P4-345: Positive changes in multiple dimensions of dementia following a 16-week resistance exercise intervention

Previous studies of functional interventions in the elderly have tended to exclude either depressed or cognitively impaired subjects. To measure the impact of resistance exercise on parameters of mood and function in demented subjects. Subjects previously diagnosed with dementia were recruited from an Alzheimer's Boarding Home in rural New England, USA and randomized into either a 16–week resistance exercise intervention (RE) (N=12) or provided with care–as–usual (CaU) (N=12). RE was performed by trained boarding home staff using Therabands three times a week. Cognition, overall function and depression were assessed using the Folstein Mini–Mental Status Exam (MMSE), the Clinical Dementia Rating Scale (CDR) sum–of–boxes method and the Dementia Mood Assessment Scale (DMAS) respectively. The CaU group was 78.9 +/– 6.4 (SD) years old (average MMSE 11.17). The RE group was 83.4 +/– 9.1(SD) years old (average MMSE, 15.33). 25% of the CaU group had an improvement in their depression scores, compared to 50% of the RE group with average changes on the DMAS of 9.0+/– 4.6 SEM and –2.5 +/– 3.8, respectively. 16.7% of the CaU group vs. 41.7% of those in the RE group showed an improvement in CDR, with average changes of 3.8 +/– 1.4 SEM (CaU) and 1.4 +/– 1.4 SEM (RE). 0/12 CaU subjects improved in both spheres, compared to 2/12 of the RE group. Overall 75% of those in the RE group improved in one or both spheres, compared to 42% of the CaU group. In those subjects that declined in both spheres, the 3 subjects from the RE group had similar outcomes to the 7 CaU subjects. Resistance exercise improved function and mood compared to care–as–usual in subjects with dementia. Improved mood scores tended to parallel improved functional scores in the RE group. Significant accumulation of depressive symptoms may overwhelm any functional benefit in some subjects regardless of the intervention. Functional improvement occurred at times despite worsening depressive symptoms. Resistance exercise shows benefits over multiple domains in dementia, and is possible to accomplish in the real–world setting of residential dementia care.