Effects of a home-based exercise program on mental health for caregivers of relatives with dementia: a randomized controlled trial

Abstract

Objective: This study was aimed to evaluate the effectiveness of a home-based physical exercise program on participants’ mental health: psychological symptoms, depression, and burden of female informal caregivers. Design and participants: In a randomized controlled trial, a sample of 48 female informal primary caregivers completed the entire study, 25 were randomly allocated to the intervention group (IG), and 23 participants to the control group (CG). Intervention: Participants in the IG performed two 60-minute-long physical exercise sessions per week (36 weeks) that were supervised by a personal trainer at caregivers’ home during 9 months. The CG continued their habitual leisure-time activities. Measurements: Subjective burden was assessed by the Zarit Burden Interview. The risk of depression was measured by the Geriatric Depression Scale Short Form 15-item version, and psychological symptoms were evaluated by the Symptom Check List-90-Revised (SCL-90-R). All participants were evaluated at baseline and at the end of the intervention. Results: A promising positive impact of the intervention on caregivers’ subjective burden and risk of depression was found in the IG. In addition, no significant between-group differences were found in any of nine subscales scores of the SCL-90-R. Finally, care recipients’ level of functional independence and area of residence were found to be predictors of the promising positive impact on caregivers’ subjective burden and risk of depression. Conclusions: The present home-based physical exercise intervention that was individually implemented has shown promising results to reduce subjective burden and risk of depression in female caregivers of relatives with dementia. However, future research efforts should elucidate both the particular dose of physical exercise and the particular duration of the intervention that are required to obtain the expected significant positive impact. Finally, future inclusion of psychological approaches, besides physical exercise, might help reduce female caregivers’ psychological symptoms.

Exercise can provide multiple health benefits for carers

“…The paper by Madruga et al . (2021) investigates mental health outcomes associated with a home-based exercise program for older (>50 years of age) female carers of people with dementia. This paper adequately describes the nature and intensity of the physical activity intervention, whereas papers in this area of research often lack detail about this aspect of the intervention.…”

“…The outcomes reported in the paper by Madruga et al . (2021) focused on mental health, and included measures of depression, psychological symptomatology, and subjective burden of care. The program achieved small-to-medium effect size improvements in depression and burden of care, and multiple linear regression identified high baseline levels of subjective burden and living in urban areas to be associated with positive subjective burden outcomes.…”

“…Making a time commitment, and having someone coming to the home to oversee the exercise program is likely to have been an important factor contributing to the program becoming part of the carers’ routine in the Madruga et al . study (2021). Another factor for the carer in making time for a physical activity program relates to concern about who is looking after the person they are providing care for while they undertake the program.…”

“…Several limitations of the Madruga et al . study (2021) should be considered. First, it excluded male carers (who make up approximately 38% of carers of older people) (Australian Institute of Health and Welfare, 2019), and second, there was no longer term follow-up to determine sustained benefits of the intervention beyond the nine-month formal intervention.…”

“…In summary, the Madruga et al . study (2021) provides some valuable findings in terms of mental health for carers of people with dementia through supervised home-based exercise. This adds to the growing evidence of improved physical and mental health outcomes in carers of older people, including those with dementia, and across a range of physical activity delivery options.…”