Feasibility of reducing frailty components in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial (AD-HOMEX).

Abstract

There is a need for interventions to reduce frailty in older people with Alzheimer's dementia (AD). The purpose of this study was to investigate the effect of a home-based multimodal exercise program for older adults with AD (AD-HOMEX) on frailty. A parallel single-blind randomized controlled trial comparing a home-based exercise program and usual care. A home-based program in Brazil. Forty individuals aged 65years or older with mild to moderate AD. The intervention group (IG) participated in a 16-week protocol involving three 60-minute sessions per week of progressive individualized physical exercises supervised by a physical therapist. The participants in the control group (CG) maintained their usual care. Frailty was assessed using the FRAIL questionnaire, the Edmonton Frail Scale (EFS) and a subjective assessment by the evaluator (SAE) at baseline and follow-up. Per-protocol analysis was performed. Thirty-five participants completed the program (IG=16; CG=19). Frailty improved in the IG based on the EFS (P=.004) and FRAIL (P≤.001). An interaction between group and time (P=.008) and a significant difference between times (P=.047) were found for the SAE responsiveness domain. An improvement in the classification of frailty (EFS and FRAIL) was found between times in the IG (P=.003) and between groups at follow-up (P=.027). A significant difference in the SAE classification was found between groups at follow-up (P=.034), with a worsening between times in the CG (P=.032). Interestingly, a more favorable frailty transition pattern was found in the IG based on both the EFS and FRAIL. AD-HOMEX seems to reduce frailty and improve frailty transition patterns. Our findings provide a further theoretical basis for designing home-based physical interventions as routine practice for older frail adults with AD.