Effects of a Physical Training Programme on Cognitive Function and Walking Efficiency in Elderly Persons with Dementia

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Abstract

Objectives: To study the effects of physical stimulation based on walking exercises, equilibrium and endurance on cognitive function and walking efficiency in patients with dementia. Methods: 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. Results: 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. Conclusion: 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.

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Author and article information

Journal

Journal ID (publisher-id): DEM

Journal ID (nlm-ta): Dement Geriatr Cogn Disord

Journal ID (doi): 10.1159/issn.1420-8008

Title: Dementia and Geriatric Cognitive Disorders

Publisher: S. Karger AG

ISSN (Print): 1420-8008

ISSN (Electronic): 1421-9824

Publication date Subscription-year: 2010

Publication date (Print): April 2010

Publication date (Electronic): 11 February 2010

Volume: 29

Issue: 2

Pages: 109-114

Affiliations

Departments of ^aPhysical Medicine and Rehabilitation and ^bGeriatrics, University Hospital of Poitiers, and ^cLaboratoire des Adaptations Physiologiques aux Activités Physiques – EA 3813, and ^dLaboratoire Performance, Motricité et Cognition, MSHS, University of Poitiers, Poitiers, France

Author notes

*Prof. Gilles Kemoun, MD, PhD, Service de Médecine Physique et de Réadaptation, Pavillon Maurice Salles, CHU de Poitiers, Rue de la Milétrie – BP 577, FR–86021 Poitiers (France), Tel. +33 549 444 454, Fax +33 549 444 426, E-Mail g.kemoun@chu-poitiers.fr

Article

Publisher ID: 272435 Other ID: Dement Geriatr Cogn Disord 2010;29:109–114

DOI: 10.1159/000272435

PubMed ID: 20150731

SO-VID: 8901f81f-e08e-483c-a776-020070053b8a

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date accepted : 18 December 2009

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Figures: 2, Tables: 1, References: 29, Pages: 6

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Effects of a Physical Training Programme on Cognitive Function and Walking Efficiency in Elderly Persons with Dementia

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Karger: Neurology and Neuroscience

Most cited references 9

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

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

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