The effect of long-term group rehabilitation on physical performance in community-dwelling people with dementia

Background: Elderly people with dementia are known to be less physically active compared with elderly, healthy people, emphasizing the need for interventions in order to maintain a high level of independence in activities of daily living. In order to meet the multi-facetted needs of people with dementia, also with respect to the dementia-related lack of initiative and motivation, group rehabilitation may have unique advantages beyond those achievable through individual rehabilitation. The aim was to evaluate the effect of long-term, group-based rehabilitation including physical activity on physical performance in elderly, community-dwellingpeople with mild to moderate dementia.
Methods: A cohort study of 18 elderly, community-dwelling people, diagnosed with mild to moderate dementia, participated in an ongoing rehabilitation program based on integrated physical, cognitive and social activities. The outcome measure was physical performance: the 30 sec sit-to-stand test, Guralnik balance test, 10-metre walking speed test, timed 6-metre walk test, and a timed dual task walk test. The repeated measure ANOVA was used to analyze any overall differences between related means.
Results: No significant effect of time was found for the five outcome meaures during the entire period. The variation in the estimate of most outcome scores was higher within subjects than between subjects during the period. Profile plots illustrated that three of the participants, who experienced severe cognitive deterioration, markedly declined in all physical performance tests.
Conclusion: The expected, progressive deterioration in physical performance was delayed in home-dwelling people with mild to moderate dementia who participated in long-term, group-based rehabilitation. The findings of this study indicate that long-term, group-based rehabilitation has the overall potential to delay deterioration in ADL performance in home-dwelling people with mild to moderate dementia.