Abstract
BackgroundThe primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care.MethodsWithin a hospital-based randomized controlled trial, the intervention group conducted a 2-week exercise program with four 20-min exercise sessions on 3 days per week. The control group conducted a social stimulation program. Effects on neuropsychiatric signs and symptoms were measured via the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change, the Neuropsychiatric Inventory, and the Cohen-Mansfield Agitation Inventory. The antipsychotic and sedative dosage was quantified by olanzapine and diazepam equivalents.ResultsEighty-five patients were randomized via minimization to an intervention group (IG) and a control group (CG). Seventy patients (82%) (mean age 80 years, 33 females, mean Mini Mental State Examination score 18.3 points) completed the trial. As compared to the CG (n = 35), the IG (n = 35) showed significantly reduced neuropsychiatric signs and symptoms. Especially, agitated behavior and lability improved. There were no between-group differences concerning antipsychotic and benzodiazepine medication.ConclusionsThis exercise program is easily applicable in hospital dementia care and significantly reduces neuropsychiatric signs and symptoms in patients suffering from predominantly moderate stages of dementia.Trial registrationGerman Clinical Trial Register DRKS00006740. Registered 28 October 2014.
Highlights
The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care
Patient flow and sample characteristics From December 1, 2014, to December 31, 2015, a total of 224 patients suffering from dementia were screened for eligibility into the trial (Fig. 1): 62% (n = 139) of these patients were not eligible for inclusion, mostly due to clinical diagnosis of delirium (n = 50; 22%)
Out of the 85 patients randomized to the intervention group (IG) and the control group (CG), 15 (18%) patients were lost to follow-up, most of them due to early hospital discharge
Summary
The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care. Neuropsychiatric signs and symptoms in dementia cover a broad range of symptoms with depression, agitation, and apathy being most common. They affect almost every patient in the course of the disease [1]. Treatment of neuropsychiatric signs and symptoms is a key challenge in acute dementia care. There is a lack of evidence for physical activation as a treatment approach in the acute hospital dementia care setting
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