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Abstract

To study the effects of physical stimulation based on walking exercises, equilibrium and endurance on cognitive function and walking efficiency in patients with dementia. Randomized controlled trial including 31 subjects suffering from dementia (age: 81.8 +/- 5.3 years). The intervention group (n = 16) benefited from a 15-week physical activity programme involving three 1-hour sessions per week. The control group (n = 15) did not practice any physical activities. Before and after rehabilitation, all subjects were evaluated with the Rapid Evaluation of Cognitive Functions test (ERFC French version) and walking analysis. After the 15 weeks of rehabilitation, the subjects from the intervention group improved their overall ERFC score (p < 0.01), while those in the control group decreased their overall ERFC score. Interactions were also observed between walking parameters and groups (p < 0.01); the intervention group improved walking capacities through heightened walking speed, stride length and a reduction in double limb support time. Lastly, the subjects from the control group presented a reduction in both walking speed and stride length. This study shows that a physical activity programme can slow cognitive decline and improve quality of walking in elderly persons suffering from dementia.

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Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial.

Yves Rolland, Fabien Pillard, Adrian Klapouszczak … (2007)

To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living (ADLs), physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer's disease (AD). Randomized, controlled trial. Five nursing homes. One hundred thirty-four ambulatory patients with mild to severe AD. Collective exercise program (1 hour, twice weekly of walk, strength, balance, and flexibility training) or routine medical care for 12 months. ADLs were assessed using the Katz Index of ADLs. Physical performance was evaluated using 6-meter walking speed, the get-up-and-go test, and the one-leg-balance test. Behavioral disturbance, depression, and nutritional status were evaluated using the Neuropsychiatric Inventory, the Montgomery and Asberg Depression Rating Scale, and the Mini-Nutritional Assessment. For each outcome measure, the mean change from baseline to 12 months was calculated using intention-to-treat analysis. ADL mean change from baseline score for exercise program patients showed a slower decline than in patients receiving routine medical care (12-month mean treatment differences: ADL=0.39, P=.02). A significant difference between the groups in favor of the exercise program was observed for 6-meter walking speed at 12 months. No effect was observed for behavioral disturbance, depression, or nutritional assessment scores. In the intervention group, adherence to the program sessions in exploratory analysis predicted change in ability to perform ADLs. No adverse effects of exercise occurred. A simple exercise program, 1 hour twice a week, led to significantly slower decline in ADL score in patients with AD living in a nursing home than routine medical care.

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The effects of exercise training on elderly persons with cognitive impairment and dementia: A meta-analysis11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

Patricia Heyn, Beatriz C. Abreu, Kenneth Ottenbacher (2004)

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Dementia as a risk factor for falls and fall injuries among nursing home residents.

George Taler, Sheryl Zimmerman, Mona Baumgarten … (2003)

To compare rates of falling between nursing home residents with and without dementia and to examine dementia as an independent risk factor for falls and fall injuries. Prospective cohort study with 2 years of follow-up. Fifty-nine randomly selected nursing homes in Maryland, stratified by geographic region and facility size. Two thousand fifteen newly admitted residents aged 65 and older. During 2 years after nursing home admission, fall data were collected from nursing home charts and hospital discharge summaries. The unadjusted fall rate for residents in the nursing home with dementia was 4.05 per year, compared with 2.33 falls per year for residents without dementia (P<.0001). The effect of dementia on the rate of falling persisted when known risk factors were taken into account. Among fall events, those occurring to residents with dementia were no more likely to result in injury than falls of residents without dementia, but, given the markedly higher rates of falling by residents with dementia, their rate of injurious falls was higher than for residents without dementia. Dementia is an independent risk factor for falling. Although most falls do not result in injury, the fact that residents with dementia fall more often than their counterparts without dementia leaves them with a higher overall risk of sustaining injurious falls over time. Nursing home residents with dementia should be considered important candidates for fall-prevention and fall-injury-prevention strategies.