Moderate exercise helps many people with Alzheimer's disease feel better — both physically and emotionally. As little as 20 minutes of walking three times a week can boost mood, decrease falls, reduce wandering and delay nursing home placement in people with Alzheimer's.

Up to 70 percent of people who have Alzheimer's disease also have symptoms of depression. They gradually lose the ability to participate in activities they once enjoyed, and may eventually withdraw from all activities.

Research shows that exercise lessens that tendency. In a sample of people with Alzheimer's, a moderate exercise program totaling at least 60 minutes a week for three months reduced rates of depression. Conversely, scores on a questionnaire that detects depression worsened in a control group that did not exercise.

People with Alzheimer's have a higher risk of falls and fractures than do people the same age without the disease. Once injured, they are also more likely to re-injure themselves. These factors are directly related to impaired mobility and loss of independence.

Moderate exercise improves strength and coordination, which can reduce the risk of falls and injury.

Sleep disturbances are common for people with Alzheimer's disease. They may become agitated at bedtime, wander at night or sleep fitfully. Caregivers become exhausted when they obtain only a few hours of sleep at a time, night after night. Regular physical activity is a natural sleep-enhancer. A daily walk or exercise class can help a person with Alzheimer's sleep more soundly at night.

As Alzheimer's disease progresses, the tendency to wander away from home and get lost increases. Wandering and the dangers that go with it often prompt caregivers to move their loved ones into nursing homes. In many cases, people with dementia appear to wander because of boredom or loneliness.

Programs that engage individuals in meaningful activities, exercise and social interaction may reduce the frequency of wandering. Walking — the most readily available form of exercise — can be combined with a useful activity, such as:

• Walking the dog
• Pushing a person in a wheelchair
• Picking up trash in the neighborhood

Starting an exercise program is hard for everyone. Having Alzheimer's just makes it harder, because the disease makes it more difficult to learn new behaviors. As a caregiver, you may have to join in the exercise program. It may work even better if you exercise with other people with Alzheimer's and their caregivers.

A thorough physical exam will reveal any health problems that may impose restrictions on an exercise program. You might ask your physician for a "prescription" for exercise that you can show your loved one periodically, to encourage participation.

The safest physical activity for someone with Alzheimer's is walking with another person. Many malls have programs that offer a climate-controlled environment for walking. Such outings can be stimulating social interactions, as well.

Exercise can help control many of the general health problems common in older persons, such as high blood pressure, high cholesterol and diabetes. It also improves flexibility, strength and mobility. When you exercise with your loved one, you both benefit.

In addition to giving you an enjoyable activity to do together, exercise can reduce some of the behaviors that make it so difficult to care for a person with Alzheimer's. This can delay placement in a nursing home and improve your loved one's quality of life.