The effect of long-term, group-based physical, cognitive and social activities on physical performance in elderly, community-dwelling people with mild to moderate dementia

Abstract

Background Elderly people with dementia are known to be less physically active compared with elderly, healthy people, emphasizing the need for interventions in order to maintain a high level of independence in activities of daily living. The aim was to evaluate the effect of long-term, group-based rehabilitation including physical activity on physical performance in elderly, community-dwelling people with mild to moderate dementia. Methods A quasi-experimental study of 18 elderly, community-dwelling people, diagnosed with mild to moderate dementia, participated in an ongoing rehabilitation programme based on integrated physical, cognitive and social activities. The outcome measure was physical performance: the 30-second sit-to-stand test, Guralnik balance test, 10-metre walking speed test, timed 6-metre walk test and a timed dual task walk test. The repeated measure ANOVA was used to analyse any overall differences between related means. Results No significant effect of time was found for the five outcome measures during the entire period. The variation in the estimate of most outcome scores was higher within subjects than between subjects during the period. Profile plots illustrated that three of the participants, who experienced severe cognitive deterioration, markedly declined in all physical performance tests. Conclusion The expected, progressive deterioration in physical performance was delayed in a small group of home-dwelling people with mild to moderate dementia participating in long-term, group-based rehabilitation. Long-term, group-based rehabilitation may have the overall potential to delay deterioration in activities of daily living performance in home-dwelling people with mild to moderate dementia; however, more studies with larger samples are needed to confirm the findings of this study.

A multicomponent psychosocial intervention among people with early-stage dementia involving physical exercise, cognitive stimulation therapy, psychoeducation and counselling: Results from a mixed-methods study

“…Attendance to the intervention was high (mean: 85%) and in line with previous studies showing that physical exercise and cognitive stimulation is acceptable components in interventions for persons with dementia (Aguirre et al, 2013;Frederiksen et al, 2014;Hoffmann et al, 2016;Spector et al, 2003;Yu and Swartwood, 2012). Results from this study correspond to previous studies showing possible cumulative effects of other kinds of multicomponent non-pharmacological interventions for people with early-stage dementia (Chalfont et al, 2020;Junge et al, 2020).…”

“…One approach is physical exercise, which has shown promising results in regard of improving physical capacities such as strength, performance and exercise self-efficacy (Lee et al, 2016;Sobol et al, 2016;Telenius et al, 2015). Moreover, being physically active can improve performance of activities of daily living, reduce depressive symptoms and thereby enhance quality of life among people with dementia (Henskens et al, 2018;Huang et al, 2020;Junge et al, 2020;Nuzum et al, 2020;Potter et al, 2011).…”

Supporting access to activities to enhance well‐being and reduce social isolation in people living with motor neurone disease

“…A recent systematic review found mindfulness to be an effective intervention for improving well‐being in people living with multiple sclerosis (Simpson et al., 2019). Well‐being and dementia has been the most widely researched with evidence for the use of exercise (Junge, Knudsen, & Kristensen, 2018; Olsson, Lampic, Skovdahl, & Engström, 2013), creative activities (Windle et al., 2018), gardening (Gonzalez & Kirkevold, 2014; Hall, Mitchell, Webber, & Johnson, 2018) and music (Evans, Garabedian, & Bray, 2017; van der Steen et al., 2018) to improve self‐worth, social interaction and QoL. There is limited published research available to determine which specific meaningful activities might enhance the well‐being of plwMND.…”

Effects of a 16-week multimodal exercise program on gait performance in individuals with dementia: a multicenter randomized controlled trial

“…These studies show promising but inconsistent results. For example, seven studies observed positive effects of physical activity on walking speed as assessed through short distance walk tests [17][18][19][20][21][22][23], whereas fifteen studies did not report statistically significant findings [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38]. Furthermore, ten studies applied an instrumented gait analysis, and mainly reported positive effects of physical activity on stride length [39][40][41][42][43][44][45][46], stride time [43,45], step time [46], double support time [40], and stride frequency [41].…”

“…Inconsistent results exist for walking speed [40][41][42][43][44][46][47][48], stride speed [39,45], percent of double support [43][44][45], and cadence [19,39,42,43,45,46]. Findings of studies investigating dual task conditions are also inconsistent regarding potential effects on gait impairments and do not allow meaningful conclusions [26,28,35,36,39,45]. Thus, more research is needed to better understand the potentially beneficial effects of physical activity on gait performance in IWD in both single and dual task conditions.…”