October 15, 2003
A home exercise program eased depression and boosted physical vitality of those suffering from Alzheimer's, a rigorous new study published in today's Journal of the American Medical Association reports. The program, combined with training sessions to teach caregivers techniques for encouraging and supervising continuing exercise, led to better patient functioning and delayed the need for placing patients in an institution.
Researchers at the University of Washington in Seattle followed 153 Alzheimer's patients from 1994 to 1999. Some received a 3-month exercise and behavioral training program in their homes, while the others received standard medical care.
The researchers also enlisted caregivers of those with Alzheimer's. Care partners were taught strategies for encouraging and supervising safe exercise among Alzheimer's patients. They were also taught ways to manage conflicts that may arise during the exercise program and to identify behavioral problems that impaired day-to-day functioning. Caregivers were taught to encourage patients to engage in activities they found pleasurable and to increase their physical and social activities.
Those patients who got the training along with their caregivers were much more likely to engage in regular exercise on an ongoing basis. They also showed greater physical stamina, better general functioning, and were less depressed, even nearly two years after the training was completed.
"Because exercise is also associated with reduced depression in adults without dementia, targeting patients with coexisting depression and dementia might enhance treatment effects," the researchers conclude. "Given these results and the consistently strong association between physical exercise and health in older adults without dementia, the potential health benefits of a simple exercise program for older adults with dementia should not be overlooked."
The Many Benefits of Exercise
While it is well known that Alzheimer's leads to mental decline and behavioral disturbances, it is less widely recognized that the disease can also greatly impair physical health and conditioning. Studies show that compared to their age-matched peers who remain mentally intact, people with Alzheimer's disease are much more likely to be malnourished, to fall down and break bones and to suffer impaired mobility. If they do get hurt, they are at higher risk of additional injuries and losing their independence.
Research also shows that even the oldest old can benefit from regular exercise. Exercise increases flexibility, balance and strength, even in frail nursing home patients. One small study of Alzheimer's patients found that a hospital-based exercise program produced benefits. Improving physical stamina and muscle mass allows patients to move around more easily on their own and enhances their quality of life.
Exercise also eases depression. Because studies show that between a quarter to three quarters of Alzheimer's patients are also depressed, regular exercise could have benefits for behavior and mood as well.
In the current study, researchers taught aerobic endurance, strength-training, balance and flexibility exercises to Alzheimer's patients in their homes. The goal was to get patients to do up to 30 minutes a day of moderate exercise.
The program consisted of 12 hourly sessions over three months: twice a week for the first three weeks, then weekly for the next four weeks and every-other-week thereafter. In each session, exercises were demonstrated and practiced, and new exercises were introduced each week.
Patients who participated in the program had higher levels of physical stamina and activity. They also were less depressed and had fewer behavioral outbursts and problems. In addition, more of those who engaged in the program were able to remain in the home and stay out of nursing homes.
What's more, adherence to the program was high. Patients and caregivers alike adapted to the program's structure. In addition, many of the patients continued to exercise, up to two years after the program was introduced.
The researchers conclude that exercise can be a vital component of any Alzheimer's care program and should not be overlooked in anyone caring for a patient at home. If you are interested in an exercise program, consult your doctor or health-professional about starting a program of your own.
By Toby Bilanow, Medical Writer for www.ALZinfo.org, The Alzheimer's Information Site.