Physical exercise for individuals with dementia: potential benefits perceived by formal caregivers

A Sampaio, I Marques-Aleixo, A Seabra, J Mota, J Carvalho, A Sampaio, I Marques-Aleixo, A Seabra, J Mota, J Carvalho

Abstract

Background: The social and economic impact of dementia for the development of accessible and sustainable care for individuals with dementia (IwD). Physical exercise has been seen as a beneficial non-pharmacological therapy in the prevention and management of dementia, and possible benefits may not only impact on participants, but also indirectly on their caregivers. Thus, this quasi-experimental non-randomized study aimed to analyze the effects of an exercise intervention on functional capacity, behavioural and psychological symptoms in dementia (BPSD) and quality of life of institutionalized older adults with dementia, perceived by their formal caregivers.

Methods: Sixty-four institutionalized older adults (from both genders, aged 65-93 yrs. old), clinically diagnosed with dementia, were divided into two groups: control group (CG, continued with usual care, n = 26) and exercise group (EG, 6-month supervised multicomponent exercise intervention, n = 38). Nine caregivers (female, aged 28-47 yrs. old) from nine different nursing homes, reported about their distress related to BPSD and proxy-reported about participants' functional capacity (Katz index), quality of life (QoL-AD), BPSD (NPI) before and after 6 months of an exercise intervention (aerobic, muscular resistance, flexibility and postural exercises).

Results: A two-way ANOVA, with repeated measures, revealed significant group and time interactions on Total Katz index and QoL-AD. The CG's performance functional capacity and quality of life score worsen over time while in EG maintains these values after the exercise intervention. Moreover, formal caregiver's distress triggered by apathy and disinhibition increased in CG while after 6 months of an exercise intervention no alterations were seen regarding these distress causes in EG. No significant main effects were observed for total NPI score or NPI distress.

Conclusions: Overall results show that after the exercise intervention, IwD from the EG, was capable of preserving the functional capacity, quality of life and neuropsychiatric symptoms were attenuate, contributing to a lower load of distress for the caregivers.

Trial registration: clinicaltrials.gov , NCT04095962 . Retrospectively registered on 19 September 2019.

Keywords: Aging; BPSD; Caregivers distress, activities of daily life; Institutionalization; Neurocognitive disorders; Neuropsychiatric symptoms.

Conflict of interest statement

Not applicable.

Figures

Fig. 1
Fig. 1
Subjects flow diagram from initial screening to the end of the study. CG, control group; EG, exercise group
Fig. 2
Fig. 2
Effects of a multicomponent training intervention on physical fitness components of institutionalized older adults with dementia; n = 26 in the CG and n = 38 in the EG. Results were expressed as a percentage of T0. *vs T0; # vs EG (p ≤ 0.05 The effect size (partial eta squared) and significant (p ≤ 0.05) main effects of Group, Time and/or their interaction are indicated. T0 baseline values, before the exercise intervention; T1 after 6 months of exercise intervention. Results adjusted to age
Fig. 3
Fig. 3
Effects of an exercise intervention on proxy-rated outcomes of neuropsychiatric symptoms score (NPI) of institutionalized older adults with dementia. n = 26 in the CG and n = 38 in the EG. Results were expressed as a percentage of T0. *vs T0; # vs CG (p ≤ 0.05). The effect size (partial eta squared) and significant (p ≤ 0.05) main effects of Group, Time and/or their interaction are indicated. T0 baseline values, before the exercise intervention; T1 after 6 months of the exercise intervention. Results adjusted to age
Fig. 4
Fig. 4
Effects of an exercise intervention on caregivers’ neuropsychiatric symptoms distress of institutionalized older adults with dementia. n = 26 in the CG and n = 38 in the EG. Results were expressed as a percentage of T0. *vs T0; # vs CG (p ≤ 0.05). The effect size (partial eta squared) and significant (p ≤ 0.05) main effects of Group, Time and/or their interaction are indicated. T0 baseline values, before the exercise intervention; T1 after 6 months of the exercise intervention. Results adjusted to age
Fig. 5
Fig. 5
Effects of an exercise intervention on proxy-rated functional capacity of and QoL outcomes of institutionalized IwD. Data are mean ± standard deviation; n= 26 in the control group (CG) and n= 38 in the exercise group (EG). Results were expressed as a percentage of T0. *vs T0; # vs EG (p ≤ 0.05). The effect size (partial eta squared) and significant (p ≤ 0.05) main effects of Group, Time and/or their interaction are indicated. T0 baseline values, before the exercise intervention; T1 after 6 months of the exercise intervention. Results adjusted to age

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Source: PubMed

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