Exercise Four Times a Day Reduces Neuropsychiatric Symptoms in People With Dementia

By Nicholas Chan | April 6th, 2020

Researchers and physicians once thought that people suffering from dementia wouldn’t understand or follow instructions to perform physical exercises, says Dr. Tim Fleiner, an exercise scientist specializing in sport and movement gerontology at German Sport University Cologne and the LVR-Hospital in Cologne. 

Fleiner and his colleagues’ research suggest otherwise. In their latest study, the researchers found that a specialized exercise program alleviates neuropsychiatric symptoms like depression and anxiety in people with dementia. As patients’ symptoms improve, the study shows that caregivers’ burdens are also eased. 

The research group, “geriatric psychiatry in motion,” of the German Sport University Cologne and the LVR-Hospital Cologne conducted a randomized controlled trial in three specialized acute dementia care wards of a psychiatric hospital. 70 patients were divided into an intervention group and a control group. 

Within a two-week study period, the intervention group performed a program called “carrousel-exercise” which includes four short exercise sessions. They performed the exercises twice in the morning and twice in the afternoon. Meanwhile, the control group attended table games for 120 minutes a week in addition to their usual treatment. 

The caregivers assessed the behaviors of their patients and reported their perceived level of burden caused by the patients’ neuropsychiatric symptoms.

Patients who participated in the carrousel-exercise showed significant improvements in neuropsychiatric symptoms compared to the control group. Subsequently, the perceived burden of the patients’ caregivers was also reduced. 

The research team first developed the carrousel-exercise in 2015. Their past studies also showed that the exercise program significantly reduces neuropsychiatric signs. The afternoon exercise sessions are crucial, said Fleiner. While the people with dementia are usually busy with hospital routines in the morning, they experience a ‘sundowning’ phenomenon in the afternoon and evening—periods of the day when their schedules slow down and their agitation increases.

Using physical exercise as a way to treat people with dementia who suffer from neuropsychiatric symptoms like apathy, depression and agitation is an emerging field. Previous research suggests that decline in physical activity is detrimental to the cognition and behavior of people with dementia.  

“The aim is to create a non-pharmacological way,” Fleiner said in an interview with Being Patient. 

After all, the side effects of psychotropic medications may pose major problems for people with dementia who show neuropsychiatric symptoms. A drug called benzodiazepines that’s commonly used to treat anxiety is associated with fall-related injuries like fractures. Research has also shown that the drug is linked to increased risk of pneumonia for people who are newly diagnosed with Alzheimer’s. 

In future studies, the team will examine participants’ circadian rhythm disturbances, a condition when a person’s body clock is out of sync with the day’s cycle. Whether exercise is more beneficial indoors or outdoors, afternoons or evening hours—these are unanswered questions that the research group will soon explore.

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