DEAR DR. ROACH: My wife, who’s 66, walks two miles every morning at a moderate pace. I’m 75 and ride an exercise bike at a moderate speed for 10 minutes per day. Which is more beneficial for overall health? — A.
ANSWER: I’m going to say your wife’s regimen is the more beneficial. The primary way to look at exercise benefit is by how much exercise you do, and that means how much time you spend exercising and how intensely you work out. However, there is more benefit to exercising a certain amount at a higher intensity. For example, speed-walking two miles gives you a bit more benefit than walking at a regular pace.
There is a standard compendium of an almost unbelievable number of exercise activities and how intense they are, available at tinyurl.com/exercisecompendium. Intensity is rated on the scale of metabolic equivalents (METs): the higher the MET, the more intense the exercise. On the scale, a moderate exercise bike is 6 METs, while moderate walking is 3.5 METs. You exercise for 1/6 of an hour at 6 METs, so you get 1 MET-hour a day. She exercises at 3.5 METs for about 40 minutes, so she gets about 2.3 MET-hours a day.
In my opinion, the longer length of time she is exercising outweighs the benefit you get by exercising at a higher intensity in terms of overall health. Both of these are a lot better than no exercise at all, and I strongly recommend doing the exercise you like.
If you were to exercise 30 minutes a day, you would have both more MET-hours and a higher intensity.
DEAR DR. ROACH: I take a lot of medication and have for a very long time. I either don’t dream or can’t remember my dreams. Could all of these medications be causing me not to dream, or maybe not being able to remember my dreams? Could this be dementia or Alzheimer’s? — D.I.
ANSWER: In most cases, there is nothing neurologically wrong with people who can’t recall their dreams. However, there are a few concerns worth considering. The first is medication, as you correctly stated. Some medicines, including some anti-depression medicines (SSRIs, such as fluoxetine or citalopram, and some actual sleep medicines, even the over-the-counter ones like diphenhydramine) suppress dream sleep. Medical conditions like sleep apnea can interfere with some people’s dream sleep, while others may notice nightmares. Depression itself can cause lack of dreaming. You should discuss any symptoms of these conditions you may have with your doctor.
It’s often said that people who worry they are developing dementia are at lower risk to do so, since a loss of awareness of what is happening occurs early on in Alzheimer’s and dementia. This is somewhat reassuring, but isn’t always true, especially early on in dementia. There are some simple screening tools for dementia that your regular doctor can do, but a neurologist who specializes in memory disorders is the expert on making the diagnosis. Nevertheless, loss of dreams is not a common presenting symptom of any kind of dementia, in my experience. Recent evidence points to vivid or unpleasant dreams being a risk factor in developing dementia.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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