Effects of Exercise on Functional Ability in People With Dementia in Nursing Homes:a Cluster Randomised Controlled Trial (LEDEN)
Effects of a Long-term Exercise Program on Functional Ability in People With Dementia Living in Nursing Homes: a Cluster Randomised Controlled Trial. The LEDEN Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Bruay-sur-l'Escaut, France, 59860
- Résidence d'Automne de Bruay sur Escaut
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L'Huisserie, France, 53970
- Korian Le Castelli
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Le Mans, France, 72000
- Korian Pontlieue
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Neuilly-Plaisance, France, 93360
- Résidence Les Lauriers de Plaisance
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Saint-Cyr-sur-Loire, France, 37540
- Korian Croix Périgourd
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Sanilhac, France, 24660
- Résidence d'Automne de Notre Dame de Sanhilac
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Sermaize-les-Bains, France, 51531
- Résidence Les Jardins de Sermaize
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Thise, France, 25220
- Korian Vill'Alizé
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Confirmed diagnosis of Alzheimer's disease, vascular or mixed dementia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV);
- MMSE ≤ 20 (out of 30);
- living in one of the participating NHs for at least 3 months at the moment of baseline measurements (this time period will allow NH staff to have a good knowledge about the patient and about recent changes in his/her health status);
- to be able of walking at least 4 meters (with walking devices if needed but without human assistance);
- to be able to rise from a chair without help or with minimal human assistance.
Exclusion Criteria:
- Mild dementia, illustrated by a MMSE > 20 (out of 30)
- Terminal illness with life expectancy less than 6 months;
- Diagnosis of Parkinson's disease;
- Diagnosis of dementia with Lewy bodies;
- Unstable cardiovascular condition or any other health condition that might be deteriorated by physical exercise;
- Planned transfer from the NH to another NH/home or to surgery during the 6-month period of intervention;
- Already participating in physical exercise ≥ 2 times/week in the last 2 months prior to the date of baseline assessments.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Exercise
Exercise sessions will be done in groups of three-to-eight persons; whilst being a group-based exercise program, participants will be guided and the exercises will be adapted in an individual basis, which may increase adherence and compliance rates.
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Exercise training will take place in the NH, twice weekly, around 60 minutes per session (session duration can be shorter during the first weeks of intervention according with participants' physical capacity), during 6 months; interval between two exercise sessions will be of at least 48 hours.
The exercise program will be a multicomponent training, with exercises specifically developed to improve participants' flexibility (10 minutes), coordination and balance (10 minutes), muscle toning (10 minutes), and cardiorespiratory capacity (25 minutes).
The exercise intensity targeted will be moderate.
All exercise sessions will be accompanied by music.
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Active Comparator: Social activity
Participants in this group will participate in group-based activities such as music (percussion instruments), arts and board games; no intervention on physical activity will be provided to these participants.
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Interventionists will be health professionals external to the NH, preferentially psychologists.
Interventions will take place in the NHs, at the same frequency and duration than the exercise intervention (twice weekly, 60 minutes per session, during 6 months).
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Functional ability
Time Frame: 6th month
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(ADL performance) as assessed by the Alzheimer Disease Cooperative Study (ADCS) ADL-sev.
This is a 19-item scale measuring the ability to perform basic (e.g., bathing, toileting) and instrumental (e.g., turning faucet/lights on/off) ADLs in the last four weeks.
The ADCS-ADL-sev was specifically validated for people with moderate or severe Alzheimer's disease (AD), i.e., the large majority of PWD in NHs.
Scores in this scale vary from 0 to 54, with higher scores indicating better functional ability.
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6th month
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of Functional ability
Time Frame: Change and evolution at different time points: baseline, 3-month intervention, Post-intervention (6month), 3-month follow-up (9 month), 6-month follow-up (12 month)
|
ADL performance) as assessed by the Alzheimer Disease Cooperative Study (ADCS) ADL-sev.
This is a 19-item scale measuring the ability to perform basic (e.g., bathing, toileting) and instrumental (e.g., turning faucet/lights on/off) ADLs in the last four weeks.
The ADCS-ADL-sev was specifically validated for people with moderate or severe Alzheimer's disease (AD), i.e., the large majority of PWD in NHs.
Scores in this scale vary from 0 to 54, with higher scores indicating better functional ability.
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Change and evolution at different time points: baseline, 3-month intervention, Post-intervention (6month), 3-month follow-up (9 month), 6-month follow-up (12 month)
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Physical function
Time Frame: Baseline, Post-intervention (6 month)
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as assessed by the Short Physical Performance Battery (SPPB) (score from 0 to 12).
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Baseline, Post-intervention (6 month)
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Cost-effectiveness of the interventions
Time Frame: 12 month (end of study)
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12 month (end of study)
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Falls and fractures
Time Frame: 12 month (end of study)
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12 month (end of study)
|
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Cognitive function
Time Frame: Baseline, Post-intervention (6month)
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as assessed by the Mini-Mental State Examination (MMSE).
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Baseline, Post-intervention (6month)
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Behavioural and psychological symptoms of dementia (BPSD)
Time Frame: Baseline, Post-intervention (6 month)
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as assessed by the Neuropsychiatric Inventory - Nursing Home version (NPI-NH).
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Baseline, Post-intervention (6 month)
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Pain
Time Frame: Baseline, Post-intervention (6 month)
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as assessed by the Algoplus scale
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Baseline, Post-intervention (6 month)
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Nutritional status
Time Frame: Baseline, Post-intervention (6 month)
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as assessed by the Mini Nutritional Assessment (MNA).
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Baseline, Post-intervention (6 month)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Yves ROLLAND, MD, Toulouse University Hospital (CHU Toulouse)
Publications and helpful links
General Publications
- de Souto Barreto P, Cesari M, Denormandie P, Armaingaud D, Vellas B, Rolland Y. Exercise or Social Intervention for Nursing Home Residents with Dementia: A Pilot Randomized, Controlled Trial. J Am Geriatr Soc. 2017 Sep;65(9):E123-E129. doi: 10.1111/jgs.14947. Epub 2017 May 19.
- de Souto Barreto P, Denormandie P, Lepage B, Armaingaud D, Rapp T, Chauvin P, Vellas B, Rolland Y. Effects of a long-term exercise programme on functional ability in people with dementia living in nursing homes: Research protocol of the LEDEN study, a cluster randomised controlled trial. Contemp Clin Trials. 2016 Mar;47:289-95. doi: 10.1016/j.cct.2016.02.004. Epub 2016 Feb 13.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Mental Disorders
- Neurocognitive Disorders
- Tauopathies
- Neurodegenerative Diseases
- Behavior
- Alzheimer Disease
- Dementia
- Motor Activity
- Motor Activity
- Movement
- Musculoskeletal Physiological Phenomena
- Musculoskeletal and Neural Physiological Phenomena
- Exercise
Other Study ID Numbers
Other Study ID Numbers
- RC31/14/7292
- 2014-A01713-44 (Other Identifier: ID-RCB)
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