Exercise Program for Nursing Home Residents with Alzheimer's Disease: A 1-Year
Randomized, Controlled Trial

Yves Rolland, MD, PhD; Fabien Pillard, MD; Adrian Klapouszczak, MD; Emma
Reynish, MD; David Thomas, MD; Sandrine Andrieu, MD, PhD; Daniel Rivière, MD;
Bruno Vellas, MD, PhD

J Am Geriatr Soc. 2007;55(2):158-165. ©2007 Blackwell Publishing
Posted 03/20/2007
Abstract and Introduction
Abstract

Objectives: 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).

Design: Randomized, controlled trial.

Setting: Five nursing homes.

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

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

Measurements: 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.

Conclusion: 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.

The full article may be found at:
http://www.medscape.com/viewarticle/553361_print