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Therapeutic Effects of Exercise Training on Elderly Patients With Dementia: A Randomized Controlled Trial

  • I-Ting Liu
    Affiliations
    Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan
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  • Wei-Ju Lee
    Affiliations
    Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan
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  • Shih-Yi Lin
    Affiliations
    Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
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  • Shin-Tsu Chang
    Affiliations
    Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan

    Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei, Taiwan

    School of Medicine, National Defense Medical Center, Taipei, Taiwan

    School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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  • Chung-Lan Kao
    Affiliations
    Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan

    School of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Yuan-Yang Cheng
    Correspondence
    Corresponding author Yuan-Yang Cheng, PhD, Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Blvd, Taichung 40705, Taiwan.
    Affiliations
    Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan

    Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan

    School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Published:February 18, 2020DOI:https://doi.org/10.1016/j.apmr.2020.01.012

      Highlights

      • Strength training can bring significant improvements in Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in elderly patients with dementia.
      • Aerobic training can bring significant improvements in Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, plasma monocyte chemotactic protein-1, and serum brain-derived neurotrophic factor levels in elderly patients with dementia.
      • The degree of improvement in Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, plasma monocyte chemotactic protein-1, and serum brain-derived neurotrophic factor levels did not achieve statistical significant difference between groups.

      Abstract

      Objective

      To investigate whether strength or aerobic training can offer significantly more benefits with regarding the activities of daily living of elderly patients with dementia as well as to determine the effects of exercise on cognition, depression, and biochemical markers.

      Design

      Single-blind randomized controlled trial.

      Setting

      A nursing home for veterans.

      Participants

      A volunteer sample of participants (N=80) whose scores on the Mini-Mental State Examination were between 15 and 26 were included. Because of cardiopulmonary or orthopedic conditions that prohibit exercise training, along with any cognitive problems that may impede answering the contents of our questionnaires, 11 participants were excluded. During the exercise training period, 8 participants voluntarily dropped out of the study.

      Interventions

      The participants were randomly assigned to perform either strength or aerobic training for a total of 4 weeks.

      Main Outcome Measures

      The main outcome measure was the Barthel Index. Other outcome measures included the Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale, plasma monocyte chemotactic protein-1 levels, insulin-like growth factor-1 levels, and serum brain-derived neurotrophic factor levels.

      Results

      After completion of the program, we discovered a significant improvement in the patients’ Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in the strength-training group. For the patients who had received aerobic training, their serum brain-derived neurotrophic factor also improved significantly. However, the degree of improvement regarding these outcome measures did not achieve significant statistical difference between the 2 groups.

      Conclusions

      Through our study, an intensive 4-week exercise program, whether it be strength or aerobic training, is evidenced to bring significant benefits to elderly patients with dementia, while the serum brain-derived neurotrophic factor was additionally improved through aerobic training.

      Keywords

      List of abbreviations:

      ADL (activities of daily living), BDNF (brain-derived neurotrophic factor), CCI (Charlson Comorbidity Index), GDS (Geriatric Depression Scale), IGF-1 (insulin-like growth factor-1), MCP-1 (monocyte chemotactic protein-1), MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment)
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