Effects of Physical Activity in Nursing Home Residents with Dementia: A Randomized Controlled Trial

Abstract

Background/aims: There is no consensus regarding the optimal nonpharmacological intervention to slow down dementia-related decline. We examined whether physical stimulation interventions were effective in reducing cognitive, physical, mood, and behavioral decline in nursing home residents with dementia.

Methods: Eighty-seven nursing home residents with dementia were randomly assigned to 3 physical activity interventions: activities of daily living (ADL) training, multicomponent exercise training, or combined multicomponent exercise and ADL training. Outcomes were measured at baseline, and after 3 and 6 months.

Results: A 6-month ADL training benefitted executive functions, physical endurance, and depression among men. Exercise training benefitted only grip strength of participants with mild-to-moderate cognitive impairment. A combined training benefitted functional mobility compared to ADL training, depressive symptoms and agitation compared to exercise training, and physical endurance compared to no physical stimulation.

Conclusions: ADL training appears to be effective for nursing home residents with moderately severe dementia. It remains unclear whether exercise training is an effective type of stimulation.

Keywords: Activities of daily living; Behavior; Cognition; Dementia; Exercise; Mood; Nursing home; Physical functions.

Fig. 1.

Flowchart of the sampling procedure. EX-ADL, exercise and ADL; ADL, social activity and ADL; EX, exercise and control; CO, social activity and control.

Fig. 2.

Forest plot of overall effect sizes and effect sizes after 3 (T1) and 6 months (T2) of ADL training. Effect sizes represented in Cohen's d; all outcomes are in favor of the ADL group. CI, confidence interval; ADL, activities of daily living; EF, executive functions; 6MWT, 6-min walk test. * p < 0.02: significant differences in outcome measure between groups.

Fig. 3.

Forest plot of overall effect size and effect sizes after 3 (T1) and 6 months (T2) of exercise training. Effect sizes represented in Cohen's d; outcome is in favor of the exercise group. CI, confidence interval. * p < 0.05: significant differences in outcome measure between groups.

Fig. 4.

Forest plot of overall effect sizes and effect sizes after 3 (T1) and 6 months (T2) of a combined exercise and ADL training. Effect sizes represented in Cohen's d; all outcomes are in favor of the EX-ADL group. CI, confidence interval; EX-ADL, exercise and ADL training; ADL, activities of daily living; TUG, timed up and go test; 6MWT, 6-min walk test. * p < 0.05: significant differences in outcome measure between groups.