Feasibility of reducing frailty components in older adults with Alzheimer's dementia: a randomized controlled home-based exercise trial (AD-HOMEX).

Autor: Cezar NOC; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil; Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil. Electronic address: nataliaoiring@yahoo.com.br., Aprahamian I; Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine of Jundiaí, Jundiaí, Brazil; Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Ansai JH; Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil., de Oliveira MPB; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil., da Silva DCP; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil., Gomes WL; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil., Barreiros BA; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil., Langelli TCO; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil., de Andrade LP; Department of Physical Therapy, Federal University of São Carlos, São Carlos, Brazil.
Jazyk: angličtina
Zdroj: Experimental gerontology [Exp Gerontol] 2021 Jul 15; Vol. 150, pp. 111390. Date of Electronic Publication: 2021 May 05.
DOI: 10.1016/j.exger.2021.111390
Abstrakt: Objectives: There is a need for interventions to reduce frailty in older people with Alzheimer's dementia (AD). The purpose of this study was to investigate the effect of a home-based multimodal exercise program for older adults with AD (AD-HOMEX) on frailty.
Design: A parallel single-blind randomized controlled trial comparing a home-based exercise program and usual care.
Setting and Participants: A home-based program in Brazil. Forty individuals aged 65years or older with mild to moderate AD.
Methods: The intervention group (IG) participated in a 16-week protocol involving three 60-minute sessions per week of progressive individualized physical exercises supervised by a physical therapist. The participants in the control group (CG) maintained their usual care. Frailty was assessed using the FRAIL questionnaire, the Edmonton Frail Scale (EFS) and a subjective assessment by the evaluator (SAE) at baseline and follow-up. Per-protocol analysis was performed.
Results: Thirty-five participants completed the program (IG = 16; CG = 19). Frailty improved in the IG based on the EFS (P = .004) and FRAIL (P ≤ .001). An interaction between group and time (P = .008) and a significant difference between times (P = .047) were found for the SAE responsiveness domain. An improvement in the classification of frailty (EFS and FRAIL) was found between times in the IG (P = .003) and between groups at follow-up (P = .027). A significant difference in the SAE classification was found between groups at follow-up (P = .034), with a worsening between times in the CG (P = .032). Interestingly, a more favorable frailty transition pattern was found in the IG based on both the EFS and FRAIL.
Conclusions and Implications: AD-HOMEX seems to reduce frailty and improve frailty transition patterns. Our findings provide a further theoretical basis for designing home-based physical interventions as routine practice for older frail adults with AD.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: