Topic: Physical Activity with Dementia

 

This article takes a look at sleep in persons with dementia and how exercise changes this. The article shows that it is common for these people to have sleep disturbances. This study compared the sleep quantity and quality between active and inactive dementia patients. This study did 40 telephone questionnaires to the caregivers of the patients who answered as proxies. Over half of the patients were able to qualify as active. When compared to their inactive counterparts’ active patients were more likely to experience appropriate sleep quantity and quality. These positive findings on physical activity and sleep with dementia warrant future studies to determine if a definite relationship exists. This is a correlational study and the association provides a foundation for future studies to explore the significance. This article is a good basis to warrant further research with randomized controlled trials.

This article looked at the association of physical activity with dementia and other subtypes. This was s systematic review and meta-analysis of longitudinal studies. This included cognitive decline, all-cause dementia, vascular dementia, and Alzheimer’s. From all the studies 117410 patients were looked at with a highest follow-up of 28 years. Physical activity showed a positive effect on reducing risk and decline of Alzheimer’s disease, dementia, and cognitive decline, but not for vascular dementia. Showed the most positive effect for Alzheimer’s, which is the most common of the dementia cases. There was no significant reduction in risk for vascular dementia; however, this could be because there was a very small number of patients in this category. Many self-reported questionnaires to obtain information on physical activity were used which could cause bias for the findings. More sound ways to obtain outcome measures should be done and structured interventions.

This study aimed at looking at the effectiveness of exercise interventions in older adults already suffering from cognitive impairment or dementia. This was a systematic review of 22 randomized controlled trials. The studies showed some positive effects on cognition, executive function, and attention with exercise. However, most studies showed that older adults with dementia had no positive effect with exercise on their cognition. The article stated that the studies on patients with dementia were underpowered and of poor quality. More studies should be done that focus on patients with mild, mod, and severe dementia. Other cognitive impairments should be addressed separately since it is likely that they would not respond to the interventions the same. The article finally states that the exercise routine should focus on aerobic, and long-term.

This article was looking at if physical exercise with music would improve cognitive function and ADLs in dementia patients over cognitive stimulation. 85 patients with mild/moderate dementia participated where half did music exercise and the other half did cognitive stimulation. The cognitive stimulation group would use small game consoles to do easy calculation, mazes, and mistake-searching in pictures. The interventions were performed once a week for 40 minutes for a 6-month period. Patients were assessed before and after the 6 months. For cognitive function, neuropsychological batteries were used to assess. Then for ADLs the FIM was conducted. The results of this study showed that both groups showed significant improvement in visuospatial function, psychomotor speed, and memory. For ADLs the music exercise group had significantly preserved function while the Cognitive stimulation group worsened. This study was done after they had done another study that looked at music exercise vs regular exercise. Where exercise with music showed more positive effects on cognitive function than in exercise alone.

This study was designed to examine the causal association with exercise and risk of developing dementia among older adults. This study was done in china as a longitudinal population-based study with a follow up duration of 9 years. This was done through a survey that included 7501 Chinese adults older than 65. It obtained regular exercise and other potential variables in this self-report questionnaire. Of these people, 338 developed dementia, after taking into account those who dropped out of the study. This study showed an association with the exercise and a decreased risk of dementia. One limitation of this study was it did not further differentiate dementia into Alzheimer’s or vascular dementia. These different diagnoses could respond differently to different exercise interventions. Further research should be done that separates the diagnosis and looks at them individually.

This study was a systematic review aimed at recommending training strategies to improve the functional capacity of older adults. The studies had to be about falls, gait, balance, and low-body strength. 20 studies were used that focused on multicomponent, resistance, endurance, and balance. Intervention programs that consisted of these ended up being the most affected for the elderly individuals. Studies that focused on strength showed greater gains in elderly with frailty of functional declines to begin with. Some did not gain much but this could be due to the exercise program not being intense enough for that individual. The article stated that in order to improve neuromuscular and cardiovascular systems of the elderly the intervention should include: Resistance training, functional resistance, endurance like walking/cycling, balance, and the programs should increase in volume, intensity, and complexity.

This study was an integrative review of literature to evaluate evidence of fall risk and fall prevention exercises in older adults with mild cognitive impairment and early stage dementia. This potential increased risk in falling affects their health and quality of life. 40 studies met the criteria to be either about fall risk factors or fall risk exercise interventions. The review showed an increased risk of falls in this patient population due to changes in gait, balance, and fear of falling. The intervention side of this review looked at exercises and multifactorial interventions that showed potential to reduce falls. However, the studies did not have strong design and therefore cannot provide evidence for recommendations for this population. This review shows a high importance in warranting early diagnosis and attention to this population do to the significant importance of fall prevention.

This study is a Randomized controlled trial that looks at the consequences of a standardized equipment-free exercise program and how it impacts elderly subjects for balance skills and pain perception. 92 subjects were tested, they were split into two groups, one an experimental the other a control. Fitness instructors ran them through standardized physical exercise program. The control group did not receive any exercise program. Both groups did the Berg Balance Scale and the Oswestry Disability index before and after. This article found that a 13-week standardized equipment free program can cause effective treatment for balance and pain perception. This would be a low-cost strategy because no equipment is required. The 13 weeks program included joint mobility, cardiovascular exercise, strengthening core stability, and proprioceptive training. A main limitation is the lack of standardized balance scores that distinguished between individuals who were trained or untrained.

This article was a systematic review that looked at the elderly population and falls. It focused on fall prevention and fall risk factors. Sarcopenia/frailty, weak muscles especially the quadricep; impaired sensorium, including visual, vestibular, somatosensory information disturbances; multimorbidity, like arthritis, diabetes, etc; vitamin D deficiency, which influences bone density, resorption, and muscles strength; polypharmacy, drugs that interact with each other and have side effects; home hazards, like stairs, lighting, rugs, and obstructed walkways. Fall prevention was also looked at. This included exercise programs that would have balance and strength training incorporated. Balance training showed the highest reduction in risk, but programs should include strength and walking. Home hazard assessment and modifications that is prescribed and done professionally is extremely effective. Vitamin D supplementation for those who are low because this can cause frailty. Polypharmacy interventions to try and reduce the number of drugs and make it more focused. Multicomponent interventions where 2 or more interventions are given based on fall risk assessment. Falls in the elderly are a major source of injury and mortality in older adults. Proper screening and recognizing risks followed by multiple interventions can help prevent further falls.

This article is a systematic literature review on studies that focused on exergaming and its application for elderly fall prevention. The most common devices used was the Nintendo Wii, and the Xbox Kinect. Training balance and promoting physical activity in the elderly has low adherence of conventional physical therapy. That is why new studies looking at ways to make it not only effective but enjoyable have emerged. 25 papers were reviewed, results showed that use of exergaming interventions improved physical and cognitive function in elderly. However, it is inconclusive if exergaming is more effective than traditional physical therapy and exercise. The exergaming technologies allowed a patient to create an interactive environment that was more enjoyable and engaging. Long term adherence is key as elderly will always decline and slowing this is important. A final point this paper made was that these gaming technologies are relatively inexpensive and can be an economical option for patients. Limitations included that many games had short bursts of movement followed by inactivity periods. A test protocol is needed to make a comparison from exergame interventions and conventional physical therapy.

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