January 3, 2019
Falls are a leading cause of broken hips and disability in elderly men and women, and they may even hasten death. And older people with Alzheimer’s disease are especially susceptible to falls.
Now a new study shows that exercise may decrease the risk of falling for older adults who have Alzheimer’s disease. The study, in the Journal of the American Geriatrics Society, found that older men and women with Alzheimer’s disease who had personality and mood changes, including depression, anxiety and irritability, were particularly prone to falling. But a structured exercise program helped prevent falls in this group.
Studies show that about 60 percent of people with Alzheimer’s or other forms of dementia fall each year. They are about twice as likely as other elderly men and women to fall. While memory loss is a cardinal symptom of Alzheimer’s disease, the researchers note that caregivers should pay particular attention to people with Alzheimer’s who exhibit behavioral changes as well.
For the study, the researchers looked at a year-long exercise program in older adults in various stages of Alzheimer’s. Study volunteers were put into one of two groups. One group followed an exercise program that was performed in groups at care centers or at home under the supervision of a geriatric exercise specialist. The other group got regular Alzheimer’s care that typically does not involve exercising.
Participants in the home-based exercise group performed individually tailored physical exercise for one hour twice a week for 12 months. Exercise included climbing stairs, balance training, walking and outdoor activities. Various kinds of equipment were used to enhance the training, such as bikes, ankle or hand weights, balls, canes, and balance pillows. Caregivers could participate in the sessions or they could use the time for their own activities.
The group-based exercise program involved four-hour visits in daycare centers twice a week for over 12 months. Supervised sessions were organized in groups of 10 and consisted of endurance training on an exercise bike, balance, and strength training using weight machines. Balance training consisted of, for example, training to walk on a line, training with a bouncing ball, and climbing a ladder. Participants also practiced getting up from the floor. Executive functioning training included, for example, throwing a ball as accurately as possible, or doing two different functions with the left and right hands while counting numbers forward or backward at the same time. Music and sing-alongs were used to set the pace and support the exercises.
Using such exercises, the researchers found that exercise training significantly reduced the risk of falls compared to the group that did not get exercise training. The findings confirm earlier reports that exercise can be good for those with Alzheimer’s disease.
Those with Alzheimer’s disease are more likely to have gait and balance problems, and may have trouble walking. They also often have problems with attention and focus as well as making decisions. So it is not surprising that they are more likely to fall than their cognitively normal peers.
Experts recommend additional measures to help prevent falls.
- Remove things you can trip over, such as papers, books, clothes, and shoes, from stairs and places where you walk.
- Remove small throw rugs or use double-sided tape to keep the rugs from slipping.
- Keep items you use often in cabinets you can reach easily without using a step stool.
- Have grab bars put in next to your toilet and in the tub or shower.
- Use non-slip mats in the bathtub and on shower floors.
- Improve the lighting in your home. As you get older, you need brighter lights to see well. Lamp shades or frosted bulbs can reduce glare.
- Have handrails and lights put in on all staircases.
- Wear shoes that give good support and have thin non-slip soles. Avoid wearing slippers and athletic shoes with deep treads.
By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.
Source: Hanna-Maria Roitto, MD; Hannu Kautiainen, biostatistician; Hannareeta Öhman, MD; et al: “Relationship of neuropsychiatric symptoms with falls in Alzheimer’s disease–Does exercise modify the risk?” Journal of the American Geriatrics Society, November 2018.