Feasibility of improving strength and functioning and decreasing the risk of falls in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial.

PURPOSE

To determine the effects of a Home-based multimodal exercise program for older people with Alzheimer's disease (AD-HOMEX) on muscle strength, mobility, the risk of falls and functioning.

MATERIALS AND METHODS

A trial with a blinded assessor was conducted involving 40 older people with mild to moderate AD randomized to an intervention group (IG) or control group (CG). The IG participated in a 16-week protocol with three 60-minute sessions per week. The sessions were performed at the participant's home by a physiotherapist and involved progressive individualized physical exercises. Muscle strength (5X Sit-to-Stand Test [5XSTS], 30-Second Chair Stand test, isokinetic and hand-grip dynamometer), functioning (DAFS-R and ADL-Q), mobility and the risk of falls (TUG) were assessed at baseline and after training. Intention-to-treat analysis was adopted.

RESULTS

There was a significant group-evaluation time interaction for the 5XSTS (p = 0.011). The IG demonstrated an improved performance on the 5XSTS (p = 0.020) and a reduced risk of falls (p = 0.000), whereas the CG exhibited a worse functional limitation (p = 0.008) after 16 weeks. The CG had an increased risk of falls (p = 0.006) and worse performance on the ADL-Q (p = 0.047) at the follow-up evaluation. An improvement in the IG and worsening in the CG were found regarding transition patterns between severity levels of functional limitation based on the ADL-Q.

CONCLUSIONS

Home-based physical exercise for older people with mild to moderate AD is an effective strategy that decreases the risk of falls and improves strength and functioning.