EFFECTIVENESS OF MENTAL IMAGERY ON MOTOR, COGNITIVE AND EMOTIONAL STATUS OF OLDER PEOPLE WITH EARLY STAGE OF DEMENTIA: PRELIMINARY DATA

A. Christakou1,2, C. Bouzineki1,3, M. Pavlou4, G. Stranjalis5, V. Sakellari1
1University of West Attica, Physiotherapy, Athens, Greece, 2University of Peloponnese, Physiotherapy, Sparta, Greece, 3Day Care Center Athens Alzheimer Association, Athens, Greece, 4King’s College, Centre for Human & Applied Physiological Sciences, London, United Kingdom, 5University of Athens, Evagelismos Hospital, Neurosurgery, Athens, Greece

Background: Dementia involves the loss of cognitive abilities and impairs functional abilities in daily life. Mental imagery (MI) is a technique that has been defined as cognitive process in which motor acts are mentally rehearsed without any overt body movements.

Purpose: The purpose of the study was to assess the effects of MI on the motor, cognitive and emotional status of older adults with early stage of dementia.

Methods: This is a part of an ongoing prospective randomized controlled trial with a total sample of 140 participants. The sample from an Athens Day Care Center of the Alzheimer Association was randomized to: (a) MI and exercise group (intervention group), (b) only exercise group (1st control group) and (c) neither MI nor exercise group (2nd control group). Participants received 24 physiotherapy exercise sessions, lasting 45 minutes each, twice a week for 12 weeks. The exercises were selected from the Otago Exercise Program. Assessment was made 1week prior to the program and after the program. Participants in the intervention group performed a 30-minute MI with exercise program content after the end of every physiotherapy exercise session. Timed Up and Go test (TUG), Multidirectional Reach Test (Reach in Four Directions Test), Five Times Sit-to-Stand Test (FTSST), Walking While Talking Test (WWITT) and the Short-Form of Geriatric Depression Scale (SF-GDS) were used to assess balance, functional status, cognitive and emotional status.

Results: The majority of the 63 participants (20 men, 43 women, with MMSE M 23.87 SD=1.85) had higher education (n=36) and were married (n=37) with a mean age of 77.22 years (SD=6.47). The participants were randomly divided into the intervention (n=23), the 1st control (n=22) and the 2nd control group (n=18). There was a statistically significant difference in the forward direction of the Multidirectional Reach Test for the 3 groups (F (2.8=5.31 p<.00). Post-hoc comparison using the Tuckey HSD test indicated that the mean score for the intervention group (M=6.14, SD=1.96, 95%CI =1.21, 11.08) was significantly different from 3rd group. Also the 2nd group (M=4.94, SD=1.96 95% CI=.005 9.88) was significantly different from 3rd group. The Kruskal Wallis H test showed that there were statistically significant differences between the intervention and the 3rd and 2nd control groups, respectively (TUG test H(2)=26.79, p<.001, H(1)=14.55 p<.00, FTSST H(2)=23.83, p<.00, H(1)=8.013, p<.00, WWITTMISTAKESH(2)=27.50, p<.00, H(1)=7.76, p<.00, WWITTTIMEH(2)=25.37, p<.00, H(2)=10.61, p<.00). Mann Whitney post-hoc U tests showed statistically significant differences between the 3 groups. The Kruskal Wallis H test showed there were statistically significant differences between the 2 control groups (FTSST H(1)=6.27, P<.01, WWITTMISTAKESH(1)=10.82, p<.00, WWITTTIMEH(2)=4.91 p<.03).

Conclusions: The present study showed some preliminary positive effect of MI on balance, functional status and cognitive ability of older adults with early stage of dementia.

Implications: Examining the processes of MI in dementia may help physiotherapists to integrate this cognitive technique into the rehabilitation program, contributing more to subjects’ mobility and cognitive status.

Funding acknowledgements: None

Keywords:
Dementia
Mental Imagery
Physiotherapy

Topics:
Older people
Neurology
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes
Institution: University of West Attica Athens Greece
Committee: Human Research Ethics Committee
Ethics number: 93292 - 26/10/2021

All authors, affiliations and abstracts have been published as submitted.

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