Exercise and activity level in Alzheimer's disease: A potential treatment focus

This article provides information on the baseline health and physical funct ion of 30 individuals with Alzheimer's disease (AD); describes a community- based program designed to increase balance, flexibility, strength, and endu rance in these persons by the training of caregivers to facilitate and supe rvise exercise activity; and documents the adherence of these subjects and their caregivers to this intervention. Subjects were recruited from an ongo ing, community-based Alzheimer's Disease Patient Registry, and met NINCDS-A DRDA criteria for probable or possible AD. Caregivers were family members l iving with the demented individuals in the community. Physical performance was measured using walking speed, functional reach, and standing balance. H ealth status was measured with the Medical Outcomes Study Short Form, the S ickness Impact Profile, and caregiver reports of subject's restricted activ ity days, bed disability days, falls, and exercise participation. Baseline data indicated that persons with AD were impaired on measures of physical p erformance and function, compared to published data on nondemented older ad ults. During a 12-wk treatment period, caregivers were taught to guide thei r demented charges in an individualized program of endurance activities (pr imarily walking), strength training, and balance and flexibility exercises. Adherence data indicated that 100% of the subjects were compliant with som e exercise recommendations, and one-third completed all assigned exercises during the training period. Caregivers were able to learn and direct subjec ts during scheduled exercise activities. These findings indicate that the i ntegration of exercise training into the care of persons with AD is both ne eded and feasible. Further research is currently underway to determine the efficacy of this approach for reducing additional physical disability in th ese individuals.