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Toots, Annika
Publications (10 of 15) Show all publications
Öhlin, J., Ahlgren, A., Folkesson, R., Gustafson, Y., Littbrand, H., Olofsson, B. & Toots, A. (2020). The association between cognition and gait in a representative sample of very old people - the influence of dementia and walking aid use. BMC Geriatrics, 20, Article ID 34.
Open this publication in new window or tab >>The association between cognition and gait in a representative sample of very old people - the influence of dementia and walking aid use
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2020 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 20, article id 34Article in journal (Refereed) Published
Abstract [en]

Background: Cognition has been related with gait speed in older adults; however, studies involving the oldest age group, where many have mobility disability and cognitive impairment, are few. The aim was to investigate the association between global cognitive function and gait speed in a representative sample of very old people, and whether the association was affected by dementia, and walking aid use.

Method: This cross-sectional study included 1317 participants, mean age 89.4 years, and 68% women, from the Umeå85+/Gerontological Regional Database. Self-paced gait speed was measured over 2.4 m, with or without walking aids, and global cognitive function with the Mini-Mental State Examination (MMSE). The association between cognition and gait speed was analyzed using multiple linear regression and stratified according to dementia. The influence of missing gait speed values was explored using multiple imputation. An interaction analysis was performed to investigate the influence of walking aid use.

Results: In comprehensively adjusted analyses, MMSE associated with gait speed (unstandardized β (β) 0.011 m/s, 95% Confidence Interval [CI] = 0.009, 0.013, p < 0.001) in the total sample. No association was found in people with dementia (β 0.003 m/s, 95%CI = 0.000, 0.006, p = 0.058), until missing gait speed values were compensated for by multiple imputation (β 0.007 m/s, 95% [CI] = 0.002, 0.011, p = 0.002). In interaction analysis the use of walking aids attenuated the association between cognition and gait speed (β − 0.019 m/s, 95%CI = − 0.024, − 0.013, p < 0.001).

Conclusion: Global cognitive function appears to associate with gait speed in very old people. However, in people with dementia selection bias was indicated since unless missing gait speed values were accounted for no association was observed. Walking aid use attenuated cognitive load, which may not apply to walking in daily activities, and requires further investigation.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Gait speed, Cognition, Walking aids, Dementia, Aged 80 and over
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-168829 (URN)10.1186/s12877-020-1433-3 (DOI)000513522000003 ()32005103 (PubMedID)
Funder
Swedish Research Council, K2014-99X-22610-01-6
Available from: 2020-03-19 Created: 2020-03-19 Last updated: 2020-03-19Bibliographically approved
Toots, A., Taylor, M. E., Lord, S. R. & Close, J. C. T. (2019). Associations Between Gait Speed and Cognitive Domains in Older People with Cognitive Impairment. Journal of Alzheimer's Disease, 71, S15-S21
Open this publication in new window or tab >>Associations Between Gait Speed and Cognitive Domains in Older People with Cognitive Impairment
2019 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, p. S15-S21Article in journal (Refereed) Published
Abstract [en]

Background: While gait has been linked with cognition, few studies have contrasted the strength of the relationships between gait speed and cognitive domains in people with cognitive impairment (CI).

Objectives: Investigate the association between gait speed and global cognitive function and cognitive domains in older people with CI.

Method: Three-hundred-and-nine community-dwelling people with CI (mean age 82 years, 47% female, and mean gait speed 0.62 +/- 0.23 m/s) were included using baseline data from the Intervention-Falls in Older Cognitively Impaired Study (iFOCIS). Usual gait speed (m/s) was measured over 2.4 m. Global cognitive function and individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) were assessed using the Addenbrooke's Cognitive Examination-III (ACE-III). Additionally, executive function was assessed using the Frontal Assessment Battery (FAB).

Results: Participants mean f standard deviation ACE-III and FAB scores were 62.8 +/- 19.3 and 11.4 +/- 4.6, respectively. In separate multiple linear regression analyses adjusting for confounders, global cognitive function, and each cognitive domain, was significantly associated with gait speed. Executive function demonstrated the strongest association (FAB: standardized (beta = 0.278, p< 0.001, adjusted R-2 = 0.431), and remained significantly associated with gait speed when adjusted for attention, memory, language, and visuospatial ability.

Conclusion: In this large study of older people with CI, global cognition and each cognitive domain were associated with gait speed. Executive function had the strongest association, possibly reflecting the higher-level cognitive processes and complex motor task responses required for gait control. Future longitudinal studies are needed to explore the temporal relationships between declines in executive function and gait, and whether the facilitation of executive function lessens gait decline.

Place, publisher, year, edition, pages
IOS Press, 2019
Keywords
Aged, cognition, dementia, executive function, gait, walking speed
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-164166 (URN)10.3233/JAD-181173 (DOI)000487075000003 ()31256121 (PubMedID)
Available from: 2019-10-15 Created: 2019-10-15 Last updated: 2019-10-15Bibliographically approved
Toots, A., Wiklund, R., Littbrand, H., Nordin, E., Nordström, P., Lundin-Olsson, L., . . . Rosendahl, E. (2019). The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial. Journal of the American Medical Directors Association, 20(7), 835-842
Open this publication in new window or tab >>The Effects of Exercise on Falls in Older People With Dementia Living in Nursing Homes: A Randomized Controlled Trial
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2019 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 20, no 7, p. 835-842Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate exercise effects on falls in people with dementia living in nursing homes, and whether effects were dependent on sex, dementia type, or improvement in balance. A further aim was to describe the occurrence of fall-related injuries.

DESIGN: A cluster-randomized controlled trial.

SETTING AND PARTICIPANTS: The Umeå Dementia and Exercise study was set in 16 nursing homes in Umeå, Sweden and included 141 women and 45 men, a mean age of 85 years, and with a mean Mini-Mental State Examination score of 15.

INTERVENTION: Participants were randomized to the high-intensity functional exercise program or a seated attention control activity; each conducted 2-3 times per week for 4 months.

MEASURES: Falls and fall-related injuries were followed for 12 months (after intervention completion) by blinded review of medical records. Injuries were classified according to severity.

RESULTS: During follow-up, 118(67%) of the participants fell 473 times in total. At the interim 6-month follow-up, the incidence rate was 2.7 and 2.8 falls per person-year in exercise and control group, respectively, and at 12-month follow-up 3.0 and 3.2 falls per person-year, respectively. Negative binomial regression analyses indicated no difference in fall rate between groups at 6 or 12 months (incidence rate ratio 0.9, 95% confidence interval (CI) 0.5-1.7, P = .838 and incidence rate ratio 0.9, 95% CI 0.5-1.6, P = .782, respectively). No differences in exercise effects were found according to sex, dementia type, or improvement in balance. Participants in the exercise group were less likely to sustain moderate/serious fall-related injuries at 12-month follow-up (odds ratio 0.31, 95% CI 0.10-0.94, P = .039).

CONCLUSIONS/IMPLICATIONS: In older people with dementia living in nursing homes, a high-intensity functional exercise program alone did not prevent falls when compared with an attention control group. In high-risk populations, in which multimorbidity and polypharmacy are common, a multifactorial fall-prevention approach may be required. Encouraging effects on fall-related injuries were observed, which merits future investigations.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Alzheimer disease, Falls, dementia, exercise, fractures, residential facilitie
National Category
Physiotherapy Geriatrics
Identifiers
urn:nbn:se:umu:diva-159680 (URN)10.1016/j.jamda.2018.10.009 (DOI)000472596100008 ()30503589 (PubMedID)
Funder
Swedish Research Council, K2009-69P-21298-01-4Swedish Research Council, K2009-69X-21299-01-1Swedish Research Council, K2009-69P-21298-04-4Swedish Research Council, K2014-99X-22610-01-6Forte, Swedish Research Council for Health, Working Life and WelfareVårdal FoundationThe Dementia Association - The National Association for the Rights of the DementedVästerbotten County Council
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-08-06Bibliographically approved
Toots, A., Taylor, M., Lord, S. & Close, J. (2019). The relationship between cognitive domain function and gait speed in community-dwelling older people with cognitive impairment. Paper presented at ANZSGM 2019 - The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2019 “Geriatric Medicine ‐ Best care to the end”, Adelaide, Australia, May 13th-15th, 2019.. Australasian Journal on Ageing, 38, 29-29
Open this publication in new window or tab >>The relationship between cognitive domain function and gait speed in community-dwelling older people with cognitive impairment
2019 (English)In: Australasian Journal on Ageing, ISSN 1440-6381, E-ISSN 1741-6612, Vol. 38, p. 29-29Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-159612 (URN)000467859100044 ()
Conference
ANZSGM 2019 - The Australian and New Zealand Society for Geriatric Medicine Annual Scientific Meeting 2019 “Geriatric Medicine ‐ Best care to the end”, Adelaide, Australia, May 13th-15th, 2019.
Note

Special Issue. Oral Presentations, OR27.

Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-06-17Bibliographically approved
Nordström, P., Toots, A., Gustafson, Y., Thorngren, K.-G., Hommel, A. & Nordström, A. (2017). Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study. Journal of the American Medical Directors Association, 18(6), 515-521
Open this publication in new window or tab >>Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study
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2017 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 18, no 6, p. 515-521Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age.

DESIGN, SETTING, AND PARTICIPANTS: From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals.

MAIN OUTCOME MEASURE: A new hip fracture.

RESULTS: During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95% CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95% CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95% CI, 0.86-1.05).

CONCLUSION: Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.

Keywords
Hip fractures, bisphosphonates, cohort study, older individuals
National Category
Orthopaedics
Identifiers
urn:nbn:se:umu:diva-134010 (URN)10.1016/j.jamda.2016.12.083 (DOI)000402431200009 ()28238673 (PubMedID)
Available from: 2017-04-25 Created: 2017-04-25 Last updated: 2018-06-09Bibliographically approved
Johansson, H., Lundin-Olsson, L., Littbrand, H., Gustafson, Y., Rosendahl, E. & Toots, A. (2017). Cognitive function and walking velocity in people with dementia: a comparison of backward and forward walking. Gait & Posture, 58, 481-486
Open this publication in new window or tab >>Cognitive function and walking velocity in people with dementia: a comparison of backward and forward walking
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2017 (English)In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 58, p. 481-486Article in journal (Refereed) Published
Abstract [en]

How forward and backward walking, both central to everyday life, relate to cognition are relatively unexplored in people with dementia. This study aimed to investigate if forward and backward walking velocity respectively, associated with global cognition and executive function in people with dementia, and whether the association differed according to walking aid use or dementia type. Using a cross-sectional design, 161 participants (77% women), a mean Mini-Mental State Examination (MMSE) score of 15, and mean age of 85.5 years and living in nursing homes were included. Self-paced forward walking (FW) and backward walking (BW) velocity over 2.4 m was measured. Global cognitive outcome measurements included MMSE and Alzheimer Disease Assessment Scale - Cognitive subscale (ADAS-Cog). Executive function was measured using Verbal Fluency (VF). In comprehensively adjusted multivariate linear regression analyses, FW was independently associated with VF (p = 0.001), but not MMSE (p = 0.126) or ADAS-Cog (p = 0.818). BW was independently associated with VF (p = 0.043) and MMSE (p = 0.022), but not ADAS-Cog (p = 0.519). Interaction analyses showed that the association between BW velocity and executive function were stronger in participants who walked without a walking aid. No associations differed according to dementia type. In conclusion, executive function appears important to walking velocity, both forward and backward, in people with dementia with mild to moderately severe cognitive impairment. Global cognitive function was associated with backward walking only, perhaps due to it being more challenging. The association between BW velocity and executive function differed according to use of walking aids, which appeared to attenuate the association.

Place, publisher, year, edition, pages
Elsevier, 2017
Keywords
Cognition, Walking aids, Frail elderly, Dementia, Walking speed, Nursing homes
National Category
Neurology Orthopaedics Sport and Fitness Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-142473 (URN)10.1016/j.gaitpost.2017.09.009 (DOI)000415234200080 ()28926815 (PubMedID)
Available from: 2017-12-04 Created: 2017-12-04 Last updated: 2018-06-09Bibliographically approved
Toots, A., Littbrand, H., Boström, G., Hörnsten, C., Holmberg, H., Lundin-Olsson, L., . . . Rosendahl, E. (2017). Effects of exercise on cognitive function in older people with dementia: a randomized controlled trial. Journal of alzheimers disease, 60(1), 323-332
Open this publication in new window or tab >>Effects of exercise on cognitive function in older people with dementia: a randomized controlled trial
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2017 (English)In: Journal of alzheimers disease, ISSN 1387-2877, Vol. 60, no 1, p. 323-332Article in journal (Refereed) Published
Abstract [en]

Background: Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia. Objectives: To investigate effects of exercise on cognitive function in people with dementia. Method: The Umea a Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umea, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean MiniMental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity. Blinded assessors measured global cognitive function using the MMSE and the Alzheimer's disease Assessment Scale -Cognitive subscale (ADAS-Cog), and executive function using Verbal fluency (VF) at baseline and 4 months (directly after intervention completion), and MMSE and VF at 7 months. Results: Linear mixed models showed no between-group effects in mean difference from baseline (95% confidence intervals, CI) at 4 months in MMSE (-0.27; 95% CI -1.4 to 0.87, p = 0.644), ADAS-Cog (-1.04, 95% CI -4 to 1.92, p = 0.491), or VF (-0.53, 95% CI -1.42 to 0.35, p = 0.241) or at 7 months in MMSE (-1.15, 95% CI -2.32 to 0.03, p = 0.056) or VF (-0.18, 95% CI -1.09 to 0.74, p = 0.707). Conclusion: A 4-month, high-intensity functional exercise program had no superior effects on global cognition or executive function in people with dementia living in nursing homes when compared with an attention control activity.

Place, publisher, year, edition, pages
IOS Press, 2017
Keywords
Cognition, dementia, exercise, residential facilities
National Category
Physiotherapy Geriatrics
Identifiers
urn:nbn:se:umu:diva-128727 (URN)10.3233/JAD-170014 (DOI)000408582800026 ()28800328 (PubMedID)
Note

Originally published in manuscript form with title [Effects of exercise on cognitive function in older people with dementia: a randomized controlled study]

Available from: 2016-12-13 Created: 2016-12-13 Last updated: 2019-05-17Bibliographically approved
Weidung, B., Toots, A., Nordström, P., Carlberg, B. & Gustafson, Y. (2017). Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umea85+/GERDA. Medicine (Baltimore, Md.), 96(51), Article ID e9161.
Open this publication in new window or tab >>Systolic blood pressure decline in very old individuals is explained by deteriorating health: Longitudinal changes from Umea85+/GERDA
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2017 (English)In: Medicine (Baltimore, Md.), ISSN 0025-7974, E-ISSN 1536-5964, Vol. 96, no 51, article id e9161Article in journal (Refereed) Published
Abstract [en]

Declining systolic blood pressure (SBP) is common in very old age and is associated with adverse events, such as dementia. Knowledge of factors associated with SBP changes could explain the etiology of this decline in SBP. This study investigated longitudinal changes in socioeconomic factors, medical conditions, drug prescriptions, and assessments and their associations with SBP changes among very old followed individuals.The study was based on data from the Umea85+/Gerontological Regional Database (GERDA) cohort study, which provided cross-sectional and longitudinal data on participants aged 85, 90, and 95 years from 2000 to 2015. Follow-up assessments were conducted after 5 years. The main outcome was a change in SBP. Factors associated with SBP changes were assessed using multivariate linear regression models.In the Umea85+/GERDA study, 454 surviving individuals underwent follow-up assessment after 5 years. Of these, 297 had SBP measured at baseline and follow-up. The mean changestandard deviation in SBP was -12 +/- 25mm Hg. SBP decline was associated independently with later investigation year (P=.009), higher baseline SBP (P<.001), baseline antidepressant prescription (P=.011), incident acute myocardial infarction during follow-up (P=.003), new diuretic prescription during follow-up (P=.044), and a decline in the Barthel Activities of Daily Living index at follow-up (P<.001).In conclusion, SBP declines among very old individuals. This decline seems to be associated with initial SBP level, investigation year, and health-related factors.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2017
Keywords
aged 80 and over, cohort effect, cohort studies, hypertension, hypotension, longitudinal studies
National Category
Endocrinology and Diabetes Physiotherapy Other Health Sciences
Identifiers
urn:nbn:se:umu:diva-144360 (URN)10.1097/MD.0000000000009161 (DOI)000422992300035 ()
Available from: 2018-02-02 Created: 2018-02-02 Last updated: 2018-06-09Bibliographically approved
Toots, A., Littbrand, H., Holmberg, H., Nordström, P., Lundin-Olsson, L., Gustafson, Y. & Rosendahl, E. (2017). Walking aids moderate exercise effects on gait speed in people with dementia: a randomized controlled trial. Journal of the American Medical Directors Association, 18(3), 227-233
Open this publication in new window or tab >>Walking aids moderate exercise effects on gait speed in people with dementia: a randomized controlled trial
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2017 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 18, no 3, p. 227-233Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate the effects of exercise on gait speed, when tested using walking aids and without, and whether effects differed according to amount of support in the test.

DESIGN: A cluster-randomized controlled trial.

SETTING: The Umeå Dementia and Exercise (UMDEX) study was set in 16 nursing homes in Umeå, Sweden.

PARTICIPANTS: One hundred forty-one women and 45 men (mean age 85 years) with dementia, of whom 145 (78%) habitually used walking aids.

INTERVENTION: Participants were randomized to the high-intensity functional exercise program or a seated attention control activity.

MEASUREMENTS: Blinded assessors measured 4-m usual gait speed with walking aids if any gait speed (GS), and without walking aids and with minimum amount of support, at baseline, 4 months (on intervention completion), and 7 months.

RESULTS: Linear mixed models showed no between-group effect in either gait speed test at 4 or 7 months. In interaction analyses exercise effects differed significantly between participants who walked unsupported compared with when walking aids or minimum support was used. Positive between-group exercise effects on gait speed (m/s) were found in subgroups that walked unsupported at 4 and 7 months (GS: 0.07, P = .009 and 0.13, P < .001; and GS test without walking aids: 0.05, P = .011 and 0.07, P = .029, respectively).

CONCLUSIONS: In people with dementia living in nursing homes exercise had positive effects on gait when tested unsupported compared with when walking aids or minimum support was used. The study suggests that the use of walking aids in gait speed tests may conceal exercise effects.

Keywords
mobility limitations, residential facilities, alzheimer disease, rehabilitation, frail elderly
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-127495 (URN)10.1016/j.jamda.2016.09.003 (DOI)000398943400008 ()27810267 (PubMedID)
Funder
Swedish Research Council, K2009-69P-21298-01-4Swedish Research Council, K2009-69X-21299-01-1Swedish Research Council, K2009-69P-21298-04-4Swedish Research Council, K2014-99X-22610-01-6Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-0775
Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2019-05-17Bibliographically approved
Toots, A., Littbrand, H., Lindelöf, N., Wiklund, R., Holmberg, H., Nordström, P., . . . Rosendahl, E. (2016). Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia. Journal of The American Geriatrics Society, 64(1), 55-64
Open this publication in new window or tab >>Effects of a High-Intensity Functional Exercise Program on Dependence in Activities of Daily Living and Balance in Older Adults with Dementia
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2016 (English)In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 64, no 1, p. 55-64Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To investigate the effects of a high-intensity functional exercise program on independence in activities of  daily living (ADLs) and balance in older people with dementia and whether exercise effects differed between dementia types.

DESIGN: Cluster-randomized controlled trial: Umeå Dementia and Exercise (UMDEX) study.

SETTING: Residential care facilities, Umeå, Sweden.

PARTICIPANTS: Individuals aged 65 and older with a dementia diagnosis, a Mini-Mental State Examination score of 10 or greater, and dependence in ADLs (N = 186).

INTERVENTION: Ninety-three participants each were allocated to the high-intensity functional exercise program, comprising lower limb strength and balance exercises, and 93 to a seated control activity.

MEASUREMENTS: Blinded assessors measured ADL independence using the Functional Independence Measure (FIM) and Barthel Index (BI) and balance using the Berg Balance Scale (BBS) at baseline and 4 (directly after intervention completion) and 7 months.

RESULTS: Linear mixed models showed no between-group effect on ADL independence at 4 (FIM=1.3, 95% confidence interval (CI)=-1.6-4.3; BI=0.6, 95% CI=-0.2-1.4) or 7 (FIM=0.8, 95% CI=-2.2-3.8; BI=0.6, 95% CI=-0.3-1.4) months. A significant between-group effect on balance favoring exercise was observed at 4 months (BBS=4.2, 95% CI=1.8-6.6). In interaction analyses, exercise effects differed significantly between dementia types. Positive between-group exercise effects were found in participants with non-Alzheimer's dementia according to the FIM at 7 months and BI and BBS at 4 and 7 months.

CONCLUSION: In older people with mild to moderate dementia living in residential care facilities, a 4-month high-intensity functional exercise program appears to slow decline in ADL independence and improve balance, albeit only in participants with non-Alzheimer's dementia.

Keywords
activities of daily living, dementia, exercise, postural balance, residential facilities
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-116818 (URN)10.1111/jgs.13880 (DOI)000371157900009 ()26782852 (PubMedID)
Funder
Swedish Research Council, K2009-69P-21298-01-4Swedish Research Council, K2009-69X-21299-01-1Swedish Research Council, K2009-69P-21298-04-4Swedish Research Council, K2014-99X-22610-01-6
Available from: 2016-02-12 Created: 2016-02-12 Last updated: 2019-05-17Bibliographically approved
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