期刊
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
卷 64, 期 1, 页码 55-64出版社
WILEY
DOI: 10.1111/jgs.13880
关键词
activities of daily living; exercise; dementia; residential facilities; postural balance
资金
- Swedish Research Council [K2009-69P-21298-01-4, K2009-69X-21299-01-1, K2009-69P-21298-04-4, K2014-99X-22610-01-6]
- Forte-Swedish Research Council for Health, Working Life and Welfare
- Vardal Foundation
- Swedish Dementia Association
- Promobilia Foundation
- Swedish Society of Medicine
- Swedish Alzheimer Foundation
- King Gustav V and Queen Victoria's Foundation of Freemasons
- European Union Bothnia-Atlantica Program
- County Council of Vasterbotten
- Umea University Foundation for Medical Research
- Ragnhild and Einar Lundstrom's Memorial Foundation
- Erik and Anne-Marie Detlof's Foundation
OBJECTIVES: To investigate the effects of a high-intensity functional exercise program on independence in activities of daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types. DESIGN: Cluster-randomized controlled trial: Umea Dementia and Exercise (UMDEX) study. SETTING: Residential care facilities, Umea, Sweden. PARTICIPANTS: Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186). INTERVENTION: Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity. MEASUREMENTS: Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months. RESULTS: Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=-1.6-4.3; BI=0.6, 95% CI=-0.2-1.4) or 7 (FIM= 0.8, 95% CI=-2.2-3.8; BI=0.6, 95% CI=-0.3-1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8-6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months. CONCLUSION: In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia.
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