University of Kansas Alzheimer's Disease Center, Fairway.
Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City.
J Geriatr Phys Ther. 2019 Jul/Sep;42(3):E129-E134. doi: 10.1519/JPT.0000000000000172.
Individuals with Alzheimer disease (AD) experience progressive loss of independence-performing activities of daily living. Identifying interventions to support independence and reduce the economic and psychosocial burden of caregiving for individuals with AD is imperative. The purpose of this analysis was to examine functional disability and caregiver time in individuals with early-stage AD.
This was a secondary analysis of a randomized controlled trial of 26 weeks of aerobic exercise (AEx) versus stretching and toning (ST). We measured functional dependence using the Disability Assessment for Dementia, informal caregiver time required using the Resources Utilization in Dementia Lite, and cognition using a standard cognitive battery.
We saw a stable function in the AEx group compared with a significant decline in the ST group (4%; F = 4.2, P = .04). This was especially evident in more complex, instrumental activities of daily living, with individuals in the AEx group increasing 1% compared with an 8% loss in the ST group over 26 weeks (F = 8.3, P = .006). Change in memory was a significant predictor of declining instrumental activities of daily living performance (r = 0.28, 95% confidence interval = 0.08 ∞, P = .01). Informal caregiver time was not different between the AEx and ST groups.
Our analysis extends recent work by revealing specific benefits for instrumental activities of daily living for individuals in the early stages of AD and supports the value of exercise for individuals with cognitive impairment.
阿尔茨海默病（AD）患者会逐渐丧失独立性——无法完成日常生活活动。确定支持独立性和减轻 AD 患者照护的经济和心理社会负担的干预措施至关重要。本分析旨在检查早期 AD 患者的功能障碍和照顾者时间。
这是一项为期 26 周有氧运动（AEx）与拉伸和塑形（ST）的随机对照试验的二次分析。我们使用失智症残疾评估量表测量功能依赖，使用失智症资源利用量表 Lite 测量非正规照顾者所需时间，使用标准认知电池测量认知。
与 ST 组相比，AEx 组的功能稳定，而 ST 组显著下降（4%；F = 4.2，P =.04）。这在更复杂的、工具性日常生活活动中表现得尤为明显，AEx 组的个体增加了 1%，而 ST 组在 26 周内下降了 8%（F = 8.3，P =.006）。记忆变化是工具性日常生活活动表现下降的显著预测因素（r = 0.28，95%置信区间 = 0.08 ∞，P =.01）。AEx 和 ST 组之间的非正式照顾者时间没有差异。
我们的分析扩展了最近的工作，揭示了早期 AD 患者工具性日常生活活动的具体益处，并支持运动对认知障碍患者的价值。
