Evaluation of a home‐based exercise program in the treatment of Alzheimer's disease: The Maximizing Independence in Dementia (MIND) study

Abstract

SUMMARY Objective To determine the feasibility and efficacy of a home-based exercise intervention program to improve the functional performance of patients with Alzheimer’s Disease (AD). Methods Twenty-seven home-dwelling patients with AD were randomized to either an exercise intervention program delivered by their caregivers or a home safety assessment control. Measures of functional performance (primary), cognition, neuropsychiatric symptoms, quality of life and caregiver burden (secondary) were obtained at baseline and at 6 and 12 weeks following randomization. For each outcome measure, intent-to-treat analyses using linear random effects models were performed. Feasibility and adverse events were also assessed. Results Adherence to the exercise program was good. On the primary outcomes (functional performance) patients in the exercise group demonstrated a trend for improved performance on measures of hand function and lower extremity strength. On secondary outcome measures, trends toward worse depression and lower quality of life ratings were noted. Conclusions The physical exercise intervention developed for the study, delivered by caregivers to home-dwelling patients with AD, was feasible and was associated with a trend for improved functional performance in this group of frail patients. Given the limited efficacy to date of pharmacotherapies for AD, further study of exercise intervention, in a variety of care setting, is warranted.

Impact of physical exercise on quality of life of older adults with depression or Alzheimer's disease: a systematic review

“…Steinberg et al 25 found a non-significant improvement of QoL measured using the Alzheimer's Disease-Related…”

“…The control group in one study was a home-safety assessment group 25 and in the other, a group of patients that received routine medical care and no intervention. 26 The evaluation of depression, also using the SF-36 ® , revealed that all studies had significant results.…”

“…In contrast, the results of another study using a QoL scale specific for individuals with AD, the Alzheimer's Disease-Related Quality of Life (ADQRL) scale, were not significant. 25 Some factors were identified as biases, such as the difference in QoL scores between groups at baseline and higher scores in the depression scale after the intervention.…”

“…15,20 Few studies have included older individuals with a clinical diagnosis of major depression and AD. [21][22][23][24][25][26] Although data about this association are scarce, previous reviews concluded that the differences in exercise type and QoL evaluations might have affected comparisons between studies. 27,28 Moreover, some of those reviews included adults in general and analyzed other variables, in addition to QoL.…”

The effect of exercise intervention on cognitive performance in persons at risk of, or with, dementia: A systematic review and meta-analysis

“…Table 1. A list of excluded studies [32,[41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60] can be also found in Suppl. Table 2.…”