Abstract
BackgroundMotivation to participate in exercise among people with dementia has not been well studied. The symptoms of dementia, including apathy, may lead to low motivation to participate in exercise. The aim of this study was to evaluate the motivation of older people with dementia to participate in a high-intensity exercise program compared with motivation of those participating in a social group activity.MethodsThe Umeå Dementia and Exercise Study (UMDEX) was a cluster-randomized controlled intervention trial including 186 people (mean age; 85, 75% female) with dementia in nursing homes. Participants were randomized to participate in the High-Intensity Functional Exercise (HIFE) Program (n = 93) or a seated social group activity (n = 93). The activities were conducted in groups of 3–8 participants for 45 minutes, five times per two-week period, for 4 months (40 sessions in total). Participants’ motivation to go to and during activity sessions were assessed by the activity leaders and nursing homes staff using a five-point Likert scale. Data were analyzed using cumulative link mixed models.ResultsMotivation was high or very high during 61.0% of attended sessions in the exercise group and 62.6% in the social activity group. No overall significant difference between groups was observed, but motivation increased over time in the exercise group and decreased in the social activity group (p < 0.05). Motivation during the sessions was significantly higher than motivation to go to the sessions, especially in the exercise group [OR 2.39 (95% CI 2.38–2.40) and 1.50 (95% CI 1.32–1.70), respectively].ConclusionsAmong older people with dementia in nursing homes, motivation to participate in a high-intensity functional exercise program seems to be high, comparable to motivation to participate in a social activity, and increase over time. Since motivation during activity sessions was higher than motivation to go to sessions the promotion of strategies to encourage people with dementia to join exercise groups is of great importance.
Highlights
People with dementia are in need of rehabilitation, including physical exercise, because of successive deterioration of cognitive and physical function [1,2,3,4,5], associated with loss of independence in activities of daily living (ADLs) [6,7,8]
Motivation during the sessions was significantly higher than motivation to go to the sessions, especially in the exercise group [odds ratio (OR) 2.39 and 1.50, respectively]
Among older people with dementia in nursing homes, motivation to participate in a highintensity functional exercise program seems to be high, comparable to motivation to participate in a social activity, and increase over time
Summary
People with dementia are in need of rehabilitation, including physical exercise, because of successive deterioration of cognitive and physical function [1,2,3,4,5], associated with loss of independence in activities of daily living (ADLs) [6,7,8]. Suggest that physical exercise can slow declines leading to ADL dependency [10,11,12]; improve physical functioning, such as muscle strength, balance, and gait [12,13,14,15]; and reduce falls [16] in people with dementia. Motivation to participate in exercise among people with dementia has not been well studied. The aim of this study was to evaluate the motivation of older people with dementia to participate in a high-intensity exercise program compared with motivation of those participating in a social group activity
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