A home-based, carer-enhanced exercise program improves balance and falls efficacy in community-dwelling older people with dementia.
Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia.



Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial.



Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to <70% of sessions.



This trial of a tailored home-based exercise intervention presents preliminary evidence that this intervention can improve balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.
Falls and Injury Prevention Group,Neuroscience Research Australia,UNSW,Sydney,Australia.
Morag E
ME
Taylor
School of Public Health and Community Medicine,UNSW,Sydney,Australia.
Stephen R
SR
Lord
Dementia Collaborative Research Centre,School of Psychiatry,Medicine,UNSW,Sydney,Australia.
Henry
H
Brodaty
Cognitive Decline Partnership Centre,Sydney Medical School,The University of Sydney,Sydney,Australia.
Susan E
SE
Kurrle
Falls and Injury Prevention Group,Neuroscience Research Australia,UNSW,Sydney,Australia.
Sarah
S
Hamilton
Falls and Injury Prevention Group,Neuroscience Research Australia,UNSW,Sydney,Australia.
Elisabeth
E
Ramsay
Falls and Injury Prevention Group,Neuroscience Research Australia,UNSW,Sydney,Australia.
Lyndell
L
Webster
Falls and Injury Prevention Group,Neuroscience Research Australia,UNSW,Sydney,Australia.
Narelle L
NL
Payne
Falls and Injury Prevention Group,Neuroscience Research Australia,UNSW,Sydney,Australia.
Jacqueline C T
JC
Close
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D017028:Caregivers; D003704:Dementia / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006699:Home Care Services; D006801:Humans; D057187:Independent Living; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D004856:Postural Balance; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome
accidental falls; cognitive impairment; dementia; exercise; fear of falling; postural control; prevention