The first signs of dementia and Alzheimer's disease are physical rather than mental, Washington researchers say of a study that produced surprising results.

While none of the 2,288 Group Health Cooperative members 65 and older showed signs of dementia at the start of the 6-year study, those whose physical functioning was highest had just one-third the risk of developing the Alzheimer's precursor.

"Everyone had expected the earliest signs of dementia would be subtle cognitive changes," said researcher Dr. Eric Larson. "We were surprised to find that physical changes can precede declines in thinking."

The changes include walking and balance problems and, in later stages, a weak hand grip.

What has been considered a brain disease may be directly linked to physical fitness, Larson said.

Other factors may include social support and a positive attitude.

The government-supported study, which included University of Washington and Veterans Affairs Puget Sound Health Care System researchers, was reported in the Archives of Internal Medicine.

Copyright 2006 by United Press International