HOW EXERCISE CAN AFFECT DEMENTIA PERSONS?

V. Papatsimpas¹, S. Vrouva¹, M. Papadopoulou¹, G. Papathanasiou¹, C. Bouzineki², D. Moutafi³, E. Margioti², D. Bakalidou¹

¹University of West Attica, Physiotherapy Department/LANECASM Research Lab, Egaleo – Athens, Greece, ²Athens Alzheimer Association, Day Center, Maroussi, Greece, ³Konstantopoulio General Hospital, Pathological Department, Nea Ionia, Greece

Background: Dementia is characterized by impaired cognitive function, behavioral and mood disorders as well as a progressive deterioration of physical function that significantly interferes with the person's ability to maintain their daily activities. Unlike previous years, there is greater interest on the role of exercise as a treatment strategy for persons with dementia.

Purpose: The purpose of this study was to investigate the effect of exercise on cognition, mood, daily living activities, physical activity and balance in persons with mild Alzheimer's disease (AD).

Methods: 128 persons were enrolled with mild AD from Maroussi Day Center of the Alzheimer Society of Athens and of the Outpatient Clinic of Athens General Hospital "G. Gennimatas". Participants were randomly allocated to three groups: Group A (aerobic and resistance exercise, n=43), Group B (resistance exercise, n=43) and the Group C (control group, n=42). The Group A did aerobic exercise (walking ) five times/week for 30 minutes at moderate intensity and resistance exercise three times/week for more than 40 minutes at moderate intensity. Group B performed only resistance exercise program such as Group A for 12 weeks. Group C carried on their usual daily activities (no exercise). Cognitive function (Mini Mental State Examination - MMSE and Digit Span Test - DST), depression (Geriatric Depression Scale - GDS -15), activities of daily living (Instrumental Activities of Daily Living Scale-IADL), physical activity (International Physical Activity Questionnaire - IPAQ) and balance (Berg Balance Scale - BBS ) were evaluated in all participants at base line and after 12 weeks.

Results: Analysis of Variance (Anova) for the three groups of patients at baseline revealed no significant differences in mean values between the three groups (p-values>0.05). 12 weeks after, scores in MMSE, DST, GDS and IADL found to differ significantly (p-values<0.05). Multiple comparisons tests between groups showed significant differences between A and Control group in IADL (mean difference 1.902, p-value<0.01), MMSE (mean difference 3.936, p-value<0.01), DST (mean difference 4.265, p-value<0.01) and GDS (mean difference -2.976, p-value<0.01). Also found significant differences between B and Control group in IADL (mean difference 1.693, p-value<0.01), MMSE (mean difference 3.029, p-value<0.01), DST (mean difference 4.009, p-value<0.01) and GDS (mean difference -2.906, p-value<0.01). No statistical significant differences between A and B groups, except of MMSE (mean difference 0.907, p-value=0.04).Chi-Square tests showed significant differences in frequencies between groups for categorical variables IPAQ (X²(2, 128) = 70.179, p-value<0.01), BBS (X²(2, 128) = 24.641, p-value<0.01), and GDS (X²(2, 128) = 21.909, p-value<0.01).

Conclusions: Τhe implementation of both exercise programs improved all parameters examined. Comparison of the two exercise programs did not reveal any significant differences, except from the MMSE that found to be significant higher, almost one unit, for the Group A.

Implications: The results help to design an individualized and appropriate exercise program in terms of type, intensity, frequency and duration in AD, which is a low-cost and low-risk intervention with positive effect.

Funding acknowledgements: None

Keywords:
Dementia
Exercise
Cognitive function

Topics:
Mental health

Did this work require ethics approval? Yes

Institution: University of West Attica

Committee: Ethics Committee of University of West Attica

Ethics number: 96645/25-11-2020