A home-based, carer-enhanced exercise program improves balance and falls efficacy in community-dwelling older people with dementia

Taylor, Mark E.; Lord, Stephen R.; Brodaty, Henry; Kurrle, Susan; Hamilton, Sarah; Ramsay, Elisabeth; Webster, Lyndell; Payne, Narelle; Close, Jacqueline C.T.

doi:10.1017/s1041610216001629

Cited by 39 publications

(47 citation statements)

References 32 publications

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“…Having the group within walking distance was a large determinant of group attendance, especially given that not everyone had access to a car, and public transport in rural areas is generally poor in terms of frequency and coverage. If more groups could be run within walking distance, this would benefit the carer and the patient in terms of getting more physical exercise, which in turn could help contribute towards improved health and well‐being (Booth, Roberts & Laye, ; Taylor et al, ). Alternatively, it would be advantageous for attendees if support group meetings could be held in places in the community which have existing accessible transport links, e.g., town centres rather than villages.…”

Section: Discussionmentioning

confidence: 99%

Carers’ experiences of dementia support groups: A qualitative exploration

West

Hogan

2019

Couns and Psychother Res

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Dementia rates are growing (WHO, 2017) and as dementia is associated with a loss of independence, carers are required. Caring for a dementia patient places great demands on the carer’s resources (WHO, 2017). Previous research has indicated that whilst carers are at increased risk of poor mental and physical health (Diener & Chan, 2011; Mahoney, Regan, Katona, & Livingston, 2005; Mausbach, Patterson, Rabinowitz, Grant, & Schulz, 2007), there are some effective protective measures against these increased risks (Cooper et al., 2012; Elvish, Lever, Johnstone, Cawley, & Keady, 2013; Kaufman, Kosberg, Leeper, & Tang, 2010). Aims This study aimed to evaluate a dementia support group, in relation to protective measures including social and emotional support, in a real‐life rural setting from a carers’ perspective. Method Fourteen informal carers of dementia patients were interviewed about their experiences of attending dementia support groups. The interviews were transcribed verbatim and subject to thematic analysis. Findings The analysis showed that attendance to the support group was associated with subjective well‐being and that social support provided by the group was both stimulating and supportive for the carers. Participants valued the opportunity to share their experiences of being a carer with fellow group members and finding out about resources. Frequently, participants reported that the time period surrounding their loved one receiving a diagnosis of dementia was traumatic and they needed time to adjust to their new circumstances before attending a support group. Conclusions Implications for wider employment of support groups as a format of support for carers are discussed.

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Section: Discussionmentioning

confidence: 99%

Carers’ experiences of dementia support groups: A qualitative exploration

West

Hogan

2019

Couns and Psychother Res

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“…Carers in one qualitative study described negative experiences of hospitalisation, such as a deterioration in patients' health, and were keen to avoid readmission [46]. Home-based exercise interventions have been shown to be feasible for at least some patients with cognitive impairment and hip fracture [47][48][49][50], though some studies reported problems with adherence [51]. Literature relating to patients with other fall-related injuries was not found.…”

Section: Cmoc1: Managing Painmentioning

confidence: 99%

“…Individually tailoring exercises to the preferences, interests, and physical and cognitive abilities of people with dementia has been described as 'vital' to successful interventions for this patient group [49]. Cognitive impairment may affect the ability of patients to follow instructions and consequently, rehabilitation success [47,51,[53][54][55][58][59][60][61][62].…”

Section: Cmoc4: Embedding Interventions In Day To Day Lifementioning

confidence: 99%

“…'Embedding' interventions into existing routines could also help make them habitual [63][64][65]. Effective tailoring requires specialised training for staff and carers involved in intervention delivery [49,66]; including a staff training component in the intervention was therefore seen as essential (see CMOc8).…”

Section: Cmoc4: Embedding Interventions In Day To Day Lifementioning

confidence: 99%

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Developing an Intervention for Fall-Related Injuries in Dementia (DIFRID): an integrated, mixed-methods approach

et al. 2019

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Background: Falls in people with dementia can result in a number of physical and psychosocial consequences. However, there is limited evidence to inform how best to deliver services to people with dementia following a fall. The aim of the DIFRID study was to determine the feasibility of developing and implementing a new intervention to improve outcomes for people with dementia with fall-related injuries; this encompasses both short-term recovery and reducing the likelihood of future falls. This paper details the development of the DIFRID intervention. Methods: The intervention was designed using an integrated, mixed-methods approach. This involved a realist synthesis of the literature and qualitative data gathered through interviews and focus groups with health and social care professionals (n = 81). An effectiveness review and further interviews and observation were also conducted and are reported elsewhere. A modified Delphi panel approach with 24 experts was then used to establish a consensus on how the findings should translate into a new intervention. After feedback from key stakeholders (n = 15) on the proposed model, the intervention was manualised and training developed. Results: We identified key components of a new intervention covering three broad areas: • Ensuring that the circumstances of rehabilitation are optimised for people with dementia • Compensating for the reduced ability of people with dementia to self-manage • Equipping the workforce with the necessary skills and information to care for this patient group Consensus was achieved on 54 of 69 statements over two rounds of the Delphi surveys. The statements were used to model the intervention and finalise the accompanying manual and protocol for a feasibility study. Stakeholder feedback was generally positive and the majority of suggested intervention components were approved. The proposed outcome was a 12-week complex multidisciplinary intervention primarily based at the patient's home. Conclusions: A new intervention has been developed to improve outcomes for people with dementia following a fall requiring healthcare attention. The feasibility of this intervention is currently being tested. Trial registration: ISRCTN41760734 (16/11/2015).

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“…The most widely recognised physical benefits of physical activity are those observed by increasing cardiovascular and cardiorespiratory fitness [7]. Research has further evidenced increases in balance, mobility, functional ability, performance of activities of daily living, flexibility, agility and muscle strength, as well as reduced concern for falls and physical abilities [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Acute Cognitive Effects of Physical Activity for People who have Dementia

Elliott-King¹,

Peel²,

Hogervorst³

2019

Int J Neurodegener Dis

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Background: Physical activity has the potential to improve cognition for those with dementia, as demonstrated by randomised controlled trials lasting at least 6 weeks. Research is yet to explore the acute cognitive effects of physical activity for people with dementia. Acute resistance physical activity with healthy late-middle aged individuals has been shown to facilitate general cognition, as well as benefit executive function specifically. This study therefore aimed to establish if people with dementia experience cognitive benefits from acute resistance physical activity over and above a social control. Methods: A cross-sectional study design was applied to compare resistance physical activity to bingo between 10 participants with dementia to 15 age-matched controls. Following University ethical approval, participants were recruited from Alzheimer's or dementia activity and support groups held in the community. Acute cognitive effects were assessed using the Mini Mental Status Examination (MMSE), Hopkins Verbal Learning Test (HVLT), Verbal Fluency (VF) and The Cognitive Computerised Test Battery for Individual's with Intellectual Disabilities (CCIID); before and after a short bout of seated resistance band physical activity or a social control, bingo. The participants then completed the opposing activity 6 weeks later, and then cognitive assessments alone a further 6 weeks later. This allowed to analyse cognitive effects immediately and 6 weeks after. Statistical analysis included Mann Whitney U test, Chi-square test and Mix-measured ANOVA to compare scores across time-points. Results: Participants had a mean age of 76 years, 40% were male and 60% were female. For participants with dementia immediately after the resistance band activity improvements can be observed on the MMSE, VF, HVLT, Series, Jigsaw and Total CCIID. Only the MMSE, Series and Total CCIID still showed improvements at 6-weeks followup. Immediately following the psychosocial intervention, participants with dementia only showed improvements on the HVLT, which were not sustained after 6-weeks. For agematched controls, bingo appeared to be more beneficial than physical activity. Conclusion: These results indicate that there are differential acute effects of activity depending upon pre-existing cognitive ability. Specific cognitive benefits may be available for people with dementia following resistance band physical activity. This pilot study shows promising indications for physical activity as a therapy for dementia, however results should be interpreted with caution due to the small sample size of this study.

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A home-based, carer-enhanced exercise program improves balance and falls efficacy in community-dwelling older people with dementia

Cited by 39 publications

References 32 publications

Carers’ experiences of dementia support groups: A qualitative exploration

Carers’ experiences of dementia support groups: A qualitative exploration

Developing an Intervention for Fall-Related Injuries in Dementia (DIFRID): an integrated, mixed-methods approach

Acute Cognitive Effects of Physical Activity for People who have Dementia

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