Exercise Plus Behavioral Management in Patients With Alzheimer Disease: A Randomized Controlled Trial

• Published in: JAMA : the journal of the American Medical Association 2003-10, Vol.290 (15), p.2015-2022
• Main Authors: Teri, Linda, Gibbons, Laura E, McCurry, Susan M, Logsdon, Rebecca G, Buchner, David M, Barlow, William E, Kukull, Walter A, LaCroix, Andrea Z, McCormick, Wayne, Larson, Eric B
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Alzheimer Disease - physiopathology; Alzheimer Disease - psychology; Alzheimer Disease - rehabilitation; Behavior Therapy; Biological and medical sciences; Caregivers - education; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Depression; Exercise Therapy; Female; Humans; Male; Medical sciences; Middle Aged; Neurology; Outcome Assessment (Health Care); Psychiatric Status Rating Scales; Sickness Impact Profile
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.290.15.2015

CONTEXT Exercise training for patients with Alzheimer disease combined with teaching caregivers how to manage behavioral problems may help decrease the frailty and behavioral impairment that are often prevalent in patients with Alzheimer disease. OBJECTIVE To determine whether a home-based exercise program combined with caregiver training in behavioral management techniques would reduce functional dependence and delay institutionalization among patients with Alzheimer disease. DESIGN, SETTING, AND PATIENTS Randomized controlled trial of 153 community-dwelling patients meeting National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer Disease and Related Disorders Association criteria for Alzheimer disease, conducted between June 1994 and April 1999. INTERVENTIONS Patient-caregiver dyads were randomly assigned to the combined exercise and caregiver training progam, Reducing Disability in Alzheimer Disease (RDAD), or to routine medical care (RMC). The RDAD program was conducted in the patients' home over 3 months. MAIN OUTCOME MEASURES Physical health and function (36-item Short-Form Health Survey's [SF-36] physical functioning and physical role functioning subscales and Sickness Impact Profile's Mobility subscale), and affective status (Hamilton Depression Rating Scale and Cornell Depression Scale for Depression in Dementia). RESULTS At 3 months, in comparison with the routine care patients, more patients in the RDAD group exercised at least 60 min/wk (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.25-6.39; P = .01) and had fewer days of restricted activity (OR, 3.10; 95% CI, 1.08-8.95; P