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Aquatic exercise for residential aged care adults with dementia: benefits and barriers to participation

Published online by Cambridge University Press:  05 May 2017

Timothy Henwood*
Affiliation:
School of Nursing and Midwifery, The University of Queensland, Brisbane, Qld, Australia Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia AgeFIT Solutions, Brisbane, Qld, Australia
Christine Neville
Affiliation:
School of Nursing and Midwifery, The University of Queensland, Brisbane, Qld, Australia
Chantelle Baguley
Affiliation:
School of Nursing and Midwifery, The University of Queensland, Brisbane, Qld, Australia
Elizabeth Beattie
Affiliation:
School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia
*
Correspondence should be addressed to: Dr Timothy Henwood, The University of Queensland, Brisbane Qld 4305, Australia. Phone: +61 7 424078209. Email: [email protected].

Abstract

Background:

Pilot work by our group has demonstrated that aquatic exercise has valuable functional and psychosocial benefits for adults living in the residential aged care setting with dementia. The aim of the currents study was to advance this work by delivering the Watermemories Swimming Club aquatic exercise program to a more representative population of older, institutionalized adults with dementia.

Methods:

The benefits of 12 weeks of twice weekly participation in the Watermemories Swimming Club aquatic exercise program were assessed among an exercise and usual care control group of residential aged care adults with advanced dementia. A battery of physical and psychosocial measures were collected before and after the intervention period, and program implementation was also investigated.

Results:

Seven residential aged care facilities of 24 approached, agreed to participate and 56 residents were purposefully allocated to exercise or control. Twenty-three participants per group were included in the final analysis. Both groups experienced decreases in skeletal muscle index and lean mass (p < 0.001), but exercise stifled losses in muscle strength and transition into sarcopenic. Behavioral and psychological symptoms of dementia and activities of daily living approached significance (p = 0.06) with positive trends observed across other psychosocial measures.

Conclusions:

This study demonstrates the value of exercise participation, and specifically aquatic exercise in comparison to usual care for older, institutionalized adults with advanced dementia. However, it also highlights a number of barriers to participation. To overcome these barriers and ensure opportunity to residents increased provider and sector support is required.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell scale for depression in dementia. Biological Psychiatry, 23, 271284.CrossRefGoogle ScholarPubMed
Alzhiemer's Australia NSW. (2014). The benefits of Physical activity and exercsie for people living with dementia. NSW. Available at: https://nsw.fightdementia.org.au/nsw/news/the-benefits-of-physical-activity-and-exercise-for-people-living-with-dementia; last accessed August 18, 2016.Google Scholar
Alzhiemer's Disease International. (2010). World Alzheimer Report 2010 The Global Economic Impact of Dementia. London: Alzhiemer's Disease International.Google Scholar
Australain Government (2014). Water Therapy. Available at: http://www.aacqa.gov.au/for-providers/2014-better-practice-award-winners/water-therapy; last accessed November 2015.Google Scholar
Australian Insitute of Health and Welfare. (2012). Dementia in Australia. Canberra: AIHW.Google Scholar
Barnes, D. E., Whitmer, R. A. and Yaffe, K. (2007). Physical activity and dementia: the need for prevention trials. Exercise and Sports Science Reviews, 35, 2429.Google Scholar
Bonnefoy, M. et al. (2003). The effects of exercise and protein-energy supplements on body composition and muscle function in frail elderly individuals: a long-term controlled randomised study. British Journal of Nurition, 89, 731739.Google Scholar
Brett, L., Traynor, V. and Stapley, P. (2016). Effects of physical exercise on health and well-being of individuals living with a dementia in nursing homes: a systematic review. Journal of the American Medical Directors Association, 17, 104116.Google Scholar
Burge, E., Kuhne, N., Berchtold, A., Maupetit, C. and Von, G. A. (2012). Impact of physical activity on activity of daily living in moderate to severe dementia: a critical review. European Review of Aging and Physical Activity, 9, 2739.CrossRefGoogle ScholarPubMed
Burgener, S. C., Jirovec, M., Murrell, L. and Barton, D. (1992). Caregiver and environmental variables related to difficult behaviors in institutionalized, demented elderly persons. Journals of Gerontology, 47, P242P249.Google Scholar
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, Hillsdale, N.J.: L. Erlbaum Associates.Google Scholar
Conradsson, M., Littbrand, H., Bostrom, G., Lindelof, N., Gustafson, Y. and Rosendahl, E. (2013). Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities? Clinical Interventions in Aging, 8, 15611568.Google Scholar
Cruz-Jentoft, A. J. et al. (2010). Sarcopenia: European consensus on definition and diagnosis: report of the European working group on Sarcopenia in older people. Age and Ageing, 39, 412423.Google Scholar
Dewing, J. (2010). Responding agitation in people with dementia. Nursing in Older People, 22, 1825.Google Scholar
Fiatarone, M. A. et al. (1994). Exercise training and nutritional supplementation for physical frailty in very elderly people. New England Journal of Medicine, 330, 17691775.CrossRefGoogle ScholarPubMed
Fiatarone, M. A., Marks, E. C., Ryan, N. D., Meredith, C. N., Lipsitz, L. A. and Evans, W. J. (1990). High-intensity strength training in nonagenarians. Effects on skeletal muscle. Journal of the American Medical Association, 263, 30293034.Google Scholar
Goldberg, L. R. et al. (2014). Hydration in older adults: the contribution of bioelectrical impedance analysis. International Journal of Speech and Language Pathology, 16, 273281.Google Scholar
Goss, J. (2008). Projection of Australain Health Care Expenditure by Disease, 2003 to 2033. Canberra: AIHW.Google Scholar
Guralnik, J. M. et al. (1994). A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. Journals of Gerontology, 49, M85M94.CrossRefGoogle Scholar
Haines, T., Kuys, S. S., Morrison, G., Clarke, J., Bew, P. and Mcphail, S. (2007). Development and validation of the balance outcome measure for elder rehabilitation. Archives of Physical and Medical Rehabilitation, 88, 16141621.CrossRefGoogle ScholarPubMed
Hancock, G. A., Woods, B., Challis, D. and Orrell, M. (2006). The needs of older people with dementia in residential care. International Journal of Geriatric Psychiatry, 21, 4349.Google Scholar
Henwood, T., Baguley, C. and Neville, C. (2015a). Achieving ethics approval in residential aged care research: a protective process or barrier. Australasian Journal on Ageing, 34, 201.Google Scholar
Henwood, T., Neville, C., Baguley, C., Clifton, K. and Beattie, E. (2015b). Physical and functional implications of aquatic exercise for nursing home residents with dementia. Geriatric Nurings, 36, 3539.Google Scholar
Heyn, P., Abreu, B. C. and Ottenbacher, K. J. (2004). The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Archives of Physical and Medical Rehabilitation, 85, 16941704.Google Scholar
Janssen, I., Heymsfield, S. B., Baumgartner, R. N. and Ross, R. (2000). Estimation of skeletal muscle mass by bioelectrical impedance analysis. Journal of Applied Physiology, 89, 465471.Google Scholar
Jorm, A. F. et al. (1995). The psychogeriatric assessment scales - a multidimensional alternative to categorical diagnoses of dementia and depression in the elderly. Psychological Medicine, 25, 447460.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. (1963). Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA, 185, 914919.Google Scholar
Laurin, D., Verreault, R., Lindsay, J., Macpherson, K. and Rockwood, K. (2001). Physical activity and risk of cognitive impairment and dementia in elderly persons. Archives of Neurology, 58, 498504.CrossRefGoogle ScholarPubMed
Littbrand, H., Stenvall, M. and Rosendahl, E. (2011). Applicability and effects of physical exercise on physical and cognitive functions and activities of daily living among people with dementia: a systematic review. American Journal of Physical and Medical Rehabilitation, 90, 495518.Google Scholar
Liu-Ambrose, T. and Donaldson, M. G. (2009). Exercise and cognition in older adults: is there a role for resistance training programmes? British Journal of Sports Medicine, 43, 2527.Google Scholar
Miranda-Castillo, C., Woods, B. and Orrell, M. (2010). People with dementia living alone: what are their needs and what kind of support are they receiving? International Psychogeriatrics, 22, 607617.Google Scholar
Neville, C., Clifton, K., Henwood, T., Beattie, E. and Mckenzie, M. A. (2013). Watermemories a swimming club for adults with dementia. Journal of Gerontological Nursing, 39, 2125.CrossRefGoogle ScholarPubMed
Neville, C. and Henwood, T. (2013). Watermemories: A Swimming Club for People With Dementia: A Manual for Aged Care Service Provider and Program Instructors. Brisbane, Australia: University of Queensland Press.Google Scholar
Neville, C., Henwood, T., Beattie, E. and Fielding, E. (2014). Exploring the effect of aquatic exercise on behaviour and psychological well-being in people with moderate to severe dementia: a pilot study of the Watermemories swimming club. Australasian Journal on Ageing, 33, 124127.CrossRefGoogle ScholarPubMed
Neville, C., Henwood, T., Clifton, K. and Beattie, E. (2012). The watermemories swim club for people with dementia. Journal of Aging and Physical Activity, 20, S8S9.Google Scholar
Ouslander, J. G. et al. (2011). Interventions to reduce hospitalizations from nursing homes: evaluation of the INTERACT II collaborative quality improvement project. Journal of the American Geriatric Society, 59, 745753.CrossRefGoogle ScholarPubMed
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the geriatric anxiety inventory. International Psychogeriatrics, 19, 103114.Google Scholar
Reisberg, B. (1988). Functional assessment staging (FAST). Psychopharmacolical Bulliten, 24, 653659.Google Scholar
Scherder, E. J., Bogen, T., Eggermont, L. H., Hamers, J. P. and Swaab, D. F. (2010). The more physical inactivity, the more agitation in dementia. 22, 12031208.Google ScholarPubMed
Smith, P. (2003). Waterworks. Working with Older People, 7, 3940.Google Scholar
Teri, L. et al. (2003). Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA, 290, 20152022.Google Scholar
Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S. and Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist. Psychological Aging, 7, 622631.CrossRefGoogle ScholarPubMed
Thune-Boyle, I., Lliffe, S., Cerga-Pashoja, A., Lowery, D. and Warner, J. (2012). The effect of exercise on behavioral and psychological symptoms of dementia: towards a research agenda. International Psychogeriatrics 24, 10461057.Google Scholar
Tilden, V. P., Thompson, S. A., Gajewski, B. J., Buescher, C. M. and Bott, M. J. (2013). Sampling challenges in nursing home research. Journal of the American Medical Directors Association, 14, 2528.Google Scholar
Williams, C. L. and Tappen, R. M. (2007). Effect of exercise on mood in nursing home residents with Alzheimer's disease. American Journal of Alzheimers Disease and Other Demenia's, 22, 389397.CrossRefGoogle ScholarPubMed