At a time when they are losing skills in virtually all arenas of life, persons with Alzheimer's disease can experience significant, esteem-building achievements in physical fitness and mood through supervised participation in an exercise program. The effects of physical exercise plus cognitive and social stimulation on persons with early stage Alzheimer's disease were assessed in a longitudinal study. Twenty-four such individuals, aged 54 to 88 at program entry, participated in 16 to 20 exercise sessions and 10 community activity sessions per semester for two to eight semesters. Half of the weekly exercise sessions included memory and language stimulation activities. Students, supplemented by family caregivers, supervised the sessions. Exercise sessions consisted of flexibility, balance, aerobic, and weight resistance activities. Preparticipation and semiannual post-testing of aerobic fitness and duration and upper and lower body strength was done. Highly significant fitness gains (p < .001) were achieved in the six-minute walk test, upper and lower body strength, and duration of aerobic exercise. Five participants, aged 86 to 91, completed six to eight semesters and were doing 27 to 45 minutes of aerobics per session at program's end. Five participants scored within the normal range for age-matched healthy active adults on the six-minute walk test at baseline. Nine others achieved and three exceeded the normal range during treatment. Cognitive decline was slowed and mood improved. First-year cognitive outcomes have been published elsewhere. An article reporting final cognitive outcomes is in preparation; Outcome data is summarized on the project website: www.u.arizona.edu/ ~sarkin/elderrehab.html. The benefits of physical exercise can be made available at nominal cost to Alzheimer's patients and other elderly persons by using students to provide transportation, supervision, and the motivational support that is key to exercise adherence. Further research is needed to determine the relative contributions of each program component to the positive outcomes.
This article reports the effects of language-enriched physical fitness interventions provided by University of Arizona undergraduate students to 24 mild- to moderate-stage Alzheimer's disease patients (AD Rehab group). Socialization experiences consisted of supervised volunteer work and cultural/recreational activities. Changes in global functioning and neuropsychological test performance were tracked and compared to those of a similar group of untreated patients from the Consortium for the Establishment of a Registry for Alzheimer's Disease (CERAD). Cohorts completing 4 semesters or longer showed no significant between-year changes after their first year on the Clinical Dementia Rating, a measure of global functioning, and on 5 or 6 of the cognitive and language measures. Comparisons with the CERAD sample suggested a slower rate of decline for the AD Rehab group. The stabilization of global and cognitive performance was not apparent among participants who completed only 2 semesters. Significant physical fitness and mood outcomes were previously reported in this journal.
This article advocates proactive Alzheimer treatment, describes rehab interventions implemented by students, and reports positive first year outcomes for 11 mild to moderate Alzheimer's disease (AD) patients who experienced these interventions in a longitudinal Alzheimer rehabilitation research programme. Students supervised physical fitness training and volunteer work sessions for all participants and administered specific memory and language stimulation exercises to 7 of them (experimental group). Outcomes were measured by standardised and project-related tests before and after two semesters (about 28 weeks) of participation. It was hypothesised that (1) the experimental group would outperform the control group at post-testing on standardised and project-specific cognitive and language measures; that both the experimental and control group would (2) maintain or improve the quality of their spontaneous discourse, (3) improve on measures of mood, and (4) improve on measures of physical fitness. Hypothesis 1 was only partially supported. The experimental group improved significantly from pre-to post-test on two measures, substantially on one measure, and showed no change on eleven measures. The control group declined significantly on three measures and showed no change on eleven measures. However, between group differences were only significant on one measure. Hypotheses 2, 3, and 4 were supported. The major conclusion was that: multi-modal interventions by students can temporarily maintain or improve cognitive, language, social, and physical functioning of Alzheimer's patients.Correspondenc e should be sent to Sharon Arkin,
The physical and mental benefits of exercise are universally recognized, but seldom available to persons with early to moderate stage dementia. Difficulty in initiating and maintaining purposeful behavior, coupled with the inability to travel independently, preclude most community-dwelling dementia sufferers from accessing organized fitness programs. Overburdened caregivers typically lack the inclination and know how to structure and supervise systematic exercise sessions. The University of Arizona Elder Rehab program offers independent study credit to students who serve as rehab partners and fitness supervisors to noninstitutionalized persons with dementia. In addition to regular aerobics and weight training workouts, participants engage in supervised volunteer work and memory- and language-stimulation activities with their student partners. Multiple benefits accrue to all participants. The program is cost effective, easily replicated, and may also be suitable for frail and depressed elderly persons without dementia.
There were no decreases in insight from baseline to year 1, 2, or 3, as measured by free responses to the AD prompt question. There was a significant decline in insight from baseline to year one on the GDS measure, but no change from year 1 to year 2 and a return to baseline level at year 3. There was no correlation between insight and baseline age, between insight and MMSE score at any time point, between MMSE score and depression, as measured by total GDS score, or between MMSE score and depression score, except for the year 3 completers, where depression score was negatively correlated with MMSE score at year 3 only. GDS insight and ADPQ scores were not correlated. Several participants that showed no insight on the quantified measures did so on the sentence completions.
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