Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons

Edris Aman, David R. Thomas

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Background: Several studies have shown an improvement in depression, activities of daily living, and agitation in cognitively impaired subjects who undergo a long-term exercise program. These studies have not considered the short-term effects of exercise. Objectives: The purpose of this study was to investigate the short-term effects of a limited, supervised exercise program on agitation, depression, and activities of daily living in cognitively impaired patients residing in the special needs unit of a nursing home. Methods: This study was a prospective comparative study. A 3-week exercise program was implemented at the special needs units of 2 nursing homes. The exercise program involved 30 minutes of exercise (15 minutes of aerobic and 15 minutes of resistance), 3 days per week. There were 50 residents in this study (76% female, 24% male) and they had a mean age of 79.2 ± 9.7 years. The subjects had a mean SLUMS (Saint Louis Mental Status Examination) score of 1.5 ± 2.1 (SLUM score range 0-30, 30 meaning full cognitive faculty). Each subject had his or her depression, agitation, activities of daily living, and 6-meter walk time measured before and after the 3-week exercise program. The Cornell Scale for Depression, Pittsburgh Agitation Scale (PAS)/Cohen-Mansfield Agitation Inventory, and ADCS-ADL (Alzheimer's disease cooperative study-activities of daily living) were used to measure depression, agitation, and activities of daily living, respectively. Multiple paired t tests were calculated for each outcome measurement. Results: The post-study scales showed an improvement in the 6-meter walk test and, using the PAS (0-16, 0 meaning no agitation), an improvement in agitation. The improvement in agitation in the entire population was P less than .05; mean PAS pre-study scores were 5.8 ± 4.8 and mean PAS poststudy scores were 4.5 ± 3.7 . Among the patients with PAS Pre-Exercise Program Scores greater than 3, thus categorized as agitated, there was a greater decrease in agitation; PAS Pre-Study Scores were 9.1 ± 3.4 and PAS Study Scores were 6.1 ± 3.4 (P < .001). There was also an improvement in 6-meter walk times; pre-study times were 12.5 ± 5.2 and post-exercise program times were 10.1 ± 4.4 (P < .001). Conclusion: There was an improvement in agitation scores and the 6-meter walk times in the subjects after their engagement in the 3-week exercise program. Further study is needed in order to expand on these results.

Original languageEnglish (US)
Pages (from-to)271-276
Number of pages6
JournalJournal of the American Medical Directors Association
Volume10
Issue number4
DOIs
StatePublished - May 2009
Externally publishedYes

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Exercise
Activities of Daily Living
Depression
Nursing Homes
Alzheimer Disease
Prospective Studies
Equipment and Supplies
Population

Keywords

  • agitation
  • behavior
  • Cognitively impaired
  • dementia
  • depression
  • exercise

ASJC Scopus subject areas

  • Nursing(all)
  • Health Policy
  • Geriatrics and Gerontology

Cite this

Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons. / Aman, Edris; Thomas, David R.

In: Journal of the American Medical Directors Association, Vol. 10, No. 4, 05.2009, p. 271-276.

Research output: Contribution to journalArticle

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title = "Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons",
abstract = "Background: Several studies have shown an improvement in depression, activities of daily living, and agitation in cognitively impaired subjects who undergo a long-term exercise program. These studies have not considered the short-term effects of exercise. Objectives: The purpose of this study was to investigate the short-term effects of a limited, supervised exercise program on agitation, depression, and activities of daily living in cognitively impaired patients residing in the special needs unit of a nursing home. Methods: This study was a prospective comparative study. A 3-week exercise program was implemented at the special needs units of 2 nursing homes. The exercise program involved 30 minutes of exercise (15 minutes of aerobic and 15 minutes of resistance), 3 days per week. There were 50 residents in this study (76{\%} female, 24{\%} male) and they had a mean age of 79.2 ± 9.7 years. The subjects had a mean SLUMS (Saint Louis Mental Status Examination) score of 1.5 ± 2.1 (SLUM score range 0-30, 30 meaning full cognitive faculty). Each subject had his or her depression, agitation, activities of daily living, and 6-meter walk time measured before and after the 3-week exercise program. The Cornell Scale for Depression, Pittsburgh Agitation Scale (PAS)/Cohen-Mansfield Agitation Inventory, and ADCS-ADL (Alzheimer's disease cooperative study-activities of daily living) were used to measure depression, agitation, and activities of daily living, respectively. Multiple paired t tests were calculated for each outcome measurement. Results: The post-study scales showed an improvement in the 6-meter walk test and, using the PAS (0-16, 0 meaning no agitation), an improvement in agitation. The improvement in agitation in the entire population was P less than .05; mean PAS pre-study scores were 5.8 ± 4.8 and mean PAS poststudy scores were 4.5 ± 3.7 . Among the patients with PAS Pre-Exercise Program Scores greater than 3, thus categorized as agitated, there was a greater decrease in agitation; PAS Pre-Study Scores were 9.1 ± 3.4 and PAS Study Scores were 6.1 ± 3.4 (P < .001). There was also an improvement in 6-meter walk times; pre-study times were 12.5 ± 5.2 and post-exercise program times were 10.1 ± 4.4 (P < .001). Conclusion: There was an improvement in agitation scores and the 6-meter walk times in the subjects after their engagement in the 3-week exercise program. Further study is needed in order to expand on these results.",
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