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Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: A Randomized Controlled Trial.
J Am Med Dir Assoc. 2019 12; 20(12):1502-1508.e1.JA

Abstract

OBJECTIVES

People with dementia are known to be physically frailer, more sedentary, and participate less in regular physical exercise compared to their healthy peers. Physical activity interventions have the potential to reduce the level of frailty in community-dwelling older adults. Exergaming combines physical exercise with cognitive stimulation in a virtual environment. It is an innovative and fun way of exercising, which may aid people with dementia to be more physically active. The primary aim of this study was to investigate the efficacy of a 12-week exergame training and equally long aerobic training, both compared to an active control group, on frailty in people with dementia.

DESIGN

A 3-armed randomized controlled trial compared exergame training, aerobic training, and an active control intervention.

PARTICIPANTS

115 people with dementia [mean (standard deviation [SD]) age = 79.2 (6.9) years; mean (SD) Mini-Mental State Examination score = 22.9 (3.4)].

METHODS

Participants were randomized and individually trained 3 times a week during 12 weeks. The Evaluative Frailty Index for Physical activity (EFIP) was used to assess the level of frailty at baseline and after the 12-week intervention period. Between-group differences were analyzed with analysis of covariance.

RESULTS

The exergame group showed a trend toward higher adherence compared to the aerobic group (87.3% vs 81.1%, P = .05). A significant reduction on the EFIP was found in the exergame group (EG) compared to the active control group (CG) [mean difference (95% confidence interval) between EG and CG: -0.034 [-0.062, -0.007], P = .012], with a small-to-moderate effect size (partial η[2] = 0.055).

CONCLUSIONS AND IMPLICATIONS

This is the first study to show that a 12-week exergame intervention reduces the level of frailty in people with dementia. This is an important and promising result, because frailty is a powerful predictor for adverse health outcomes, and its reduction may have positive effects on health status. Moreover, exergaming resulted in high adherence rates of physical exercise, which makes it an effective strategy to engage people with dementia in physical activity.

Authors+Show Affiliations

Department of Geriatric Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands.BeweegStrateeg, Groningen, the Netherlands; Center for Human Movement Sciences, University Medical Center, University of Groningen, Groningen, the Netherlands.Department of Medical Psychology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.Center for Human Movement Sciences, University Medical Center, University of Groningen, Groningen, the Netherlands.Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Medical Psychology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Center for Cognition, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.Department of Geriatric Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Marcel.OldeRikkert@Radboudumc.nl.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31409559

Citation

Karssemeijer, Esther G A., et al. "Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: a Randomized Controlled Trial." Journal of the American Medical Directors Association, vol. 20, no. 12, 2019, pp. 1502-1508.e1.
Karssemeijer EGA, Bossers WJR, Aaronson JA, et al. Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: A Randomized Controlled Trial. J Am Med Dir Assoc. 2019;20(12):1502-1508.e1.
Karssemeijer, E. G. A., Bossers, W. J. R., Aaronson, J. A., Sanders, L. M. J., Kessels, R. P. C., & Olde Rikkert, M. G. M. (2019). Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: A Randomized Controlled Trial. Journal of the American Medical Directors Association, 20(12), 1502-e1. https://doi.org/10.1016/j.jamda.2019.06.026
Karssemeijer EGA, et al. Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: a Randomized Controlled Trial. J Am Med Dir Assoc. 2019;20(12):1502-1508.e1. PubMed PMID: 31409559.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exergaming as a Physical Exercise Strategy Reduces Frailty in People With Dementia: A Randomized Controlled Trial. AU - Karssemeijer,Esther G A, AU - Bossers,Willem J R, AU - Aaronson,Justine A, AU - Sanders,Lianne M J, AU - Kessels,Roy P C, AU - Olde Rikkert,Marcel G M, Y1 - 2019/08/10/ PY - 2019/03/22/received PY - 2019/06/18/revised PY - 2019/06/24/accepted PY - 2019/8/15/pubmed PY - 2020/11/11/medline PY - 2019/8/15/entrez KW - Cognition KW - dementia KW - exercise KW - exergaming KW - frailty KW - randomized controlled trial SP - 1502 EP - 1508.e1 JF - Journal of the American Medical Directors Association JO - J Am Med Dir Assoc VL - 20 IS - 12 N2 - OBJECTIVES: People with dementia are known to be physically frailer, more sedentary, and participate less in regular physical exercise compared to their healthy peers. Physical activity interventions have the potential to reduce the level of frailty in community-dwelling older adults. Exergaming combines physical exercise with cognitive stimulation in a virtual environment. It is an innovative and fun way of exercising, which may aid people with dementia to be more physically active. The primary aim of this study was to investigate the efficacy of a 12-week exergame training and equally long aerobic training, both compared to an active control group, on frailty in people with dementia. DESIGN: A 3-armed randomized controlled trial compared exergame training, aerobic training, and an active control intervention. PARTICIPANTS: 115 people with dementia [mean (standard deviation [SD]) age = 79.2 (6.9) years; mean (SD) Mini-Mental State Examination score = 22.9 (3.4)]. METHODS: Participants were randomized and individually trained 3 times a week during 12 weeks. The Evaluative Frailty Index for Physical activity (EFIP) was used to assess the level of frailty at baseline and after the 12-week intervention period. Between-group differences were analyzed with analysis of covariance. RESULTS: The exergame group showed a trend toward higher adherence compared to the aerobic group (87.3% vs 81.1%, P = .05). A significant reduction on the EFIP was found in the exergame group (EG) compared to the active control group (CG) [mean difference (95% confidence interval) between EG and CG: -0.034 [-0.062, -0.007], P = .012], with a small-to-moderate effect size (partial η[2] = 0.055). CONCLUSIONS AND IMPLICATIONS: This is the first study to show that a 12-week exergame intervention reduces the level of frailty in people with dementia. This is an important and promising result, because frailty is a powerful predictor for adverse health outcomes, and its reduction may have positive effects on health status. Moreover, exergaming resulted in high adherence rates of physical exercise, which makes it an effective strategy to engage people with dementia in physical activity. SN - 1538-9375 UR - https://www.unboundmedicine.com/medline/citation/31409559/Exergaming_as_a_Physical_Exercise_Strategy_Reduces_Frailty_in_People_With_Dementia:_A_Randomized_Controlled_Trial_ DB - PRIME DP - Unbound Medicine ER -