Abstract
BackgroundBesides cognitive decline, Alzheimer's disease (AD) leads to physical disability, need for help and permanent institutional care. The trials investigating effects of exercise rehabilitation on physical functioning of home-dwelling older dementia patients are still scarce. The aim of this study is to investigate the effectiveness of intensive exercise rehabilitation lasting for one year on mobility and physical functioning of home-dwelling patients with AD.MethodsDuring years 2008-2010, patients with AD (n = 210) living with their spousal caregiver in community are recruited using central AD registers in Finland, and they are offered exercise rehabilitation lasting for one year. The patients are randomized into three arms: 1) tailored home-based exercise twice weekly 2) group-based exercise twice weekly in rehabilitation center 3) control group with usual care and information of exercise and nutrition. Main outcome measures will be Guralnik's mobility and balance tests and FIM-test to assess physical functioning. Secondary measures will be cognition, neuropsychiatric symptoms according to the Neuropsychiatric Inventory, caregivers' burden, depression and health-related quality of life (RAND-36). Data concerning admissions to institutional care and the use and costs of health and social services will be collected during a two year follow-up.DiscussionTo our knowledge this is the first large scale trial exploring whether home-dwelling patients with AD will benefit from intense and long-lasting exercise rehabilitation in respect to their mobility and physical functioning. It will also provide data on cost-effectiveness of the intervention.Trial registrationACTRN12608000037303
Highlights
Besides cognitive decline, Alzheimer’s disease (AD) leads to physical disability, need for help and permanent institutional care
One third of patients receive homebased tailored exercise twice a week one hour at the time for one year or until the patient is admitted to permanent institutional care
Another third of patients are receiving versatile exercise training including endurance, balance, and strength training as well as dual task training and exercises directed to improve executive functioning. This intervention is provided in day centers for four hours/day twice weekly for one year or until the patient is admitted to permanent institutional care
Summary
Alzheimer’s disease (AD) leads to physical disability, need for help and permanent institutional care. The trials investigating effects of exercise rehabilitation on physical functioning of home-dwelling older dementia patients are still scarce. One pivotal problem in dementia leading to need for help and institutional care is decline in mobility. Going outdoors, getting dressed and undressed as well as transfers from one place to another become challenging [1]. This process is accelerated by patient’s progressive sarcopenia, weight loss and muscular weakness which impede body control and predisposes to falls [4]
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