Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial.
OBJECTIVE
To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living (ADLs), physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer's disease (AD).


METHODS
Randomized, controlled trial.


METHODS
Five nursing homes.


METHODS
One hundred thirty-four ambulatory patients with mild to severe AD.


METHODS
Collective exercise program (1 hour, twice weekly of walk, strength, balance, and flexibility training) or routine medical care for 12 months.


METHODS
ADLs were assessed using the Katz Index of ADLs. Physical performance was evaluated using 6-meter walking speed, the get-up-and-go test, and the one-leg-balance test. Behavioral disturbance, depression, and nutritional status were evaluated using the Neuropsychiatric Inventory, the Montgomery and Asberg Depression Rating Scale, and the Mini-Nutritional Assessment. For each outcome measure, the mean change from baseline to 12 months was calculated using intention-to-treat analysis.


RESULTS
ADL mean change from baseline score for exercise program patients showed a slower decline than in patients receiving routine medical care (12-month mean treatment differences: ADL=0.39, P=.02). A significant difference between the groups in favor of the exercise program was observed for 6-meter walking speed at 12 months. No effect was observed for behavioral disturbance, depression, or nutritional assessment scores. In the intervention group, adherence to the program sessions in exploratory analysis predicted change in ability to perform ADLs. No adverse effects of exercise occurred.


CONCLUSIONS
A simple exercise program, 1 hour twice a week, led to significantly slower decline in ADL score in patients with AD living in a nursing home than routine medical care.
Rolland
Yves
Y
Internal Medicine Service and Gerontology Clinic, Hôpital La Grave-Casselardit, Toulouse, France. yvesmrolland@yahoo.fr
Pillard
Fabien
F
Klapouszczak
Adrian
A
Reynish
Emma
E
Thomas
David
D
Andrieu
Sandrine
S
Rivière
Daniel
D
Vellas
Bruno
B
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000175:diagnosis; D005081:Exercise Therapy; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D009735:Nursing Homes; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D016138:Walking