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A home-based, carer-enhanced exercise program improves balance and falls efficacy in community-dwelling older people with dementia

Published online by Cambridge University Press:  03 October 2016

Morag E. Taylor ,
Stephen R. Lord ,
Henry Brodaty ,
Susan E. Kurrle ,
Sarah Hamilton ,
Elisabeth Ramsay ,
Lyndell Webster ,
Narelle L. Payne  and
Jacqueline C. T. Close
Morag E. Taylor*
Affiliation:
Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Sydney, Australia Cognitive Decline Partnership Centre, Sydney Medical School, The University of Sydney, Sydney, Australia
Stephen R. Lord
Affiliation:
School of Public Health and Community Medicine, UNSW, Sydney, Australia Falls and Balance Research Group, Neuroscience Research Australia, UNSW, Sydney, Australia
Henry Brodaty
Affiliation:
Dementia Collaborative Research Centre, School of Psychiatry, Medicine, UNSW, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, Australia Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, UNSW, Sydney, Australia
Susan E. Kurrle
Affiliation:
Cognitive Decline Partnership Centre, Sydney Medical School, The University of Sydney, Sydney, Australia
Sarah Hamilton
Affiliation:
Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Sydney, Australia
Elisabeth Ramsay
Affiliation:
Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Sydney, Australia
Lyndell Webster
Affiliation:
Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Sydney, Australia
Narelle L. Payne
Affiliation:
Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Sydney, Australia
Jacqueline C. T. Close
Affiliation:
Falls and Injury Prevention Group, Neuroscience Research Australia, UNSW, Sydney, Australia Prince of Wales Clinical School, Medicine, UNSW, Sydney, Australia
*
*Correspondence should be addressed to: Morag Taylor, Neuroscience Research Australia, Barker Street, Randwick, NSW, 2031, Australia. Phone: +61293991852; Fax: +61293991204. Email: m.taylor@neura.edu.au.
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Abstract

Background:

Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia.

Methods:

Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial.

Results:

Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to <70% of sessions.

Conclusions:

This trial of a tailored home-based exercise intervention presents preliminary evidence that this intervention can improve balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.

Keywords

dementiacognitive impairmentaccidental fallspreventionexercisepostural controlfear of falling
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 1 , January 2017 , pp. 81 - 91
Copyright
Copyright © International Psychogeriatric Association 2016 

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