Attenuation of neuropsychiatric symptoms and caregiver burden in Alzheimer's disease by motor intervention: a controlled trial

Abstract

OBJECTIVE:To analyze the effects of motor intervention on the neuropsychiatric symptoms of Alzheimer's disease and on the caregivers' burden.DESIGN:This is a controlled trial evaluating the effects of a motor intervention program on the neuropsychiatric symptoms.SETTING:The intervention was performed on community patients from two university centers specializing in physical exercise for the elderly.SUBJECTS:Patients with Alzheimer's disease were divided into two groups: sixteen received the motor intervention and sixteen controls (five controls were excluded because of clinical intercurrences).INTERVENTIONS:Aerobic exercises (flexibility, strength, and agility) and functional balance exercises were conducted over six months for 60 minutes three times per week.MAIN MEASURES:Psychopathological features of patients were evaluated with the Neuropsychiatric Inventory and Cornell Scale for Depression in Dementia. Caregivers were evaluated using the Neuropsychiatric Inventory-Distress and Burden Interview. A two-way analysis of variance (ANOVA) was applied to observe interactions (pre- vs. post-intervention; participants vs. controls).RESULTS:Patients from the intervention presented a significant reduction in neuropsychiatric conditions when compared to controls (Neuropsychiatric Inventory: F∶11.12; p = 0.01; Cornell Depression scale: F∶11.97; p = 0.01). The burden and stress of caregivers responsible for patients who participated in the intervention significantly decreased when compared to caregivers responsible for controls (Neuropsychiatric Inventory-Distress: F: 9.37; p = 0.01; Burden Interview: F: 11.28; p = 0.01).CONCLUSIONS:Aerobic exercise was associated with a reduction in the neuropsychiatric symptoms and contributed to attenuate the caregivers' burden. However, the researchers were not blinded to the patient's intervention status, which constitutes an important limitation of this study.

Cognitive–behavioural group therapy improves a psychophysiological marker of stress in caregivers of patients with Alzheimer's disease

“…Furthermore, the frequency and intensity of neuropsychiatric symptoms such as aggressiveness, hallucinations and delusions tend to increase at sunset (an effect termed the 'sundown syndrome') and are often correlated with caregiver's burden (Allegri et al, 2006;Khachiyants, Trinkle, Son, & Kim, 2011). CBT reduces anger and aggressiveness in patients with brain injury (Aboulafia-Brakha, Greber Buschbeck, Rochat, & Annoni, 2013), and the frequency of these symptoms also decreases in AD patients following psychosocial interventions for their caregivers (Stella et al, 2011). In line with this finding, in the current study caregivers reported a significant reduction of neuropsychiatric symptoms of their AD relatives, with a large effect size and high statistical power.…”

[ARTIGO RETRATADO] Exercício e suas interações com vários aspectos da vida do homem e dos animais

“…Exercise facilitates the treatment of depressive elderly adults, leading to clinical and physical improvement and protecting against a decrease in cortical activity. Stella et al 58 analyzed the effects of aerobic exercise (flexibility, strength, and agility, and functional balance exercises conducted over six months for 60 minutes three times per week) on the neuropsychiatric symptoms of 32 Alzheimer's disease patients and on the caregivers' burden. Patients were divided into two groups: 16 performed exercise and 16 controls remained sedentary.…”

A controlled clinical trial on the effects of exercise on neuropsychiatric disorders and instrumental activities in women with Alzheimer's disease

“…Trudeau 42 found significant improvements in agitation and mood in patients who went for regular walks. It is important to remember that, according to Lyketsos 2 , Christofoletti et al 18 , and Stella et al 17 , even a slight reduction of a few points in the NPI may reflect a significant decrease in the rate of caregiver burden. Interventions that can attenuate the neuropsychiatric disturbances may have a positive impact on the quality of life of patients with dementia and their caregivers 2 .…”

“…Other clinical trials recently verified that the exercise had a significantly good impact on behavioral disturbances and functionality in basic daily activities with a positive reduction in caregiver burden 17,18 . To measure psychopathological symptoms, these authors applied the Neuropsychiatric Inventory, which is the same scale used in our investigation.…”

“…In a meta-analysis, Heyn, Abreu and Ottenbacher 16 demonstrated that regular exercise, mainly aerobic exercise, could reduce cognitive decline, with greater impact on the performance of activities of daily living. Stella et al 17 and Christofoletti et al 18 also found a significant improvement in neuropsychiatric disturbances in demented patients who took part in a long-term regular exercise program compared with sedentary patients.…”