P2-263: Reduction in falls found for people with dementia from carer-directed home exercise program

Abstract

One third of older community dwelling people fall each year. People with dementia are at increased risk of falling compared with those who have no cognitive impairment. Objective: To evaluate the efficacy of a carer-directed home exercise program in improving balance and reducing falls in people with dementia. 33 participant/carer dyads (n=66) were randomly allocated to an exercise (n=42) or usual care group (n=24). Carers in the exercise group (n=21) were taught to guide their loved ones through a series of exercises. They were visited at home 8 times in the first 6 months. Visits to participants in the exercise group were designed to help the carer embed the exercises into daily routines and ensure that the exercises were being done accurately and safely. In the second 6 months, participants were left to carry out the program independently. They were given a 12 month calendar where they recorded falls, exercise sessions and other periods of physical activity of 15 minutes or greater (e.g. walks). They were required to complete these daily. At the end of each month participants posted the calendars to our clinic. The participants in the usual care group (n=12) also received 8 home visits and were given a 12 month calendar to record falls and other periods of physical activity. At 6 months there was a significant difference (p =.047) in rate of falling between the exercise and usual care groups in the expected direction. On the Berg Balance Scale the exercise group made significant gains over 12 months while scores of the control group deteriorated. A home exercise program with the carer as the main agent of change is efficacious in improving balance and reducing falls in people with dementia.