Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial

Abstract

BackgroundAlmost all of the 820,000 people in the UK with dementia will experience Behavioural and Psychological Symptoms of Dementia (BPSD). However, research has traditionally focused on treating cognitive symptoms, thus neglecting core clinical symptoms that often have a more profound impact on living with dementia. Recent evidence (Kales et al, 2007; Ballard et al, 2009) indicates that the popular approach to managing BPSD - prescription of anti-psychotic medication - can increase mortality and the risk of stroke in people with dementia as well as impair quality of life and accelerate cognitive decline. Consequently, there is a need to evaluate the impact that non-pharmacological interventions have on BPSD; we believe physical exercise is a particularly promising approach.Methods/DesignWe will carry out a pragmatic, randomised, single-blind controlled trial to evaluate the effectiveness of exercise (planned walking) on the behavioural and psychological symptoms of individuals with dementia. We aim to recruit 146 people with dementia and their carers to be randomized into two groups; one will be trained in a structured, tailored walking programme, while the other will continue with treatment as usual. The primary outcome (BPSD) will be assessed with the Neuropsychiatric Inventory (NPI) along with relevant secondary outcomes at baseline, 6 and 12 weeks.DiscussionDesigning this study has been challenging both ethically and methodologically. In particular to design an intervention that is simple, measurable, safe, non-invasive and enjoyable has been testing and has required a lot of thought. Throughout the design, we have attempted to balance methodological rigour with study feasibility. We will discuss the challenges that were faced and overcome in this paper.Trial RegistrationISRCTN01423159

Systematic review of behaviour change techniques to promote participation in physical activity among people with dementia

“…() are reports from the same trial; each provided unique data for our analysis on physical activity and intervention adherence, respectively. 3 During data extraction, the following articles identified from the reference lists were obtained to supplement the BCT coding from the included articles: Cerga‐Pashoja et al . (; trial protocol for Lowery et al . ()), Hüger et al .…”

Cost‐effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM‐E randomised controlled trial

“…Trial participants, carers, the participant's GP and the therapist were not blinded to treatment allocation; however, other individuals involved with the trail were blinded until analyses were completed. A full discussion of randomisation within the trial can be found in the published trial protocol (Cerga-Pashoja et al, 2010).…”

Physical Exercise for Seniors with Dementia: Potential Benefits Perceived by Formal Caregivers

“…Although some studies revealed positive outcomes of an exercise intervention on cognitive function, most of these studies were conducted in older adults without dementia (28,29). In fact, in this special population physical exercise showed controversial results, with studies suggesting no alterations in (8) found no clear evidence of the positive effects of an exercise intervention on BPSD, other authors a rm that exercise interventions can be bene cial to reduce some of the BPSD (32,33). Besides the controversy, these studies agree that further work is needed to comprehend the potential of exercise as non-pharmacological therapy to manage BPSD (32).…”