Resistance exercise to reduce risk of falls in people with Alzheimer’s disease: a randomised clinical trial

Abstract

Objectives

To evaluate the impact of resistance exercise on the risk of falls, fear of falling, muscle strength, neuropsychiatric symptoms and ability to perform activities of daily living in people with Alzheimer’s disease (AD).

Design

Single-blinded randomised controlled trial.

Setting

Five aged care centres specialising in AD, located in Andalucía, Spain.

Participants

Sixty people diagnosed with AD were assigned at random to either the intervention group (n = 30) or the control group (n = 30).

Interventions

The intervention group completed three weekly resistance exercise sessions for 12 weeks, in addition to cognitive training, until completion of the study. The control group undertook cognitive training alone.

Main outcome measure

Main outcome measure: risk of falls (Short Physical Performance Battery). Secondary outcomes: muscle strength (hand dynamometry), neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire), fear of falling (Activities-Specific Balance Confidence Scale) and ability to perform activities of daily living (Lawton Instrumental Activities of Daily Living Scale).

Results

The analysis demonstrated differences in favour of the intervention group, in both the short and medium term, for risk of falls [post-treatment: mean difference (MD) 1.5, 95% CI of the difference 0.9 to 2.0; 3-month follow up: MD 1.1, 95% CI of the difference 0.6 to 1.6]; fear of falling (post-treatment: MD 1.5, 95% CI of the difference 4.0 to 7.7; 3-month follow up: MD 6.3, 95% CI of the difference 4.3 to 8.2); activities of daily living (post-treatment: MD 0.2, 95% CI of the difference −0.01 to 0.4; 3-month follow up: MD 0.3, 95% CI of the difference 0.01 to 0.5); neuropsychiatric symptoms (post-treatment: MD −2.2, 95% CI of the difference −3.3 to −1.0; 3-month follow up: MD −2.4, 95% CI of the difference −3.7 to −1.2); and dynamometry (post-treatment: MD 3.1, 95% CI of the difference 2.5 to 3.7; 3-month follow up: MD 2.6, 95% CI of the difference 1.9 to 3.3).

Conclusion

Resistance exercise effectively reduces the risk of falls, fear of falling and neuropsychiatric symptoms, and improves muscle strength in people with AD in both the short and medium term.

Contribution of the Paper

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  Resistance training reduces the risk of falls, fear of falling and neuropsychiatric symptoms in people with AD.
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  Resistance training improves muscle strength in people with AD.
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  The short-term effects of resistance training are maintained in the medium term in people with AD.