Does physical exercise improve ADL capacities in people over 65 years with moderate or severe dementia hospitalized in an acute psychiatric setting? A multisite randomized clinical trial

Bürge, Elisabeth; Berchtold, André; Maupetit, Christine; Bourquin, Nathalie M.-P.; Gunten, Armin von; Ducraux, Daniel; Zumbach, Serge; Peeters, Anne; Kühne, Nicolas

doi:10.1017/s1041610216001460

Cited by 26 publications

(48 citation statements)

References 35 publications

(53 reference statements)

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“…The exercise program had no effect on recovery from baseline in functional independence [ 19 ]. In addition, an exercise program which included group training on strength, flexibility, walking and balance did not show positive results on functional independence measured by BI en FIM [ 21 ]. A rehabilitation intervention in combination with nutritional supplementation had no effect on physical performance assessed by BI [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

et al. 2018

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BackgroundTo counteract decline in physical performance and physical activity in older patients during hospitalization, multiple physical interventions were developed. However, it is unknown whether these are effective in this particular population. This systematic review aimed to identify the effect of physical interventions on physical performance and physical activity in older patients during hospitalization.MethodsThe systematic search included PubMed, EMBASE, Cinahl, the Trials database of The Cochrane Library and SPORTdiscus from inception to 22 November 2017. Studies were included if the mean age of the patient cohort was 65 years and older and the effect of physical interventions on physical performance or physical activity was evaluated during hospitalization.ResultsFifteen randomized controlled trials met the inclusion criteria. Overall, the effect of physical interventions on physical performance was inconsistent. Patient tailored interventions, i.e. continuously adapted to the capabilities of the patient were not found to be superior over interventions that were not. Physical activity as outcome measure was not addressed. Reporting of intensity of the interventions and adherence were frequently lacking.ConclusionsEvidence for the effect of physical interventions on physical performance in older patients during hospitalization was found uncertain. Further research on the efficacy of the intervention is needed, comparing types of intervention with detailed reporting of frequency, intensity and duration.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-0965-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

et al. 2018

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“…This was also identified as a theme in another study addressing caregiver distress in families of dementia patients in Rawalpindi, Pakistan [20]. This is known to increase dependence, caregiver burden and mortality in general [21] and may be more difficult to manage in a resource poor setting such as Pakistan and other LMICs [22].…”

Section: Discussionmentioning

confidence: 98%

Dementia Survey amongst Attendees of a Dementia Awareness Event in Karachi, Pakistan

Khan¹

2017

AND

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2016, over 47 million people worldwide have dementia and this number is expected to rise to more than 131 million by 2050 [1]. In 2015 58% of the total dementia population is estimated to reside in Low and Middle Income Countries (LMICs) which is expected to rise to 63% by 2030 and 68% by 2050 [2]. Dementia and related issues in LMICs are different than in the West including assessment, diagnosis, awareness, caregiver characteristics, resources, and policy and strategies. Therefore research done in the West may not be applicable to LMICs in all aspects and contextualized research is needed for tailored solutions in such settings [3].Pakistan is a low middle income country in South East Asia with a rapidly aging population. It is currently the sixth most populous country in the world and is expected to become the third most populous by 2050 [4,5] and 10% of the country's total population is estimated to be over 60 years of age [6]. Islam is the religion of the state with 97 % of the population being Muslim [7], with a very low literacy rate of 56% and low GDP per capita [8]. Among several factors identified as contributors to people's understanding of different medical conditions, religious and cultural beliefs, level of education and living arrangements are also important ones that play a role in explanatory models of disease symptomatology [9] and outcomes [10]. In Pakistan, joint family system prevails and people with dementia are mostly cared for at home by family members and informal caregivers. A qualitative study conducted in Lahore, Pakistan interviewed 8 dementia caregivers to explore thinking patterns, physical health; identified maladaptive cognitive patterns fatigue and sleep disturbances as causes of caregiver distress [11]. Caregiver distress is also often associated with type, severity, and frequency of dementia symptoms [12]. Caregiver characteristics and relationship with patient may also differ in different geographical regions, affecting the dynamics, quality of care and care burden [11]. In Pakistan, caregiver role is usually assigned to women [13] who may be spouses, daughters or daughter in laws of the affected person. Due to the unique characteristics of this society and dearth of dementia related research, it is important to study people's knowledge about dementia, cultural beliefs, most common and difficult to manage symptoms and resources available.We designed a 15 item questionnaire survey to be filled out by the participants of a dementia awareness program in Karachi to study patients' knowledge, care arrangement and caregiver characteristics. MethodsAga Khan University Hospital (AKUH) is a private teaching hospital located in a densely populated area of Karachi. The hospital is considered to be one of the most sophisticated in the country and regularly organizes CME sessions, awareness events and capacity building exercises for trainees, physicians and general public in the city and the country. The hospital has the only trained neuropsychiatrist (Khan Q) in the country. As a part of ...

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“…For example, in a study of patients with mild-to-moderate dementia who were living in residential care facilities, a high-intensity physical activity program slowed decline in functional independence and improved balance, but only in patients with non-Alzheimer's-type dementia [69]. Another physical activity intervention for patients in an acute psychiatric ward, on the other hand, delayed loss of mobility in patients with moderate-to-severe dementia but did not significantly impact other forms of daily living [70]. Thus, more research is needed to clarify the extent to which physical activity may affect functioning in patients who are institutionalized.…”

Section: Physical Activity Interventions and Functioning Amongmentioning

confidence: 97%

Potential Benefits of Physical Activity in MCI and Dementia

Nuzum

Stickel

Corona

et al. 2020

Behavioural Neurology

138

116

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Physical activity improves overall health and reduces the risk of many negative health outcomes and may be effective in improving cognition, independent functioning, and psychological health in older adults. Given the evidence linking physical activity with improvements in various aspects of health and functioning, interventions exploring pathways for decreasing risk of dementia in those with mild cognitive impairment (MCI) and improving outcomes for those with dementia are of critical importance. The present review highlights the work examining physical activity interventions in order to achieve a comprehensive understanding of the potential benefits of physical activity for individuals experiencing cognitive decline. The primary focus is on aerobic exercise as this is the main intervention in the literature. Our review supports the thesis that physical activity can promote healthy aging in terms of cognition, independent functioning, and psychological health for individuals experiencing cognitive decline. Specifically, physical activity improves cognition, especially executive functioning and memory in MCI, independent functioning in MCI and dementia, and psychological health in dementia. Given that benefits of physical activity have been observed across these domains, such interventions provide an avenue for preventing decline and/or mitigating impairment across several domains of functioning in older adults with MCI or dementia and may be recommended (and adjusted) for patients across a range of settings, including medical and mental health settings. Further implications for clinical intervention and future directions for research are discussed.

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Does physical exercise improve ADL capacities in people over 65 years with moderate or severe dementia hospitalized in an acute psychiatric setting? A multisite randomized clinical trial

Cited by 26 publications

References 35 publications

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

Effect of physical interventions on physical performance and physical activity in older patients during hospitalization: a systematic review

Dementia Survey amongst Attendees of a Dementia Awareness Event in Karachi, Pakistan

Potential Benefits of Physical Activity in MCI and Dementia

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