Ries Julie D, Carroll Martha
Center for Optimal Aging, Physical Therapy Department, School of Health Sciences, College of Health & Education, Marymount University, Arlington, VA 22207, USA.
Geriatrics (Basel). 2022 Feb 24;7(2):23. doi: 10.3390/geriatrics7020023.
Older adults with dementia experience more frequent and injurious falls than their cognitively-intact peers; however, there are no evidence-based fall-prevention programs (EBFPP) for this population. The Otago Exercise Program (OEP) is an EBFPP for older adults that has not been well-studied in people with dementia. We sought to explore the feasibility of group delivery of OEP in an adult day health center (ADHC) for people with dementia. We collected demographic data, Functional Assessment Staging Tool (FAST), and Mini Mental State Exam (MMSE) scores for seven participants with dementia. Pre- and post-test data included: Timed-Up-and-Go (TUG), 30-Second Chair-Stand (30s-CST), Four-Stage-Balance-Test (4-SBT), and Berg Balance Scale (BBS). We implemented a supervised group OEP, 3x/week × 8 weeks. Most participants required 1:1 supervision for optimal challenge and participation. Five participants completed the program. All had moderately severe to severe dementia based upon FAST; MMSE scores ranged from mild to severe cognitive impairment. Four of five participants crossed the threshold from higher to lower fall risk in at least one outcome (TUG, 30s-CST, 4-SBT, or BBS), and four of five participants improved by >Minimal Detectible Change (MDC90) score in at least one outcome. The group delivery format of OEP required significant staff oversight for optimal participation, making the program unsustainable.
患有痴呆症的老年人比认知健全的同龄人更容易摔倒且摔倒造成的伤害更大；然而，针对这一人群尚无基于证据的预防跌倒计划（EBFPP）。奥塔哥运动计划（OEP）是一项针对老年人的EBFPP，但尚未在痴呆症患者中得到充分研究。我们试图探讨在成人日间健康中心（ADHC）为痴呆症患者集体提供OEP的可行性。我们收集了7名痴呆症患者的人口统计学数据、功能评估分期工具（FAST）和简易精神状态检查表（MMSE）评分。测试前和测试后的数据包括：定时起立行走测试（TUG）、30秒椅子站立测试（30s-CST）、四阶段平衡测试（4-SBT）和伯格平衡量表（BBS）。我们实施了一项由专人监督的集体OEP，每周3次，共8周。大多数参与者需要一对一的监督，以获得最佳挑战和参与度。5名参与者完成了该计划。根据FAST，所有参与者都患有中度至重度痴呆症；MMSE评分范围从轻度到重度认知障碍。5名参与者中有4名在至少一项结果（TUG、30s-CST、4-SBT或BBS）中从较高跌倒风险降至较低跌倒风险，5名参与者中有4名在至少一项结果中改善超过最小可检测变化（MDC90）评分。OEP的集体授课形式需要大量工作人员监督以实现最佳参与度，这使得该计划难以持续。
