Eijden, D. van (Daniël) (2019) Effects of passive exercise on cognition of institutionalized older adults with dementia and the moderating effect of anticholinergic and sedative drug burden: a randomized controlled trial. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background: People with dementia or Mild Cognitive Impairment show a stronger cognitive- and motor decline compared to cognitively healthy people. Interventions aim at combating this decline. A common intervention to reduce both cognitive- and motor decline is physical activity, but this is not always possible. Cognitive therapy and sensory stimulation may be alternatives, but convincing evidence for their effectiveness is lacking. A more promising alternative is passive exercise in the form of Therapeutic Motion Simulation (TMSim), Whole Body Vibration (WBV) or combined TMSim and WBV. Improvements in cognition were found after WBV in mice and in healthy adults. However, in people with dementia the effects still need to be investigated. Objectives: To examine whether TMSim, WBV and TMSim+WBV have an effect on cognition of older adults (≥65 yrs) with dementia. In addition, to explore whether these effects are moderated by drug intake. Method: A randomized controlled trial (RCT) was performed in 106 institutionalized inactive older adults with dementia ((mean age 85.,2±7.1) yrs, 67,9% female). The participants were randomly assigned to one of the four groups: TMSim, WBV, TMSim + WBV or control group (regular care). Neuropsychological assessments took place at pretest (T0), posttest (T1) and follow-up two weeks after the last intervention (T2). Drug intake was obtained from medical files. Total Drug Burden (TDB) was calculated as the sum of Anticholinergic drug burden (AchDB) and Sedative drug burden (SDB). Results: A time x group interaction effect is found for the Mini Mental State Examination (MMSE) (F(3,67)= 3.771, p<.05) but the observed difference between the intervention groups separately and the control group appeared non-significant by Dunnett planned comparison. For all other seven neuropsychological tests no significant time x group interaction effects were found. Group x time x TDB interaction was examined for all intervention groups versus the control group. Interaction effects (p<.05) of group x time x TDB were present for the Trail Making Test part A (TMT-A), Digit Span Backward (DSB) and Semantic Fluency Test (SFT) with beneficial effects of passive exercise in the low (≤1) TDB group but not in the high (>1) TDB group. Conclusion: Based on this study, the intervention effects are moderated by TDB when looking at working memory, attention and EF. The low TDB intervention groups are improved for the TMT-A, DSB and SFT but no effects were found for the high TDB intervention groups. However, this effect was only found for three tests out of eight and therefore it is recommended to investigate whether this research is replicable. It is also advised to look at the intervention groups separately versus the control group for TDB and if there is a difference between AchDB and SDB.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Heuvelen, dr. M.J.G. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 23 May 2022 07:28 |
| Last Modified: | 23 May 2022 07:28 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3405 |
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