Functional dependence and caregiver burden in Alzheimer's disease: a controlled trial on the benefits of motor intervention

Abstract

Background: Cognitive decline has a negative impact on functional activities in Alzheimer's disease. Investigating the effects of motor intervention with the intent to reduce the decline in functionality is an expected target for patients and caregivers. The aim of this study was to verify if a 6-month motor intervention programme promoted functionality in Alzheimer's patients and attenuated caregivers' burden. Methods: The sample comprised 32 community patients with Alzheimer's disease and their 32 respective caregivers. Patients were divided into two groups: 16 participated in the motor intervention programme and 16 controls. Subjects performed 60 minutes of exercises, three times per week during the 6-month period, to improve flexibility, strength, agility and balance. Caregivers followed the procedures with their patients during this period. Functionality was evaluated by the Berg Functional Balance Scale and the Functional Independence Measure. Caregivers completed the Neuropsychiatric Inventory Caregiver Distress Scale and the Zarit Carer Burden Scale. Two-way ANOVA was used to verify the interaction between time (pre-and post-intervention) and the motor intervention program. Results: While patients in the motor programme preserved their functionality, as assessed by the Functional Independence Measure, the controls suffered a relative decline (motor intervention group: from 109.6 to 108.4 vs controls: from 99.5 to 71.6; P = 0.01). Patients from motor intervention also had better scores than the controls on functional balance assessed by Berg scale (F: 22.2; P = 0.001). As assessed by the Neuropsychiatric Inventory and Zarit scale, burden was reduced among caregivers whose patients participated in the motor intervention programme compared with caregivers whose patients did not participate in this programme (Neuropsychiatric Inventory, caregiver's part: F: 9.37; P = 0.01; Zarit: F: 11.28; P = 0.01). Conclusion:Patients from the motor intervention group showed reduced functional decline compared to the controls, and there was an associated decrease in caregivers' burden.

Social/economic costs and health-related quality of life in patients with fragile X syndrome in Europe

“…As with HRQOL, our study is the first to report the burden for caregivers of FXS patients through the Zarit Burden Interview, and we found the score to be significantly higher than any Zarit burden measure reported for other diseases with relatively comparable functional impairment in the three countries for which we had data. The highest score reported in the literature was 35.6 and was measured in caregivers of patients with Alzheimer's disease in Brazil [52], while a recent study found a mean score of 29.3 in Japanese mothers of children with intellectual disability [53]. In addition, the substantial burden documented here is consistent with a study reporting that a considerable proportion of caregivers were injured in the past year by their child with FXS [10].…”

Exercise Training for Persons with Alzheimer's Disease and Caregivers: A Review of Dyadic Exercise Interventions

“…The search strategy led to four controlled trials investigating the effect of a dyadic exercise intervention including both the persons with dementia due to AD and the caregivers (Canonici et al, 2012; Lowery et al, 2014; Pitkala et al, 2013; Prick, de Lange, Twisk, & Pot, 2015). We also included secondary analyses of the Pitkala et al study (Öhman et al, 2016).…”

“…All the studies evaluated a dyadic exercise intervention against a no-exercise control group (usual care; Canonici et al, 2012; Lowery et al, 2014; Öhman et al, 2016; Pitkala et al, 2013; Prick et al, 2015). One study also compared two different types of intervention: customized home-based exercise and group-based exercise (Pitkala et al, 2013).…”

“…One study used a combination of flexibility, strengthening, balance, and endurance exercises as well as psychoeducation, communication training, skills training, and pleasant activities training (Prick et al, 2015). Walking with progressively increasing intensity was used in one study (Lowery et al, 2014), whereas a combination of flexibility, strength, agility and balance exercises as well as walking and dancing were used in another study (Canonici et al, 2012). Three studies reported supervision for the exercise intervention (Lowery et al, 2014; Pitkala et al, 2013; Prick et al, 2015).…”

Análise de protocolos com intervenção motora domiciliar para pacientes com doença de Alzheimer: uma revisão sistemática

“…[2][3][4][5] Para o tratamento, indica-se terapia farmacológica, mas também a não farmacológica, que pode incluir: estimulação cognitiva, convívio social 6,7 e prática regular de atividade física. 8 A literatura científica tem mostrado que, de uma forma geral, a prática regular de atividade física é capaz de proporcionar benefícios cognitivos, comportamentais e funcionais, [9][10][11] além de contribuir para um bom desempenho nas atividades de vida diária. 12 Nota-se, no entanto, que a maioria das estratégias não farmacológicas, sobretudo a intervenção motora, em geral são desenvolvidas em clínicas ou universidades, o que pode dificultar o acesso ao tratamento, principalmente para aqueles que se encontram no estágio avançado da doença, por apresentarem maior comprometimento cognitivo e motor e, consequentemente, maior dificuldade de acesso a tratamentos fora de seu domicílio.…”