Exercise or Social Intervention for Nursing Home Residents with Dementia: A Pilot Randomized, Controlled Trial

Barreto, Philipe de Souto; Cesari, Matteo; Denormandie, P.; Armaingaud, Didier; Vellas, Bruno; Rolland, Yves

doi:10.1111/jgs.14947

Cited by 60 publications

(94 citation statements)

References 32 publications

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“…Similar to other studies performed in LTNH residents, this study failed to report a significant reduction of visits to the emergency department and number of hospital admissions . However, the number of deaths was lower in the IG than the CG at 12 months after beginning the intervention.…”

Section: Discussionsupporting

confidence: 86%

“…However, little is known about the capacity of these interventions to tackle frailty among LTNH residents, a complex population in terms of physical and cognitive functions . Recent studies show that implementation of physical exercise programs in LTNH settings is effective for improving strength, gait ability, and balance . Considering that clinical frailty scales include components such as strength and gait ability, exercise programs could also be effective to reduce frailty in this population.…”

mentioning

confidence: 99%

“…Nevertheless, subgroup analysis suggests that exercise might reduce falls in older adults in intermediate‐level facilities while increasing falls in facilities providing high levels of nursing care . Further, a recent study found significantly fewer falls in LTNH residents with dementia when they engaged in an exercise intervention compared with a social activity group …”

mentioning

confidence: 99%

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Effects of Multicomponent Exercise on Frailty in Long‐Term Nursing Homes: A Randomized Controlled Trial

Arrieta

Rezola-Pardo

Gil

et al. 2019

J American Geriatrics Society

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OBJECTIVES To determine the effect of multicomponent exercise on frailty and related adverse outcomes in residents of long‐term nursing homes (LTNHs). DESIGN A single‐blind randomized controlled trial. SETTING Ten LTNHs in Gipuzkoa, Spain. PARTICIPANTS The study sample comprised 112 men and women aged 70 years or older who scored 50 or higher on the Barthel Index, 20 or higher on the MEC‐35 test (an adapted and validated version of the Mini‐Mental State Examination in Spanish), and who were capable of standing up and walking independently for at least 10 m. INTERVENTION Subjects in the control group (CG) participated in routine activities. The intervention group (IG) participated in a 6‐month program of individualized and progressive multicomponent exercise at moderate intensity. MEASUREMENTS Frailty was assessed by four different scales at baseline and at 6 months. The Barthel Index was measured at baseline and at 12 months. Frailty‐related adverse outcomes were recorded from 12 months before to 12 months after starting the intervention. RESULTS A lower prevalence of frailty was observed in the IG compared with the CG according to Fried's frailty phenotype, Short Physical Performance Battery, and Tilburg Frailty Indicator after 6 months (p < .05). There was a decline in the CG on the Barthel Index after 12 months (p < .05), whereas score was maintained in the IG. Both groups experienced a similar number of falls before and after the intervention (p > .05), but during the 6‐month intervention period, fewer falls were observed in the IG than the CG (p < .05). Lower overall mortality was observed 12 months after starting the intervention for the IG than the CG (1 vs 6, respectively; p = .05). CONCLUSION Individualized and progressive multicomponent exercise at moderate intensity seems to be effective to prevent falls and reduce frailty and mortality.

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

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confidence: 99%

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Effects of Multicomponent Exercise on Frailty in Long‐Term Nursing Homes: A Randomized Controlled Trial

Arrieta

Rezola-Pardo

Gil

et al. 2019

J American Geriatrics Society

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“…The included studies illustrated the wider problems of variation in the methods of ascertaining, recording, analysing, and reporting falls described in Hauer 2006. Many trials have used a single approach for ascertaining the number of falls, the limitations of this have been demonstrated in a study of falls data derived from a large hospital based randomised controlled trial (Hill 2010). For some aspects of study design, minimisation of bias is difficult.…”

Section: Discussionmentioning

confidence: 99%

“…In a study conducted in 40 Canadian residential care facilities, 62% of participants fell over a one-year period, with a falls rate of 2.51 falls per person per year (Kennedy 2015). It should be noted, however, that routine recording of falls incidents in standard reporting systems is likely to under-estimate the incidence of falls (Hill 2010; Sutton 1994). In a prospective one-year study in 528 nursing homes in Bavaria, Germany, about 75% of falls occurred in the residents' rooms or in bathrooms; 41% occurred during transfers and 36% when walking (Becker 2012).…”

Section: Introductionmentioning

confidence: 99%

Interventions for preventing falls in older people in care facilities and hospitals

Cameron

Dyer²,

Panagoda

et al. 2018

Cochrane Database of Systematic Reviews

346

370

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Background Falls in care facilities and hospitals are common events that cause considerable morbidity and mortality for older people. This is an update of a review first published in 2010 and updated in 2012. Objectives To assess the effects of interventions designed to reduce the incidence of falls in older people in care facilities and hospitals. Search methods We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Selection criteria Randomised controlled trials of interventions for preventing falls in older people in residential or nursing care facilities, or hospitals. Data collection and analysis One review author screened abstracts; two review authors screened full‐text articles for inclusion. Two review authors independently performed study selection, 'Risk of bias' assessment and data extraction. We calculated rate ratios (RaR) with 95% confidence intervals (CIs) for rate of falls and risk ratios (RRs) and 95% CIs for outcomes such as risk of falling (number of people falling). We pooled results where appropriate. We used GRADE to assess the quality of evidence. Main results Thirty‐five new trials (77,869 participants) were included in this update. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants; mean age 84 years; 75% women) in care facilities and 24 (97,790 participants; mean age 78 years; 52% women) in hospitals. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low‐quality, which means that we are uncertain of the estimates. Only the falls outcomes for the main comparisons are reported here. Care facilities Seventeen trials compared exercise with control (typically usual care alone). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20; 2002 participants, 10 studies; I² = 76%; very low‐quality evidence). Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18; 2090 participants, 10 studies; I² = 23%; low‐quality evidence). There is low‐quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35; 2409 participants, 6 studies; I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09; 5139 participants, 6 studies; I² = 48%). There is moderate‐quality evidence that vitamin D supplementation (4512 particip...

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Exercise and dementia

Rolland

Barreto

2022

Pathy's Principles and Practice of Geriatric Medicine

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Exercise or Social Intervention for Nursing Home Residents with Dementia: A Pilot Randomized, Controlled Trial

Abstract: A larger, longer trial is required to determine whether exercise has greater health benefits than nonphysical interventions for institutionalized PWDs.

Cited by 60 publications

References 32 publications

Effects of Multicomponent Exercise on Frailty in Long‐Term Nursing Homes: A Randomized Controlled Trial

Effects of Multicomponent Exercise on Frailty in Long‐Term Nursing Homes: A Randomized Controlled Trial

Interventions for preventing falls in older people in care facilities and hospitals

Exercise and dementia

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