise (AE) versus stretching and toning (SAT) in a group of 70 participants with MCI. The purpose of the study was to test the effect of a moderate-high intensity aerobic exercise program on memory, executive/cognitive function, brain volume, and amyloid plaque formation in MCI patients. Patients were men and women aged 55-80, who did not exercise on a regular basis.


The aerobic exercise group completed a year-long aerobic exercise program that gradually increased in frequency and intensity. They started with exercising three times per week for 25-30 minutes at moderate intensity (75-80% of maximum heart rate) and progressed to exercising 5 times per week for 30-40 minutes including two high intensity (85-90% of maximum heart rate) sessions. Participants in this group used a heart rate monitor to keep track of their heart rate.

The stretching and toning group exercised at the same frequency and duration but needed to keep their HR below 50% of maximum heart rate as they performed  upper and lower body strengthening and stretching exercises. They progressed the exercise intensity through the use of a resistance bands later in the program.

All participants were supervised for the first few weeks, and then continued on their own. They continued to meet once a month with an exercise specialist to review their training log.


The findings of the study were as follows:

  1. Slightly improved memory and cognitive performance in both groups on pencil and paper memory and executive functioning testing. Executive functioning includes thinking skills such as attention, concentration, and the ability to multi-task.
  2. Neither program prevented amyloid plaque progression. Amyloid plaques are clumps in the brain made of beta amyloid (a type of protein fragment) that form in between neurons. This is one abnormal finding found in Alzhiemer’s disease.
  3. Most participants in the aerobic exercise group had significant improvement in cardiorespiratory fitness
  4. Participants in the aerobic exercise group who had amyloid plaques when they started the exercise program, showed less shrinking of the hippocampus over time. This is a positive finding as the hippocampi (you have two of them) are small structures deep inside the brain that are important in new learning and memory.


The researchers believe that better blood flow, chemical changes, and creation of new brain cells were causing the improvements. They concluded that: “Collectively these findings suggest benefits of both aerobic exercise and stretching and toning exercise on neuropsychological function in aMCI patients.” (page 431).


If you are not currently doing regular aerobic exercise, these findings may give you additional motivation to get started. Try Dr. Shandera’s suggestions to get started. Mayo Clinic encourages a consultation with a physician before starting a vigorous exercise program. He or she may suggest that you have certain tests first. This may be the case for people who have diabetes or more than one risk factor for heart disease, and for men over age 45 and women over age 55.

In addition to speaking with your physician, for more information on starting an exercise program, finding the proper intensity, and how to measure maximum heart rate, please refer to this article by Mayo Clinic.

Have you had some success getting active?  Do you see other benefits? Let us know what’s working for you and how it is working!


Nov 28, 2018 · The Best Exercise for Strong Legs in Living with Mild Cognitive Impairment (MCI)


The why:

There are many reasons for keeping the legs strong including reducing fall risk, improving metabolism, and getting out of a chair with more ease. Additionally, according to a British study done on twins, published in 2015, there is also a link between brain health and leg strength.

The how:

As a physical therapist, I teach my patients exercises every day, and over the years I have found the chair squat to be one of the most functional and practical leg strengthening exercise.

To get started you can test yourself by following the directions below:

(Please check with your physician or physical therapist if you have any concerns about this exercise or if you are not sure that you can do it safely.)


  1. Sit in the middle of a sturdy firm chair (no wheels!)
  2. Cross arms over chest, with hands on opposite shoulders*
  3. Keep your feet flat on the floor
  4. Have someone time you (or look at the clock yourself), and on “start”, you come to a full standing position with arms still crossed and back straight-then sit down again.
  5. Repeat for 30 seconds, counting the number of times you get up.

*If you have any balance difficulties, do the exercise with hands on a table and have a person standing next to you for support if needed.

You should aim to meet or exceed the following average scores (per 30 seconds):

60-64 14 12
65-69 12 11
70-74 12 10
75-79 11 10
80-84 10 9
85-89 8 8
90-94 7 4

Once you have determined your number of repetitions, I suggest you do 2-3 sets of that number, either fast or at an easy pace, every day. Make sure you don’t hold your breath as you practice this exercise. If the exercise makes your knees achy, progress slowly as tolerated, or check with a healthcare provider first.

For more information on the test, please visit the CDC website. And, let’s get out of those chairs (and sit in them again, and stand, and sit)!


Meet others talking about exercise and healthy habits in the Healthy Living group.

Jul 9, 2018 · The 1-minute breathing meditation for relaxation in Living with Mild Cognitive Impairment (MCI)

Dr. Rubenzer,

The quote is fine to use with the following edits:
1. Please capitalize Mayo Clinic.
2. We say "Arizona campus" rather than location.

Additionally, can you please include a link back to the original post here on Connect for the electronic publications: https://connect.mayoclinic.org/newsfeed-post/the-1-minute-breathing-meditation-for-relaxation/

Thank you and all the best with your work.

Jul 4, 2018 · The 1-minute breathing meditation for relaxation in Living with Mild Cognitive Impairment (MCI)

Hi Dr. Rubenzer, yes absolutely feel free to share-please include the source: Dr. Pauline H. Lucas, Mayo Clinic in Arizona

Jul 3, 2018 · The 1-minute breathing meditation for relaxation in Living with Mild Cognitive Impairment (MCI)


Do you have just 1 minute?

Do you find yourself frequently worrying about the future, ruminating about past events, or simply having a hard time quieting your mind? Using a simple breathing practice for relaxation might help calm your overactive mind. Breathing practices have been used for thousands of years and have gained much popularity lately. They are easy to practice, free of charge, and don’t have negative side-effects.

Fight or Flight

When we are stressed, either because of difficult circumstances, or because of our stressful thoughts, our nervous system gets ready for action. You may have heard of the “fight/flight response”. When our brain perceives danger, the body gets ready to either fight or run away from the threat. This is a great nervous system survival response for short term stressors and when we need to act quickly. An example of this is when a car comes swerving into our lane on the freeway and is about to collide with our car. We quickly jerk our steering wheel, maybe honk the horn, and once the situation is over, we might feel our muscles tighten, feel our heart beat fast, and our breath may be shallow and rapid. After a few minutes however, these sensations resolve and the body is typically calm again. If our nervous system experiences chronic stress, either because of a difficult situation or our constant worry thoughts, the same response happens, only now it doesn’t just ease up. The result can be chronically tense muscles, faster heart beat, fast and shallow breathing, digestive problems, and insomnia, just to name only a few!

The power of breath

The breath is an interesting function of the body as it typically (thankfully!) happens automatically, but we can also control it –for example to energize or calm our system. By becoming mindful of our breathing, purposely breathing in a calm way, and by breathing out a little slower than our inbreath, we can calm our nervous system and lessen the “fight or flight” response and instead move the nervous system to a calmer state called the “rest/restore” response. The result is relaxation of the body and a calmer mind. Some of this happens immediately, but with regular practice, the results are even more significant.

Easy steps to practice a 1-minute breathing meditation:

  1. Find a comfortable seated position, feel your feet on the ground and keep your spine tall and straight. Relax your shoulders away from your ears, and relax the face. If appropriate, you can choose to close your eyes.
  2. Take a long, slow breath in through the nose, and then calmly, slowly, and without tension breathe all the air out through the nose.
  3. Resume regular breathing by allowing the next breath to come in automatically, without any effort, and notice the cool sensations at the nostrils.
  4. Keep your awareness with the sensations at the nostrils as you breathe out calmly, and notice warmer air leaving the nose. Ideally your outbreath is a bit longer than the inbreath.
  5. For 1 minute (longer if desired) keep your awareness with the breath gently entering and leaving the nostrils.
  6. If you find your mind wandering, simply return it to the breathing practice.

Regular practice

Once you have practiced this technique a few times you can try a “mantra” practice, which means you use a word or short phrase to keep your mind focused on the breathing practice. For example: as you breathe in you might mentally say, “I am”, and as you slowly breathe out say “calm”, and you repeat this with each breath.

This is a simple practice that can be used pretty much anytime and anywhere. Although we tend to initially practice sitting or lying down, it can be done in standing as well. So the next time you find yourself in a doctor’s waiting room, or in line at the grocery store, instead of getting frustrated about the wait, you might use the time as an opportunity to practice some relaxed breathing and de-stress your nervous system instead.