Effect Of Structured And Maintenance Exercise Programs On Physical And Mental Functioning Of Dementia Patients

Abstract

PURPOSE: This study examined the effects of a structured exercise training program and of a subsequent maintenance exercise program on physical and mental abilities of Elderly Care Unit (ECU) patients with early to middle stage of dementia. METHODS: Eighteen patients with early to middle dementia (16 females and 2 males, age: 80.4 ± 1.8 yrs, 69.4 ± 2.8 kg, 163 ± 2 cm, mean ± SE) participated in the study. The volunteers were randomly assigned to either the intervention group (IG), which received a 50-min structured exercise program 3 days/week, or the control group (CG), which followed the usual care, for an experimental period of 9 months. After the completion of the 9-month structured exercise training program, patients of the IG continue receiving a 30-min maintenance exercise program, 2 days/week for 9 more months, while patients in the CG continue following the usual care. Functional and cognitive parameters were evaluated in both groups before (0 months, t0), after the completion of the structured exercise program (9 months, t1) and at the end of the maintenance program (18 months, t2). RESULTS: Compared to pre-exercise values (t0), significant improvements (p < 0.05-0.01) were found at t1 and t2 in the IG: HG (12.3 ± 2.0 vs 13.4 ± 2.3 vs 16.3 ± 2.7), TUG (12.2 ± 2.0 vs 10.3 ± 1.8 vs 9.9 ± 1.7 sec), Berg Balance Scale-BBS (37.4 ± 4.9 vs 40.3 ± 5.3 vs 39.1 ± 5.2, Functional Rating Scale for Symptoms of Dementia-FRSSD (4.6 ± 1.3 vs 2.4 ± 1.1 vs 3.3 ± 1.3), Geriatric Depression Scale-GDS (5.1 ± 1.0 vs 2.6 ± 0.8 vs 2.3 ± 0.7). In the CG, no changes or deterioration (p < 0.05) was observed over time compared to baseline: HG (11.4 ± 1.5 vs 10.5 ± 1.6 vs 8.8 ± 0.8), CST (9.2 ± 1.7 vs 6.4 ± 1.4 vs 5.3 ± 1.2 reps), BBS (20.2 ± 8.2 vs 17.1 ± 7.2 vs 16.4 ± 7.0), 6MWT (148.3 ± 61.8 vs 125.0 ± 56.2 vs 103.3 ± 49.3 m), FRSSD (4.2 ± 0.8 vs 7.8 ± 0.9 vs 9.6 ± 0.6), GDS (2.7 ± 1.0 vs 4.9 ± 1.2 vs 5.3 ± 0.9). CONCLUSIONS: A 9-month structured exercise training program leads to significant improvements of physical and mental performance of ECU patients in early and middle stages of dementia, while a subsequent maintenance exercise program of the same duration appears to preserve the beneficial effects of exercise training in those patients.