Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
Version of Record online: 19 JAN 2016
© 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Journal of the American Geriatrics Society
Volume 64, Issue 1, pages 55–64, January 2016
How to Cite
J Am Geriatr Soc 64:55–64, 2016.
- Issue online: 19 JAN 2016
- Version of Record online: 19 JAN 2016
- Swedish Research Council. Grant Numbers: K2009–69P-21298–01–4, K2009–69X-21299–01–1, K2009–69P-21298–04–4, K2014–99X-22610–01–6
- Forte—Swedish Research Council for Health
- County Council of Västerbotten
- Umeå University Foundation for Medical Research
- Ragnhild and Einar Lundström's Memorial Foundation
- Erik and Anne-Marie Detlof′s Foundation. Grant Number: Forte—Swedish Research Council for Health
- Vårdal Foundation
- Swedish Dementia Association
- Promobilia Foundation
- Swedish Society of Medicine
- Swedish Alzheimer Foundation
- King Gustav V and Queen Victoria's Foundation of Freemasons
- European Union Bothnia-Atlantica Program
- activities of daily living;
- residential facilities;
- postural balance
To investigate the effects of a high-intensity functional exercise program on independence in activities of daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types.
Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study.
Residential care facilities, Umeå, Sweden.
Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186).
Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity.
Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months.
Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=−1.6–4.3; BI=0.6, 95% CI=−0.2–1.4) or 7 (FIM=0.8, 95% CI=−2.2–3.8; BI=0.6, 95% CI=−0.3–1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8–6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months.
In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia.