Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial
Open accessAbstract
Background: Almost all of the 820,000 people in the UK with dementia will experience Behavioural and Psychological Symptoms of Dementia (BPSD). However, research has traditionally focused on treating cognitive symptoms, thus neglecting core clinical symptoms that often have a more profound impact on living with dementia. Recent evidence (Kales et al, 2007; Ballard et al, 2009) indicates that the popular approach to managing BPSD - prescription of anti-psychotic medication - can increase mortality and the risk of stroke in people with dementia as well as impair quality of life and accelerate cognitive decline. Consequently, there is a need to evaluate the impact that non-pharmacological interventions have on BPSD; we believe physical exercise is a particularly promising approach. Methods/Design: We will carry out a pragmatic, randomised, single-blind controlled trial to evaluate the effectiveness of exercise (planned walking) on the behavioural and psychological symptoms of individuals with dementia. We aim to recruit 146 people with dementia and their carers to be randomized into two groups; one will be trained in a structured, tailored walking programme, while the other will continue with treatment as usual. The primary outcome (BPSD) will be assessed with the Neuropsychiatric Inventory (NPI) along with relevant secondary outcomes at baseline, 6 and 12 weeks. Discussion: Designing this study has been challenging both ethically and methodologically. In particular to design an intervention that is simple, measurable, safe, non-invasive and enjoyable has been testing and has required a lot of thought. Throughout the design, we have attempted to balance methodological rigour with study feasibility. We will discuss the challenges that were faced and overcome in this paper. Trial Registration: ISRCTN01423159
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Nonpharmacological alternatives, including music therapy, aromatherapy, art therapy, behavioral therapy, reality orientation, tailored activities, and physical exercises, have shown promising results for the management of BPSD.
“Nonpharmacological alternatives, including music therapy, aromatherapy, art therapy, behavioral therapy, reality orientation, tailored activities, and physical exercises, have shown promising results for the management of BPSD [21–23].”
From Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia: A Systematic Review (2015) · cites this paper as [22]
The Background reports positive effects for music therapy, behavioural interventions and exercise, and the Discussion calls exercise promising for BPSD. The paper does not address aromatherapy, art therapy, reality orientation or tailored activities in the cited list. The supplied passages have section labels but no page numbers. (LLM, conf=0.88)
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Cites
The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A., & Gornbein, J. (1994) · Neurology · doi:10.1212/wnl.44.12.2308 · Cited by 7,568 · see citing works
Borg's Perceived Exertion and Pain Scales
Borg, G. A. V. (1998) · Cited by 3,366 · see citing works
Borg's Perceived Exertion and Pain Scales
Heath, E. M. (1998) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199809000-00018 · Cited by 3,049 · see citing works
The detection of psychiatric illness by questionnaire
Levy, R. (1973) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(73)90039-1 · Cited by 2,707 · see citing works
Bédard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A., & O'Donnell, M. (2001) · The Gerontologist · doi:10.1093/geront/41.5.652 · Cited by 1,691 · see citing works
Uber eine eigenartige Erkrankung der Hirnrinde
Alzheimer, A. (1907) · Medical Entomology and Zoology · Cited by 1,503 · see citing works
Heyn, P., Abreu, B. C., & Ottenbacher, K. J. (2004) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2004.03.019 · Cited by 1,223 · see citing works
Exercise Plus Behavioral Management in Patients With Alzheimer Disease
Teri, L. L., Gibbons, L. E., McCurry, S. M., Logsdon, R. G., Büchner, D. M., Barlow, W. E., Kukull, W. A., LaCroix, A. Z., McCormick, W. C., & Larson, E. B. (2003) · JAMA · doi:10.1001/jama.290.15.2015 · Cited by 765 · see citing works
The Impact of Dementia on the Family
Rabins, P. V. (1982) · JAMA · doi:10.1001/jama.1982.03330030039022 · Cited by 739 · see citing works
Costing psychiatric interventions.
Beecham, J. K., & Knapp, M. R. J. (1992) · Kent Academic Repository (University of Kent) · Cited by 710 · see citing works
Slade, M., & Thornicroft, G. (2025) · doi:10.1093/med/9780198898818.003.0007 · Cited by 679 · see citing works
Smith, S. C., Lamping, D. L., Banerjee, S., Harwood, R., Foley, B., Smith, P. B., Cook, J., Murray, J., Prince, M. J., Levin, E., et al. (2005) · Health Technology Assessment · doi:10.3310/hta9100 · Cited by 651 · see citing works
Finkel, S. I., Miller, S., Silva, J. C. E., Cohen, G. D., & Sartorius, N. (1997) · International Psychogeriatrics · doi:10.1017/s1041610297003943 · Cited by 651 · see citing works
Ballard, C., Hanney, M. L., Theodoulou, M., Douglas, S., McShane, R., Kossakowski, K., Gill, R., Juszczak, E., Yu, L.-M., & Jacoby, R. (2009) · The Lancet Neurology · doi:10.1016/s1474-4422(08)70295-3 · Cited by 567 · see citing works
Predictors of Institutionalization Among Caregivers of Patients With Alzheimer's Disease
Colerick, E. J., & George, L. K. (1986) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1986.tb04239.x · Cited by 393 · see citing works
Mather, A. S., Rodriguez, C., Guthrie, M., McHarg, A. M., Reid, I., & McMurdo, M. E. T. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.180.5.411 · Cited by 370 · see citing works
Grosser, R. C. (1994) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-199407000-00029 · Cited by 311 · see citing works
Behavioral Problems in Dementia: A Factor Analysis of the Neuropsychiatric Inventory
Aalten, P., de Vugt, M. E., Lousberg, R. L., Korten, E. C. C. M., Jaspers, N., Senden-Gijsbers, B. L. M. G., Jolles, J., & Verhey, F. R. J. (2003) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000067972 · Cited by 269 · see citing works
Kales, H. C., Valenstein, M., Kim, H. M., McCarthy, J. F., Ganoczy, D., Cunningham, F., & Blow, F. C. (2007) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2007.06101710 · Cited by 258 · see citing works
Predicting Falls: The Role of Mobility and Nonphysical Factors
Studenski, S. A., Duncan, P. W., Chandler, J., Samsa, G., Prescott, B., Hogue, C. C., & Bearon, L. B. (1994) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1994.tb01755.x · Cited by 245 · see citing works
Exercise training for depressed older adults with Alzheimer's disease
Williams, C. L., & Tappen, R. M. (2008) · Aging & Mental Health · doi:10.1080/13607860701529932 · Cited by 187 · see citing works
Nandy, S., Parsons, S., Cryer, C., Underwood, M. R., Rashbrook, E., Carter, Y., Eldridge, S. M., Close, J., Skelton, D. A., Taylor, S. J., et al. (2004) · Journal of Public Health · doi:10.1093/pubmed/fdh132 · Cited by 158 · see citing works
The impact of dementia on the family
Rabins, P. V. (1982) · JAMA · doi:10.1001/jama.248.3.333 · Cited by 108 · see citing works
Assessment of disruptive behavior/agitation in the elderly: function, methods, and difficulties.
Cohen‐Mansfield, J. (1995) · PubMed · Cited by 86 · see citing works
Jirovec, M. M. (1991) · International Journal of Nursing Studies · doi:10.1016/0020-7489(91)90004-m · Cited by 86 · see citing works
Behavioral and psychological symptoms of dementia (BPSD) : a clinical and research update
Finkel, S. I., & Burns, A. S. (2000) · International Psychogeriatrics · Cited by 45 · see citing works
Livingston, G. (1994) · Springer eBooks · doi:10.1007/978-1-4615-6805-6_2 · Cited by 11 · see citing works
„Health Technology Assessment“
Wild, C. (2006) · Der Anaesthesist · doi:10.1007/s00101-006-0999-2 · Cited by 6 · see citing works
Treatment of behavioural and psychological symptoms in dementia
Hassett, A. M. (2001) · Australian & New Zealand Journal of Psychiatry · doi:10.1046/j.1440-1614.2001.0949g.x · Cited by 5 · see citing works
Basic Clinical Science: Describing a rose with a ruler
Tidswell, M. E. (1995) · Physiotherapy · doi:10.1016/s0031-9406(05)66671-0 · Cited by 3 · see citing works
Basic Clinical Science : Describing a Rose with a Ruler
Rowley, N. (1994) · Cited by 2 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- JED Esquirol 'Mental Maladies: a treatise on insanity' fascimile of the English edition of 1845; published under the auspices of the Library of The New York Academy of Medicine New York: Hafner 1965
Cited by
Sorted by citations
Exercise programs for people with dementia
Forbes, D. A., Forbes, S. C., Blake, C. M., Thiessen, E., & Forbes, S. C. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006489.pub4 · Cited by 693 · see citing works
Oliveira, A. M. D., Radanovic, M., Mello, P. C. H. D., Buchain, P. C., Vizzotto, A. D. B., Celestino, D. L., Stella, F., Piersol, C. V., & Forlenza, O. V. (2015) · BioMed Research International · doi:10.1155/2015/218980 · Cited by 247 · see citing works
The influence of exercise on brain aging and dementia
Lautenschlager, N. T., Cox, K. L., & Cyarto, E. (2011) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2011.07.010 · Cited by 157 · see citing works
Exercise programs for people with dementia
Forbes, D., Thiessen, E. J., Blake, C. M., Forbes, S. C., & Forbes, S. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006489.pub3 · Cited by 154 · see citing works
Pitkälä, K., Savikko, N., Poysti, M., Strandberg, T., & Laakkonen, M.-L. (2013) · Experimental Gerontology · doi:10.1016/j.exger.2012.08.008 · Cited by 152 · see citing works
A Novel and Intelligent Home Monitoring System for Care Support of Elders with Cognitive Impairment
Lazarou, I., Καρακώστας, Α., Stavropoulos, T. G., Tsompanidis, T., Μεδίτσκος, Γ., Kompatsiaris, I. Y., & Tsolaki, M. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-160348 · Cited by 114 · see citing works
Lowery, D., Cerga‐Pashoja, A., Iliffe, S., Thuné‐Boyle, I., Griffin, M., Lee, J., Bailey, A., Bhattacharya, R., & Warner, J. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4062 · Cited by 102 · see citing works
Self-citationThuné-Boyle, I. C. V., Iliffe, S., Cerga-Pashoja, A., Lowery, D., & Warner, J. (2012) · International Psychogeriatrics · doi:10.1017/s1041610211002365 · Cited by 93 · see citing works
Self-citationPrevalence of Frailty in Mild to Moderate Alzheimer's Disease: A Systematic Review and Meta-analysis
Kojima, G., Liljas, A. E. M., Iliffe, S., & Walters, K. R. (2017) · Current Alzheimer Research · doi:10.2174/1567205014666170417104236 · Cited by 80 · see citing works
Self-citationDoes physical activity reduce burden in carers of people with dementia? A literature review
Orgeta, V., & Miranda‐Castillo, C. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4060 · Cited by 68 · see citing works
Physical activity in caregivers: What are the psychological benefits?
Loi, S. M., Dow, B., Ames, D. J., Moore, K. J., Hill, K., Russell, M. A., & Lautenschlager, N. T. (2014) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2014.04.001 · Cited by 65 · see citing works
Use of antipsychotics increases the risk of fracture: a systematic review and meta-analysis
Lee, S.-H., Hsu, W., Lai, C., Esmaily-Fard, A., Tsai, Y.-H., Chiu, C.-C., Wang, J., Chang, S.-S., & Lee, C. (2017) · Osteoporosis International · doi:10.1007/s00198-016-3881-3 · Cited by 66 · see citing works
Nyman, S. R., Adamczewska, N., & Howlett, N. (2017) · British Journal of Health Psychology · doi:10.1111/bjhp.12279 · Cited by 63 · see citing works
Physical exercise for individuals with dementia: potential benefits perceived by formal caregivers
Sampaio, A., Marques‐Aleixo, I., Seabra, A., Mota, J. A. P. S., & Carvalho, J. (2021) · BMC Geriatrics · doi:10.1186/s12877-020-01938-5 · Cited by 52 · see citing works
Park, J., Tolea, M. I., Sherman, D., Rosenfeld, A., Arcay, V., Lopes, Y., & Galvin, J. E. (2019) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/1533317519872635 · Cited by 48 · see citing works
Trivedi, D. P., Braun, A., Dickinson, A. M., Gage, H., Hamilton, L. K., Goodman, C. M., Ashaye, K., Iliffe, S., & Manthorpe, J. (2018) · Dementia · doi:10.1177/1471301218762851 · Cited by 38 · see citing works
Self-citationD’Amico, F., Rehill, A., Knapp, M. R. J., Lowery, D., Pashoja, A. C., Griffin, M., Iliffe, S., & Warner, J. P. (2015) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4376 · Cited by 35 · see citing works
Self-citationFrost, R., McClurg, D., Brady, M., & Williams, B. (2016) · Trials · doi:10.1186/s13063-016-1615-7 · Cited by 31 · see citing works
Cuthbert, C. A., King‐Shier, K. M., Ruether, D., Tapp, D. M., & Culos-Reed, S. N. (2017) · Journal of Physical Activity and Health · doi:10.1123/jpah.2016-0280 · Cited by 27 · see citing works
Berkheimer, S. D., Chen, Q., & Malmstrom, T. K. (2017) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2017.09.009 · Cited by 18 · see citing works
Clinicians as recruiters to dementia trials: lessons from the EVIDEM‐E project
Lowery, D., Warner, J. P., Pashoja, A. C., Thuné‐Boyle, I., & Iliffe, S. (2011) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2671 · Cited by 15 · see citing works
Self-citationfor the DERIVA Group, Rodríguez‐Sánchez, E., Criado, J. M., Mora‐Simón, S., Muriel-Diez, M. P., Gómez-Marcos, M. Á., Recio-Rodriguez, J. I., Patino-Alonso, M. C., Juan, L. F. V., Maderuelo-Fernández, J. Á., et al. (2014) · BMC Neurology · doi:10.1186/1471-2377-14-63 · Cited by 12 · see citing works
Kotting, P. M., Beicher, K., McKeith, I. G., & Rossor, M. N. (2012) · Alzheimer s Research & Therapy · doi:10.1186/alzrt126 · Cited by 9 · see citing works
Körperliche Aktivität und Hirnfunktion
Kempermann, G. (2012) · Der Internist · doi:10.1007/s00108-011-2935-z · Cited by 8 · see citing works
Treatment of Alzheimer's disease in Brazil: II. Behavioral and psychological symptoms of dementia
do Vale, F. D. A. C., Neto, Y. C., Bertolucci, P. H. F., Machado, J. C. B., da Silva, D. J., Allam, N., & Balthazar, M. L. F. (2011) · Dementia & Neuropsychologia · doi:10.1590/s1980-57642011dn05030006 · Cited by 6 · see citing works
Tratamento da doença de Alzheimer
de Assis, F., do Vale, C., Neto, Y. C., Bertolucci, P. H. F., Machado, J. C., da Silva, D. J., Allam, N., & Balthazar, M. L. F. (2011) · Dementia & Neuropsychologia · Cited by 6 · see citing works
Julião, M., Bruera, E. D., Silva, C., Calado, J., Cruz, M., Vaz, M., & Paiva, B. S. R. (2023) · Palliative & Supportive Care · doi:10.1017/s147895152300007x · Cited by 1 · see citing works
Koutrou, N., Bistaraki, A., & Ikramullah, A. (2024) · Sport in Society · doi:10.1080/17430437.2024.2346145 · Cited by 2 · see citing works
Non-Pharmacological Interventions Project: Treatment for Dementia
Richards, M. (2014) · Digital Commons - Gardner-Webb University (Gardner–Webb University)
Threatening to burn the house down
Malhi, N. K., & Kiani, I. A. (2021) · Current Psychiatry · doi:10.12788/cp.0077
- Authors
- Cerga-Pashoja, A., Lowery, D., Bhattacharya, R., Griffin, M., Iliffe, S., Lee, J., Leonard, C., Ricketts, S., Strother, L., Waters, F., Ritchie, C. W., & Warner, J.
- Affiliations
- Central and North West London NHS Foundation Trust (GB)
- Mile End Hospital (GB)
- University College London (GB)
- Avon and Wiltshire Mental Health Partnership NHS Trust (GB)
- Imperial College London (GB)
- Corresponding author
- Warner, James
- Venue
- Trials
- Published
- 2010-05-13
- Volume
- 11
- Issue
- 1
- Pages
- 53-53
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC2881915
- OpenAlex
- W2150039790
- Cited by
- 31
- References
- 31
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 2 · 2019: 1 · 2018: 1 · 2017: 5 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 3
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Trials (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Kent Academic Repository (University of Kent) (submittedVersion)
- Funders
- National Institute for Health and Care Research (ACF-2007-11-006)
- Programme Grants for Applied Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- dementia, behavioral and psychological symptoms of dementia, physical activity, walking program, non-pharmacological treatment, caregivers, Neuropsychiatric Inventory, intervention design, research feasibility
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Exercise Therapy, Humans, Neuropsychological Tests, Quality of Life, Research Design, Single-Blind Method, Walking, Caregivers
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