Theories supporting the existence of a use-dependent neuroplasticity in the older brain were used to guide this pilot study. A repeated-measures randomized design was used to test the effectiveness of a multimodal (Taiji exercises, cognitive-behavioral therapies, support group) intervention on cognitive functioning, physical functioning, and behavioral outcomes in persons with dementia. The treatment group (n = 24 persons with dementia) participated in a 40-week intervention, with outcomes assessed at 20 and 40 weeks to assess optimal treatment length. Control group subjects (n = 19 persons with dementia) received attention-control educational programs. At 20 weeks, differences between groups were found for mental ability and self-esteem, with gains in balance being evident. Also, stability in depression and physical health were evident at 20 and 40 weeks for treatment group subjects. Continued improvement in outcomes was not observed at 40 weeks. However, findings support further testing of the intervention along with potential for achieving positive outcomes in early-stage dementia.Keywords multimodal intervention; Taiji exercises; randomized design; cognition; balance Persons with dementia (PWD) experience progressive loss of cognitive, physical, and functional ability beyond that accounted for by normal aging processes. 1 Nonpharmacological interventions initiated early in the disease have the potential to improve outcomes, including cognition and functional ability. Functional status could be improved with exercise, but exercise interventions are rarely recommended for PWD, despite a large body of evidence showing the efficacy of exercise. 2 Studies supporting the effects of exercise on cognitive function have been conducted primarily in institutional settings and with persons at later disease stages. [2][3][4][5] Cognitive therapies have also been tested extensively in PWD with consistent improvements in cognitive outcomes that are comparable to drug trials. 6,7 Support programs, such as support groups, have been used with PWD for over a decade, although systematic studies of the benefits of support programs are lacking. Few studies, however, have tested multimodal interventions that combine exercise, cognitive therapies, and support programs for persons in the early to early-middle stages of
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript dementia. 8 The purpose of this pilot study was to test the feasibility and the effects of a multimodal intervention (Taiji exercise, cognitive therapies, and support group) on cognitive functioning, physical functioning, and behavioral outcomes of PWD. The research questions guiding this pilot study included 1. What are the effects of a multimodal intervention (Taiji exercise, cognitivebehavioral therapies [CBT], and support group) on cognitive functioning, physical functioning, and behavioral outcomes of PWD compared with PWD not receiving the intervention? It was hypothesized that the treatment group would show improved cognitive fun...