Abstract
Decreased ability to perform activities of daily living (ADLs) associated with deterioration
in physical capacity are key determinants of the poor quality of life and loss of
independence of patients with Alzheimer's disease (AD). The purpose of this study
was to determine the effects of a 12-week training program (including resistance,
flexibility, joint mobility and balance/coordination exercises) for Spanish patients
with AD on their i) overall functional capacity (muscle strength and flexibility,
agility and balance while moving, and endurance fitness), and ii) ability to perform
ADLs. Using a randomized block design, 16 patients were assigned to a training (mean
[SD] age: 76 [4] yrs) or control group (73 [4] yrs) (n = 8 subjects [3 male, 5 female]
per group). The results showed significant improvements after training (p < 0.05)
in upper and lower body muscle strength and flexibility, agility and dynamic balance,
and endurance fitness (using the Senior Fitness test), gait and balance abilities
(with subsequent decrease in risk of falls) (Tinetti scale) and in the ability to
perform ADLs independently (Katz and Barthel scores). No changes (p > 0.05) were found
in the control group over the 12-week period. Exercise training could be included
in the overall medical/nursing care protocol for patients with AD.
Key words
activities of daily living - physical activity - elderly - resistance training - neurological
disease
References
- 1
Ades P A, Ballor D L, Ashikaga T, Utton J L, Nair K S.
Weight training improves walking endurance in healthy elderly persons.
Ann Intern Med.
1996;
124
568-572
- 2
American College of Sports Medicine (ACSM) .
American College of Sports Medicine position stand. Exercise and physical activity
for older adults.
Med Sci Sports Exerc.
1998;
30
992-1008
- 3
Andersen C K, Wittrup-Jensen K U, Lolk A, Andersen K, Kragh-Sørensen P.
Ability to perform activities of daily living is the main factor affecting quality
of life in patients with dementia.
Health Qual Life Outcomes.
2004;
2
52
- 4
Blumenthal J A, Babyak M A, Moore K A, Craighead W E, Herman S, Khatri P, Waugh R,
Napolitano M A, Forman L M, Appelbaum M, Doraiswamy P M, Krishnan K R.
Effects of exercise training on older patients with major depression.
Arch Int Med.
1999;
159
2349-2356
- 5
Brookmeyer R, Gray S, Kawas C.
Projections of Alzheimer's disease in the United States and the public health impact
of delaying disease onset.
Am J Public Health.
1998;
88
1337-1342
- 6
Cao Z B, Maeda A, Shima N, Kurata H, Nishizono H.
The effect of a 12-week combined exercise intervention program on physical performance
and gait kinematics in community-dwelling elderly women.
J Physiol Anthropol.
2007;
26
325-332
- 7
Collin C, Wade D T, Davies S, Hoene V.
The Barthel ADL index: a reliability study.
Int Disabil Stud.
1988;
10
61-63
- 8
de Vreede P L, Samson M M, van Meeteren N L, Duursma S A, Verhaar H J.
Functional-task exercise versus resistance strength exercise to improve daily function
in older women: a randomized, controlled trial.
J Am Geriatr Soc.
2005;
53
2-10
- 9
Dvorak R V, Poehlman E T.
Appendicular skeletal muscle mass, physical activity, and cognitive status in patients
with Alzheimer's disease.
Neurology.
1998;
51
1386-1390
- 10
Folstein M, Folstein S E, McHugh P.
Mini-mental state: A practical method for grading the cognitive state of patients
for the clinician.
J Psychiatr Res.
1975;
12
189-198
- 11
Foster C, Cadwell K, Crenshaw B, Dehart-Beverley M, Hatcher S, Karlsdottir A E, Shafer N N,
Theusch C, Porcari J P.
Physical activity and exercise training prescriptions for patients.
Cardiol Clin.
2001;
19
447-457
- 12
Fratiglioni L, Launer L J, Andersen K, Breteler M M, Copeland J R, Dartigues J F,
Lobo A, Martinez-Lage J, Soininen H, Hofman A.
Incidence of dementia and major subtypes in Europe: a collaborative study of population
based cohorts.
Neurology.
2000;
54 (Suppl 5)
S10-S15
- 13
Gotshalk L A, Volek J S, Staron R S, Denegar C R, Hagerman F C, Kraemer W J.
Creatine supplementation improves muscular performance in older men.
Med Sci Sports Exerc.
2002;
34
537-543
- 14
Jones C J, Rikli R E, Beam W C.
A 30-s chair-stand test as a measure of lower body strength in community-residing
older adults.
Res Q Exerc Sport.
1999;
70
113-119
- 15
Katz S, Ford A B, Moskowitz R W, Jackson B A, Jaffe M W.
Studies of illness in the aged. The index of ADL: a standardized measure of biological
and psychosocial function.
JAMA.
1963;
185
914-919
- 16
Knopman D S, Berg J D, Thomas R, Grundman M, Thal L J, Sano M.
Nursing home placement is related to dementia progression: experience from a clinical
trial. Alzheimer's Disease Cooperative Study.
Neurology.
1999;
52
714-718
- 17
Lautenschlanger N T, Almeida O P.
Physical activity and cognition in old age.
Curr Opin Psychiatry.
2006;
19
190-193
- 18
Lobo A, Saz P, Marcos G, Díaz J L, de la Cámara C, Ventura T, Morales Asón F, Fernando
Pascual L, Montañés J A, Aznar S.
Revalidation and standardization of the cognition mini-exam (first Spanish version
of the Mini-Mental Status Examination) in the general geriatric population.
Med Clin (Barc).
1999;
112
767-774
- 19
Logsdon R G, McCurry M S, Teri L.
A home health care approach to exercise for persons with Alzheimer's disease.
Care Manag J.
2005;
6
90-97
- 20
Lucia A, Earnest C, Perez M.
Cancer-related fatigue: how can exercise physiology assist oncologists?.
Lancet Oncol.
2003;
4
616-625
- 21
Magaziner J, Simonsick E M, Kashner T M, Hebel J R, Kenzora J E.
Predictors of functional recovery one year following hospital discharge for hip fracture:
a prospective study.
J Gerontol.
1990;
45
M101-M107
- 22
Mahoney F I, Barthel D W.
Functional evaluation: the Barthel index.
Md State Med J.
1965;
14
61-65
- 23
Mazzetti S A, Kraemer W J, Volek J S, Duncan N D, Tatamess N A, Gomez A L, Newton R U,
Hakkinen K, Fleck S J.
The influence of direct supervision of resistance training on strength performance.
Med Sci Sports Exerc.
2000;
32
1175-1184
- 24
McCartney N, McKelvie R S, Martin J, Sale D G, MacDougall J D.
Weight-training-induced attenuation of the circulatory response of older males to
weight lifting.
J Appl Physiol.
1993;
74
1056-1060
- 25
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan E M.
Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under
the auspices of Department of Health and Human Services Task Force on Alzheimer's
Disease.
Neurology.
1984;
34
939-944
- 26
Nelson M E, Layne J E, Bernstein M J, Nurenberger A, Castaneda C, Kaliton D, Hausdorff J,
Judge J O, Buchner D M, Roubenoff R, Fiatarone Singh M A.
The effects of multidimensional home-based exercise on functional performance in elderly
people.
J Gerontol A Biol Sci Med Sci.
2004;
59
154-160
- 27
Newson S R, Kemps B E.
The influence of physical and cognitive activities on simple and complex cognitive
tasks in older adults.
Exp Aging Res.
2006;
32
341-362
- 28
Prigerson H G.
Costs to society of family caregiving for patients with end-stage Alzheimer's disease.
N Engl J Med.
2003;
349
1891-1892
- 29 Rikli R E, Jones C J. Senior Fitness Test Kit – Updated Edition. Champaign, IL;
Human Kinetics 2007
- 30
Rolland Y, Pillard F, Klapauszczak A, Reynish E, Thomas D, Andrieu S, Rivière D, Vellas B.
Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized,
controlled trial.
J Am Geriatr Soc.
2007;
55
158-165
- 31
Rolland Y, Rival L, Pillard F, Lafont C H, Riviere D, Albarede J-L, Vellas B.
Feasibility of regular physical exercise for patients with moderate to severe Alzheimer
disease.
J Nutr Health Aging.
2000;
4
109-113
- 32
Teri L, Gibbons L E, McCurry S M, Logsdon R G, Buchner D M, Barlow W E.
Exercise plus behavioral management in patients with Alzheimer disease.
JAMA.
2003;
290
2015-2022
- 33
Tinetti M E.
Performance-oriented assessment of mobility problems in elderly patients.
J Am Geriatr Soc.
1986;
34
119-126
- 34
Tinetti M E, Doucette J, Claus E, Marotolli R.
Risk factors for serious injury during falls by older persons in the community.
J Am Geriatr Soc.
1995;
43
1214-1221
- 35
Van Dijk P T, Mehr D R, Ooms M E, Madsen R, Petroski G, Frijters D H, Pot A M, Ribbe M W.
Comorbidity and 1-year mortality risks in nursing home residents.
J Am Geriatr Soc.
2005;
53
660-665
Prof. Alejandro Lucia
Department of Physiology
Universidad Europea De Madrid
Villaviciosa de Odón
28670 Madrid
Spain
Phone: + 34 9 16 64 78 00
Fax: + 34 9 16 16 82 65
Email: alejandro.lucia@uem.es
