Study finds regular activity delays physical decline, reduces falls
WebMD News from HealthDay
By Brenda Goodman
HealthDay Reporter
MONDAY, April 15 (HealthDay News) -- Regular exercise slows disability and prevents falls in patients with Alzheimer's disease without increasing overall costs, a new study from Finland says.
The findings suggest that exercise, particularly when tailored to an individual's needs and performed at home, may help Alzheimer's patients maintain their independence and delay the move to a nursing home.
"This is an important study," said Dr. Kostos Lyketsos, director of the Johns Hopkins Memory and Alzheimer's Treatment Center, in Baltimore. "If we could ever deliver exercise for people with dementia in their homes, I think we could accomplish very substantial benefits for patients and reduce costs, which is a very big deal ... in health care these days." Lyketsos was not involved in the new research.
Mental changes are the first wrenching signs of Alzheimer's disease, and they often are the symptoms that get the most attention. But physical declines are also a part the disease. Over time, muscles become stiff and uncoordinated, or may start to tremor. Alzheimer's patients may lose the ability to brush their teeth, climb stairs, and dress, feed and bathe themselves.
"These people are at very high risk of disability. That's one of the reasons they end up in institutional care," said study author Dr. Kaisu Pitkala, a general practitioner at the University of Helsinki. "They need so much help that their caregivers often get very tired, and after a few years they will end up in institutional care, which is very expensive and often not the wish of the patients nor the caregivers."
For the study, published online April 15 in the journal JAMA Internal Medicine, the researchers chose more than 200 patients with moderate to severe Alzheimer's disease who were living at home with a caregiver and showing signs of physical decline. The patients were randomly assigned to one of three groups: home exercise, group exercise at a day care center, or a control group that got usual care through the Finnish national health care system.
Those in the home-exercise group got visits from a physical therapist for one hour twice a week. The physical therapists specialized in dementia care, and they tailored these sessions to each patient's problems with function and mobility.
Patients in the group-exercise classes traveled to an adult care center twice a week, where two physical therapists guided them through exercises to improve endurance, balance, strength and mental function.
The patients in the usual-care group were followed by the study nurses and were given advice on nutrition and exercise.
After one year, all the groups saw declines in physical function, but the groups that exercised regularly fared better than those who got usual care. Those in the home-exercise group did the best. Their physical function declined about half as much as that of the control group. Importantly, they also had half as many falls as those who got usual care.
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