The Applicability of a High-Intensity Functional Exercise Program Among Older People With Dementia Living in Nursing Homes

Abstract

A group-based, supervised, and individualized high-intensity functional exercise program seems to be applicable with regard to attendance, achieved intensity, and adverse events during the exercise sessions, in people with mild to moderate dementia in nursing homes. Effective strategies to enhance motivation to participate in exercise, as well as prevention and treatment of pain and behavioral and psychological symptoms of dementia, are important when promoting exercise participation in this population.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial

“…25 All adverse events recorded during exercise sessions were minor or temporary. 27 In the exercise group, participants performed strength exercises with moderate intensity (40%) and at high intensity (49%) of attended sessions, and balance exercises with moderate intensity (26%) and high intensity (68%) of attended sessions. 27…”

High-intensity functional exercise in older adults with dementia: A systematic review and meta-analysis

“…13 However, older individuals with dementia may find it difficult to participate in an intensive exercise program because of their dependence on assistance, diminished function, and high prevalence of physical and psychological comorbidities. 14,15 Furthermore, whether high-intensity exercise is feasible and has the same benefits among older individuals with dementia remains unclear. Some randomized controlled trials have investigated the effects of high-intensity functional exercise among older populations 16–22 and patients with mild-to-moderate dementia 23–35 ; however, none involved a systematic review or meta-analysis.…”

Is the Effect of a High-Intensity Functional Exercise Program on Functional Balance Influenced by Applicability and Motivation among Older People with Dementia in Nursing Homes?

“…The Umeå Dementia and Exercise (UMDEX) study evaluated the effects of a high-intensity functional exercise program in older people with dementia living in nursing homes. The majority of participants had high attendance rates and could exercise at moderate to high lower-limb strength intensity and high balance intensity, which led to only minor and temporary (mostly musculoskeletal) adverse events (27). The participants had high motivation levels in the majority of attended sessions, similar to those observed for the social control activity (29).…”

“…Hence, task specificity when exercising may be very important in this population (25). Consequently, combined consideration of these factors might influence the effect of exercise on balance and alter the associations of applicability (defined by the authors of this paper as attendance, intensity and presence of adverse events (26,27)) and motivation with the exercise effect seen in older people in general. This potential difference might be especially true for people with dementia who reside in nursing homes, who form a heterogeneous group with high prevalence of comorbidities and medical conditions (20).…”

“…A positive effect was observed in participants with other types of dementia only in contrast to participants with Alzheimer's disease (AD) (30). Participants with non-AD dementia performed more strength exercise sessions at high intensity than did participants with AD, which might explain the superior effect (27). However, whether factors such as attendance, intensity, adverse events and motivation are associated with the effect of exercise on functional balance in people with dementia living in nursing homes is not known.…”