Structured physical exercise improves neuropsychiatric symptoms in acute dementia care: a hospital-based RCT
Open accessAbstract
BACKGROUND: The primary objective of this trial is to investigate the effects of a short-term exercise program on neuropsychiatric signs and symptoms in acute hospital dementia care. METHODS: Within a hospital-based randomized controlled trial, the intervention group conducted a 2-week exercise program with four 20-min exercise sessions on 3 days per week. The control group conducted a social stimulation program. Effects on neuropsychiatric signs and symptoms were measured via the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change, the Neuropsychiatric Inventory, and the Cohen-Mansfield Agitation Inventory. The antipsychotic and sedative dosage was quantified by olanzapine and diazepam equivalents. RESULTS: Eighty-five patients were randomized via minimization to an intervention group (IG) and a control group (CG). Seventy patients (82%) (mean age 80 years, 33 females, mean Mini Mental State Examination score 18.3 points) completed the trial. As compared to the CG (n = 35), the IG (n = 35) showed significantly reduced neuropsychiatric signs and symptoms. Especially, agitated behavior and lability improved. There were no between-group differences concerning antipsychotic and benzodiazepine medication. CONCLUSIONS: This exercise program is easily applicable in hospital dementia care and significantly reduces neuropsychiatric signs and symptoms in patients suffering from predominantly moderate stages of dementia. TRIAL REGISTRATION: German Clinical Trial Register DRKS00006740 . Registered 28 October 2014.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Exercise reduces behavioral and psychological symptoms of dementia in patients with AD or dementia.
“Exercise has been documented to improve physical health and well-being (33), to reduce behavioral and psychological symptoms of dementia (BPSD) (34–36), and to enhance performance in the activities of daily living (ADL) (37, 38) in patients with AD or dementia.”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [36]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,588 · see citing works
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,406 · see citing works
Hirono, N., Mori, E., Ikejiri, Y., Imamura, T., Shimomura, T., Hashimoto, M., Yamashita, H., & Ikeda, M. (1997) · PubMed · Cited by 21,010 · see citing works
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589 · see citing works
The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons
Podsiadlo, D., & Richardson, S. (1991) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1991.tb01616.x · Cited by 14,418 · cited 1× · see citing works
“The following inclusion criteria were applied: diagnosis of dementia according to ICD-10 [14]; a minimum length of stay of 1 week before enrollment into the study in order to help patients become familiarized with the ward setting and to exclude delirium; clinical exclusion of delirium based on the validated German ve…”
MethodBundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz
(2013) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/103.1437-1588 · Cited by 11,769 · see citing works
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 · cited 1× · see citing works
“Effects on different dimensions of neuropsychiatric signs and symptoms have been rated using the Neuropsychiatric Inventory (NPI) [21] and the Cohen-Mansfield Agitation Inventory (CMAI) [22].”
MethodEffectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S. E., Davis, S. M., Davis, C. E., Lebowitz, B. D., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa051688 · Cited by 5,892 · see citing works
Clarifying Confusion: The Confusion Assessment Method: A New Method for Detection of Delirium
Inouye, S. K., van Dyck, C. H., Alessi, C. A., Balkin, S., Siegal, A. P., & Horwitz, R. I. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-113-12-941 · Cited by 5,250 · see citing works
Exercise and Physical Activity for Older Adults
Chodzko-Zajko, W. J., Proctor, D. N., Fiatarone Singh, M. A., Minson, C. T., Nigg, C. R., Salem, G. J., & Skinner, J. S. (2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181a0c95c · Cited by 5,153 · see citing works
A Description of Agitation in a Nursing Home
Cohen-mansfield, J., Marx, M. S., & Rosenthal, A. S. (1989) · Journal of Gerontology · doi:10.1093/geronj/44.3.m77 · Cited by 1,349 · see citing works
Effectiveness of Atypical Antipsychotic Drugs in Patients with Alzheimer's Disease
Schneider, L. S., Tariot, P. N., Dagerman, K. S., Davis, S. M., Hsiao, J. K., Ismail, M. S., Lebowitz, B. D., Lyketsos, C. G., Ryan, J. M., Stroup, T. S., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa061240 · Cited by 1,206 · see citing works
Living Well with Dementia: A National Dementia Strategy
(2009) · PsycEXTRA Dataset · doi:10.1037/e608082011-001 · Cited by 1,118 · see citing works
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
Schneider, L., Olin, J. T., Doody, R. S., Clark, C. M., Morris, J. C., Reisberg, ., Schmitt, F. A., Grundman, M., Thomas, R. G., & Ferris, S. H. (1997) · Alzheimer Disease & Associated Disorders · doi:10.1097/00002093-199700112-00004 · Cited by 647 · see citing works
Savva, G., Zaccai, J., Matthews, F., Davidson, J., McKeith, I., & Brayne, C. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.108.049619 · Cited by 384 · see citing works
Clinical Handbook of Psychotropic Drugs
Bezchlibnyk-Butler, K. Z., Joel, J. J., & Martin, B. A. (2015) · Hogrefe Publishing eBooks · doi:10.1027/00474-000 · Cited by 314 · see citing works
Saghaei, M., & Saghaei, S. (2011) · Journal of Biomedical Science and Engineering · doi:10.4236/jbise.2011.411090 · Cited by 239 · see citing works
Grill, J. D., & Karlawish, J. H. (2010) · Alzheimer s Research & Therapy · doi:10.1186/alzrt58 · Cited by 196 · see citing works
The more physical inactivity, the more agitation in dementia
Scherder, E. J. A., Bogen, T., Eggermont, L. H. P., Hamers, J. P. H., & Swaab, D. F. (2010) · International Psychogeriatrics · doi:10.1017/s1041610210001493 · Cited by 121 · see citing works
Supervised Exercise to Reduce Agitation in Severely Cognitively Impaired Persons
Aman, E. A., & Thomas, D. R. (2009) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2008.12.053 · Cited by 112 · see citing works
Barreto, P. D. S., Demougeot, L., Pillard, F., Lapeyre‐Mestre, M., & Rolland, Y. (2015) · Ageing Research Reviews · doi:10.1016/j.arr.2015.09.001 · Cited by 109 · see citing works
Effects of Continuous Activity Programming on Behavioral Symptoms of Dementia
Volicer, L., Simard, J., Pupa, J. H., Medrek, R., & Riordan, M. E. (2006) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2006.02.003 · Cited by 109 · see citing works
Stevens, J., & Killeen, M. (2006) · Contemporary Nurse · doi:10.5172/conu.2006.21.1.32 · Cited by 107 · see citing works
Thuné-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
Zuidema, S. U., Buursema, A. L., Gerritsen, M. G. J. M., Oosterwal, K. C., Smits, M. M. M., Koopmans, R. T. C. M., & de Jonghe, J. F. M. (2010) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2499 · Cited by 85 · see citing works
Hestermann, U., Backenstraß, M., Gekle, I., Hack, M., Mundt, C., Oster, P., & Thomas, C. (2009) · Psychopathology · doi:10.1159/000224151 · Cited by 84 · see citing works
Clinical Handbook of Psychotropic Drugs
(2017) · Hogrefe Publishing eBooks · doi:10.1027/00496-000 · Cited by 59 · see citing works
Citalopram for agitation in Alzheimer's disease: Design and methods
Drye, L. T., Ismail, Z., Porsteinsson, A. P., Rosenberg, P. B., Weintraub, D. A., Marano, C. M., Pelton, G. H., Frangakis, C., Rabins, P. V., Munro, C. A., et al. (2012) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2011.01.007 · Cited by 50 · see citing works
Fleiner, T., Leucht, S., Förstl, H., Zijlstra, W., & Häussermann, P. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-160683 · Cited by 43 · see citing works
Self-citationEdwards, N. E., Gardiner, M., Ritchie, D. M., Baldwin, K. M., & Sands, L. P. (2008) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e31818ecbbc · Cited by 37 · see citing works
Matura, S., Carvalho, A. F., Alves, G. S., et al. (2016) · Current Alzheimer Research · doi:10.2174/1567205013666160502123428 · Cited by 34 · see citing works
Joint geriatric and psychiatric wards: a review of the literature
George, J., Adamson, J., & Woodford, H. J. (2011) · Age and Ageing · doi:10.1093/ageing/afr080 · Cited by 31 · see citing works
Zusammenhang zwischen Verschreibungsverhalten der Ärzte und Medikamentenabhängigkeit ihrer Patienten
Holzbach, R., Martens, M., Kalke, J., & Raschke, P. (2010) · Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz · doi:10.1007/s00103-010-1029-8 · Cited by 30 · see citing works
Netz, Y., Yaretzky, A., Salganik, I., Jacob, T., Finkeltov, B., & Argov, E. (1994) · Clinical Gerontologist · doi:10.1300/j018v15n01_06 · Cited by 29 · see citing works
Developing an Interactive Physical Activity Group in a Geriatric Psychiatry Facility
Holliman, D. C., Orgassa, U. C., & Forney, J. P. (2001) · Activities Adaptation & Aging · doi:10.1300/j016v26n01_04 · Cited by 16 · see citing works
Fleiner, T., Zijlstra, W., Dauth, H., & Häussermann, P. (2015) · Trials · doi:10.1186/s13063-015-0758-2 · Cited by 14 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Zucchella, C., Sinforiani, E., Tamburin, S., Federico, A., Mantovani, E., Bernini, S., Casale, R., & Bartolo, M. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.01058 · Cited by 297 · see citing works
- Authors
- Fleiner, T., Dauth, H., Gersie, M., Zijlstra, W., & Haussermann, P.
- Affiliations
- German Sport University Cologne (DE)
- University of Cologne (DE)
- Corresponding author
- Fleiner, Tim
- Venue
- Alzheimer's Research & Therapy
- Published
- 2017-08-29
- Volume
- 9
- Issue
- 1
- Pages
- 68-68
- ISSN
- 1758-9193 (ISSN-L)
- PMC
- PMC5576378
- OpenAlex
- W2753574162
- Cited by
- 48
- References
- 37
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 4
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Alzheimer s Research & Therapy (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- German Sport University Cologne
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- physical activity, neuropsychiatric symptoms, dementia, acute hospital care, agitation, lability, antipsychotic drugs, benzodiazepines, social stimulation, Alzheimer's disease, structured exercise program
- MeSH terms
- Aged, Aged, 80 and over, Dementia, Exercise Therapy, Female, Follow-Up Studies, Hospitalization, Humans, Hypnotics and Sedatives, Male, Mental Status Schedule, Antipsychotic Agents, Exercise, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
