The 40 patients were randomly allocated to either the
treatment (exercise) group or the control group (usual
treatment). Those in the treatment group participated in
a 4-month at-home exercise programme in addition to
their usual treatment and controls received their usual
treatment only. Those allocated to the control group
were offered training in the exercise programme at the
conclusion of the study. The exercise programme involved
daily home-based exercises and walking, under
the supervision of their carer. The exercise intervention
was based on the Home
Support
Exercise
Program
for the
frail elderly, developed by the Canadian Centre for
Activity and Aging (20) and was adapted for use with
people with dementia by a hospital rehabilitation physiotherapist
(one of the investigators on this study). The
exercise programme incorporates ten simple exercises,
each with three progressively challenging levels, focusing
on upper and lower body strength and balance training
in addition to at least 30 minutes of brisk walking. Participants
were asked to exercise daily if possible. The
programme was trialled in an earlier feasibility and
safety study with 12 people with dementia and was
found to be both feasible and safe. For those in the
exercise group, the person with dementia and their carer
were both trained in the exercise programme and provided
with an exercise manual containing descriptions
and illustrations of the exercises as well as safety
instructions. During the trial, all participants (treatment
and control) received a telephone call at around 2 weeks
and again at 2 months to check on their well-being.
Those who were exercising were also asked about their
progression through the levels of exercising.
Participants (or their carers) provided demographic
information at baseline including years of education,
smoking and alcohol consumption and an estimate of the
number of hours walked per week. Information about age,
gender, duration of memory problems and medications
was retrieved from the hospital patient record. Participants
were assessed on outcome measures at baseline and
4-month follow-up by an assessor blinded as to their
allocation to the treatment or control group. Assessments
were made of cognitive and physical functioning, ADL,
depression and global functional change using standardized
assessment scales (detailed elsewhere). Measures of
height, weight, waist and hip circumference were taken
from which body mass index and waist-to-hip ratio were
calculated. In addition, carers completed a self-reported
assessment of carer burden.