Promoting independence in Lewy body dementia through exercise: the PRIDE study
Abstract Background Lewy body dementia (LBD) is an aggressive type of dementia of rapid, fluctuating disease trajectory, higher incidence of adverse events, and poorer functional independence than observed in Alzheimer’s disease dementia. Non-pharmacological treatments such as progressive, high-inte...
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| Format: | Article |
| Language: | English |
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BMC
2022-08-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-022-03347-2 |
| _version_ | 1798042652772401152 |
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| author | Michael J. Inskip Yorgi Mavros Perminder S. Sachdev Jeffrey M. Hausdorff Inbar Hillel Maria A. Fiatarone Singh |
| author_facet | Michael J. Inskip Yorgi Mavros Perminder S. Sachdev Jeffrey M. Hausdorff Inbar Hillel Maria A. Fiatarone Singh |
| author_sort | Michael J. Inskip |
| collection | DOAJ |
| description | Abstract Background Lewy body dementia (LBD) is an aggressive type of dementia of rapid, fluctuating disease trajectory, higher incidence of adverse events, and poorer functional independence than observed in Alzheimer’s disease dementia. Non-pharmacological treatments such as progressive, high-intensity exercise are effective in other neurological cohorts but have been scarcely evaluated in LBD. Methods The Promoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial was a non-randomised, non-blinded, crossover pilot trial involving older adults with LBD consisting of a baseline assessment, an 8-week wait-list, and an 8-week exercise intervention. The aims of this study were to evaluate the determinants of the primary outcome functional independence, as measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, and the feasibility and preliminary efficacy of an exercise intervention on this outcome. Additionally, important clinical characteristics were evaluated to explore associations and treatment targets. The exercise intervention was supervised, clinic-based, high-intensity progressive resistance training (PRT), challenging balance, and functional exercises, 3 days/week. Results Nine participants completed the baseline cross-sectional study, of which five had a diagnosis of Parkinson’s disease dementia (PDD), and four dementia with Lewy Bodies (DLB). Six completed the exercise intervention (three PDD, three DLB). The cohort was diverse, ranging from mild to severe dementia and living in various residential settings. Greater functional independence at baseline was significantly associated with better physical function, balance, cognition, quality of life, muscle mass ratio, walking endurance, faster walking speed and cadence, and lower dementia severity (p < 0.05). Participants declined by clinically meaningful amounts in functional independence, cognition, physical function, muscle mass, and weight over the wait-list period (p < 0.05). Following exercise, participants improved by clinically meaningful amounts in functional independence, cognition, physical function, and strength (p < 0.05). Progressive, high intensity exercise was well-tolerated (> 80% adherence), and only one minor exercise-related adverse event occurred. Conclusions PRIDE is the first exercise trial conducted specifically within individuals diagnosed with LBD, and provides important insight for the design of larger, randomized trials for further evaluation of progressive, high-intensity exercise as a valuable treatment in LBD. Trial registration The PRIDE trial protocol has previously been prospectively registered (08/04/2016, ANZCTR: ACTRN12616000466448). |
| first_indexed | 2024-04-11T22:38:27Z |
| format | Article |
| id | doaj.art-3cf2c3c5bc7941fa80b739bd4ec0d4d9 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-11T22:38:27Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-3cf2c3c5bc7941fa80b739bd4ec0d4d92022-12-22T03:59:06ZengBMCBMC Geriatrics1471-23182022-08-0122111410.1186/s12877-022-03347-2Promoting independence in Lewy body dementia through exercise: the PRIDE studyMichael J. Inskip0Yorgi Mavros1Perminder S. Sachdev2Jeffrey M. Hausdorff3Inbar Hillel4Maria A. Fiatarone Singh5Sport and Exercise Science, College of Healthcare Sciences, James Cook UniversityExercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of SydneyCentre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, University of New South WalesCenter for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical CenterCenter for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical CenterExercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, The University of SydneyAbstract Background Lewy body dementia (LBD) is an aggressive type of dementia of rapid, fluctuating disease trajectory, higher incidence of adverse events, and poorer functional independence than observed in Alzheimer’s disease dementia. Non-pharmacological treatments such as progressive, high-intensity exercise are effective in other neurological cohorts but have been scarcely evaluated in LBD. Methods The Promoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial was a non-randomised, non-blinded, crossover pilot trial involving older adults with LBD consisting of a baseline assessment, an 8-week wait-list, and an 8-week exercise intervention. The aims of this study were to evaluate the determinants of the primary outcome functional independence, as measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale, and the feasibility and preliminary efficacy of an exercise intervention on this outcome. Additionally, important clinical characteristics were evaluated to explore associations and treatment targets. The exercise intervention was supervised, clinic-based, high-intensity progressive resistance training (PRT), challenging balance, and functional exercises, 3 days/week. Results Nine participants completed the baseline cross-sectional study, of which five had a diagnosis of Parkinson’s disease dementia (PDD), and four dementia with Lewy Bodies (DLB). Six completed the exercise intervention (three PDD, three DLB). The cohort was diverse, ranging from mild to severe dementia and living in various residential settings. Greater functional independence at baseline was significantly associated with better physical function, balance, cognition, quality of life, muscle mass ratio, walking endurance, faster walking speed and cadence, and lower dementia severity (p < 0.05). Participants declined by clinically meaningful amounts in functional independence, cognition, physical function, muscle mass, and weight over the wait-list period (p < 0.05). Following exercise, participants improved by clinically meaningful amounts in functional independence, cognition, physical function, and strength (p < 0.05). Progressive, high intensity exercise was well-tolerated (> 80% adherence), and only one minor exercise-related adverse event occurred. Conclusions PRIDE is the first exercise trial conducted specifically within individuals diagnosed with LBD, and provides important insight for the design of larger, randomized trials for further evaluation of progressive, high-intensity exercise as a valuable treatment in LBD. Trial registration The PRIDE trial protocol has previously been prospectively registered (08/04/2016, ANZCTR: ACTRN12616000466448).https://doi.org/10.1186/s12877-022-03347-2Lewy bodyAnabolic exerciseFrailtyFunctional independenceExercise physiology |
| spellingShingle | Michael J. Inskip Yorgi Mavros Perminder S. Sachdev Jeffrey M. Hausdorff Inbar Hillel Maria A. Fiatarone Singh Promoting independence in Lewy body dementia through exercise: the PRIDE study BMC Geriatrics Lewy body Anabolic exercise Frailty Functional independence Exercise physiology |
| title | Promoting independence in Lewy body dementia through exercise: the PRIDE study |
| title_full | Promoting independence in Lewy body dementia through exercise: the PRIDE study |
| title_fullStr | Promoting independence in Lewy body dementia through exercise: the PRIDE study |
| title_full_unstemmed | Promoting independence in Lewy body dementia through exercise: the PRIDE study |
| title_short | Promoting independence in Lewy body dementia through exercise: the PRIDE study |
| title_sort | promoting independence in lewy body dementia through exercise the pride study |
| topic | Lewy body Anabolic exercise Frailty Functional independence Exercise physiology |
| url | https://doi.org/10.1186/s12877-022-03347-2 |
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