Evaluating physical activity in dementia: a systematic review of outcomes to inform the development of a core outcome set

Gonçalves, Ana-Carolina; Cruz, Joana; Marques, Alda; Demain, Sara; Samuel, Dinesh

doi:10.1093/ageing/afx135

Cited by 32 publications

(37 citation statements)

References 9 publications

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“…In line with Gonçalves et al [ 4 ], we encourage scientists and clinical practitioners to reach a consensus concerning the use of motor assessments, and to apply a standardised assessment procedure aiming to enhance comparability in the research field and clinical practice. With regard to scientific publications, we therefore ask scientists to give a detailed report on how they perform motor assessments in IWD, as different modifications exist and it is often not clear which has been applied.…”

Section: Discussionmentioning

confidence: 58%

“…Designing studies to investigate the efficacy and effectiveness of physical activity on motor and cognitive performance in individuals with dementia (IWD) is challenging. Despite increasing research in this area [ 1 ], there still is insufficient evidence, which can be explained by methodological limitations, unspecific interventions, or inappropriate assessments [ 2 – 4 ]. This emphasises the need for further high quality studies guided by suggestions for optimised interventions and sensitive assessment tools.…”

Section: Introductionmentioning

confidence: 99%

“…Besides tailoring motor assessments to the specific characteristics of IWD, their standardisation is also important. Gonçalves et al [ 4 ] note that large heterogeneity in outcomes and assessment tools limits evidence of the efficacy and effectiveness of physical activity in IWD. A detailed review of previous trials also shows that different variations of motor assessment tools were used, which hampers comparability.…”

Section: Introductionmentioning

confidence: 99%

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Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Trautwein

Barisch‐Fritz

Scharpf

et al. 2019

Eur Rev Aging Phys Act

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Background Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials. Methods Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations. Results The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively. Conclusions These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Trautwein

Barisch‐Fritz

Scharpf

et al. 2019

Eur Rev Aging Phys Act

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“…Cognitive Impairment.-Limited evidence from the 2018 PAGAC Scientific Report suggested that for individuals with cognitive impairment, physical activity programs improved physical function, including ADL measures. Two SR/MA examining the relationship between physical activity and physical function in older people with cognitive impairment were identified in the updated search (39,40). One of these meta-analyses (39) comprising 43 trials (N=3,988) reported significant differences between supervised exercise training and control conditions on improvements in performance on the 30-second sit-tostand test (mean difference (MD)=2.1 repetitions; 95% CI: 0.3 to 3.9; 4 trials), step length (MD=5 cm; 95% CI: 2 to 8; 5 trials), Berg Balance Scale (MD=3.6 points; 95% CI: 0.3 to 7.0; 6 trials), functional reach (MD=3.9 cm; 95% CI: 2.2 to 5.5; 6 trials), TUG test (MD=−1 second; 95% CI: −2 to 0; 11 trials), walking speed (MD=0.13 m/s; 95% CI: 0.03 to 0.24; 7 trials), and the 6MWT (MD=50 m; 95% CI: 18 to 81; 7 trials) in this population.…”

Section: Physical Activity and Physical Function In Older People Withmentioning

confidence: 99%

Physical Activity, Injurious Falls, and Physical Function in Aging: An Umbrella Review

DiPietro

Campbell

Buchner

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

197

134

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Purpose: To review and update the evidence of the relationship between physical activity, risk of fall-related injury, and physical function in community-dwelling older people that was presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (PAGAC Report). Methods: Duplicate independent screenings of 1,415 systematic reviews and meta-analyses published between 2006 and 2016 identified from PubMed®, Cochrane Library, and CINAHL databases yielded 111 articles used for the PAGAC Report. The PAGAC Aging Subcommittee members graded scientific evidence strength based upon a 5-criteria rubric and assigned one of four grades: strong, moderate, limited, or not assignable. An updated search of 368 articles published between January 2017 and March 2018 yielded 35 additional pertinent articles.

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“…Automaticity is the ability to perform motor and cognitive functions simultaneously without a decline of performance in either task. The automaticity of this dual task (DT) performance has been shown to be significantly decreased in those with AD (Ansai et al 2017), and slow walking speed during DT gait has been shown to be associated with and predictive of falls, presence of mild cognitive impairment (MCI)-a precursor to AD and other dementias, and the progression of dementia in people MCI (Goncalves et al 2018;Lowe et al 2019;MacAulay et al 2014MacAulay et al , 2015MacAulay et al ,2017Montero-Odasso et al 2017).…”

Section: Introductionmentioning

confidence: 99%

Brain volumes and dual-task performance correlates among individuals with cognitive impairment: a retrospective analysis

et al. 2020

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Cognitive impairment (CI) is a prevalent condition characterized by loss of brain volume and changes in cognition, motor function, and dual-tasking ability. To examine associations between brain volumes, dual-task performance, and gait and balance in those with CI to elucidate the mechanisms underlying loss of function. We performed a retrospective analysis of medical records of patients with CI and compared brain volumes, dual-task performance, and measures of gait and balance. Greater cognitive and combined dual-task effects (DTE) are associated with smaller brain volumes. In contrast, motor DTE is not associated with distinct pattern of brain volumes. As brain volumes decrease, dual-task performance becomes more motor prioritized. Cognitive DTE is more strongly associated with decreased performance on measures of gait and balance than motor DTE. Decreased gait and balance performance are also associated with increased motor task prioritization. Cognitive DTE appears to be more strongly associated with decreased automaticity and gait and balance ability than motor DTE and should be utilized as a clinical and research outcome measure in this population. The increased motor task prioritization associated with decreased brain volume and function indicates a potential for accommodative strategies to maximize function in those with CI. Counterintuitive correlations between motor brain volumes and motor DTE in our study suggest a complicated interaction between brain pathology and function.

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Evaluating physical activity in dementia: a systematic review of outcomes to inform the development of a core outcome set

Abstract: the need for the development and implementation of a Core Outcome Set has been reinforced. Ahead of the completion of the Core Outcome Set, researchers and clinicians are advised to measure the impact of physical activity interventions on these frequently reported outcome domains.

Cited by 32 publications

References 9 publications

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel – a qualitative approach

Physical Activity, Injurious Falls, and Physical Function in Aging: An Umbrella Review

Brain volumes and dual-task performance correlates among individuals with cognitive impairment: a retrospective analysis

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