Dementia, Exercise and Falls Prevention
“There is promising evidence that exercise programs may improve the ability to perform ADLs in people with dementia….” forbes, Forbes and Blake et al
“In further analyses, in one trial we found that the burden experienced by informal caregivers providing care in the home may be reduced when they supervise the participation of the family member with dementia in an exercise program. “Forbes, Forbes and Blake et al
“Exercise training increases fitness, physical function, cognitive function, and positive behavior in people with dementia and related cognitive impairments”. Heyn, Abreu et al
Each Contact Period – an introduction, a re-introduction
Assess for mood, physical and mental capability, remembrance, cognisance, physical health, determining if recovered from last training session, any sore areas since last session.
Use of Name Badges but associated with the non-familiarity or familiarity of each training venue.
Referencing past achievements to stimulate thinking, conversation and comfort.
Commentary and observations on local and common interests.
Prompt for and encourage a thinking process.
Exercise
Targeting exercises that replicate and support daily lifestyle needs, prevent falls or lessen impact of falls.
Test for joint Integrity, muscle flexibility, endurance, strength, confidence, balance capability, core strength.
Exercises broken down into basic singular joint movements. Isolationist movements to begin, then joining those movements to make a two joint compound movement.
Then over time further link the movements together to create and install instinctive habits.
Habit Forming – Creating Instinctive Reactions
Relates to the concept of body and core reaction that is subject to a stimulus. Presetting the core before and in anticipation of a stimulus. Creating a habit to support and develop movement patterns which can occur instinctively.
Getting out of bed – automatic that some muscle reacts from habit to create movement. Can this be developed for clients with Dementia?
Falls prevention
The main positive effects suggested for exercise are:
less or slower cognitive and behavioral impairment or decline,
less development of health-associated conditions (stress, sleep),
reduction of dementia risk factors including chronic non-communicable disease (diabetes, cardiovascular disease),
increase in neurotrophins, enhancement of brain blood flow, angiogenesis, neurogenesis, synaptogenesis and synaptic plasticity in the brain memory-related region (e.g., hippocampus), and reduction of neuroinflammation and apoptosis.
that exercise stabilises choline levels. Studies have found that choline levels influence cognitive capacity.
Further research is needed to determine the type of exercise most beneficial and to clarify the specific outcomes required to provide most benefit for dementia patients.
“….designing standard clinical and experimental studies to reveal the correlation between physical activity and dementia sign and symptom ………………..is necessary for preparation of effective guidelines and recommendations”. Gholamnezhad, Boskabady & Jahangiri
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006489.pub4/full
https://www.sciencedirect.com/science/article/abs/pii/S0003999304003971
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2007-964853
https://www.bmj.com/content/361/bmj.k1675
https://link.springer.com/chapter/10.1007/978-981-15-1792-1_20
https://www.bunzlcatering.co.uk/what-are-nootropics-and-what-foods-do-they-appear-in/
https://www.dementia.org.au/support-and-services/families-and-friends/personal-care/nutrition
https://www.alz.org/help-support/caregiving/daily-care/food-eating#:~:text=Offer%20vegetables%2C%20fruits%2C%20whole%20grains,and%20fatty%20cuts%20of%20meats.
https://www.nia.nih.gov/health/what-do-we-know-about-diet-and-prevention-alzheimers-disease
https://www.sciencedirect.com/science/article/pii/S026156141500237X