BACKGROUND:Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia. METHODS:Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial. RESULTS: Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to <70% of sessions. CONCLUSIONS: This trial of a tailored home-based exercise intervention presents preliminary evidence that this intervention can improve balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.
RCT Entities:
BACKGROUND: Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia. METHODS: Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial. RESULTS: Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to <70% of sessions. CONCLUSIONS: This trial of a tailored home-based exercise intervention presents preliminary evidence that this intervention can improve balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.
Entities:
Keywords:
accidental falls; cognitive impairment; dementia; exercise; fear of falling; postural control; prevention
Authors: Claire K Ankuda; Bruce Leff; Christine S Ritchie; Omari-Khalid Rahman; Katelyn B Ferreira; Evan Bollens-Lund; Katherine A Ornstein Journal: J Am Geriatr Soc Date: 2020-06-20 Impact factor: 7.538
Authors: Vicky Booth; Rowan H Harwood; Victoria Hood-Moore; Trevor Bramley; Jennie E Hancox; Kate Robertson; Judith Hall; Veronika Van Der Wardt; Pip A Logan Journal: Clin Rehabil Date: 2018-02-13 Impact factor: 3.477
Authors: Jennie E Hancox; Veronika van der Wardt; Kristian Pollock; Vicky Booth; Kavita Vedhara; Rowan H Harwood Journal: PLoS One Date: 2019-05-23 Impact factor: 3.240
Authors: Alison Wheatley; Claire Bamford; Caroline Shaw; Elizabeth Flynn; Amy Smith; Fiona Beyer; Chris Fox; Robert Barber; Steve W Parry; Denise Howel; Tara Homer; Louise Robinson; Louise M Allan Journal: BMC Geriatr Date: 2019-02-28 Impact factor: 3.921
Authors: Claudio Di Lorito; Alessandro Bosco; Vicky Booth; Sarah Goldberg; Rowan H Harwood; Veronika Van der Wardt Journal: Prev Med Rep Date: 2020-06-01