This article was produced and financed by Oslo Metropolitan University
Elderly people with dementia need more physical activity
A new study shows that elderly people with dementia who have good balance, muscular strength and mobility are less likely to suffer from depression.
Oslo Metropolitan University
As many as 80% of nursing home residents have dementia, and many of them develop depression. They are normally sedentary and inactive.
Elderly people with dementia who have good muscular strength and balance and also high gait speed, show considerably less symptoms of depression, according to a new study conducted by doctoral research fellow and physiotherapist Linda Kvæl at Oslo and Akershus University College of Applied Sciences (HiOA).
"Depression is a complex phenomenon, and physical functioning is not the sole reason here. There are many factors at play. But it is clear that physical function such as balance, muscular strength and condition can be positive for nursing home residents who have dementia," she says.
Many suffer from depression
Kvæl has considered the functioning of 170 nursing home residents with dementia, and she has studied whether there was a connection between the groups with and without depression as regards their physical functioning. The residents were divided between 18 nursing homes in Oslo.
The physical tests consisted of strength, balance, gait speed and the ability to carry out everyday activities.
Around 24% of the participants in the study were classified as depressed. This is consistent with previous research which says that around 50% of all nursing home residents suffer from mild depression symptoms, while one out of four suffer from depression that should be treated.
Maintain their balance longer
The researcher believes that more should be done to keep people with dementia physically active.
Exercise improves balance and strength and can in some cases slow down cognitive impairment. Previous research also shows that exercise can counteract the apathy that characterises many elderly people with dementia.
We also know that exercise can have a positive effect on depression, quality of sleep and condition, among other things. It also prevents and improves symptoms of conditions such as type 2 diabetes and cardiovascular disease.
"I believe the quality of life or nursing home residents would improve if they were given the opportunity to maintain their physical functioning and to walk from place to place themselves. It will give them the opportunity to maintain their strength and balance longer," says Kvæl.
She says that the residents are often wheeled about in a wheelchair even if they are actually capable of walking.
"Staff who work with residents with dementia in nursing homes shouldn’t deprive them of the physical resources they still have," she says, and adds:
"In light of the modern hectic nursing home environment, this requires staff that have more time, positive attitudes and increased expertise."
Much more should be done
Life in a nursing home must be filled with more meaningful activities that can encourage involvement and participation. In addition, the health personnel must ensure that the residents get the opportunity to engage in physical activity through their everyday activities.
She adds that all activity throughout the day is important to the total functional ability. Standing up without help, using one’s legs to move about, walking up and down stairs and walking in the garden are activities that help to preserve leg strength and balance.
"Where needed, individual exercise programmes should be developed by a physiotherapist, as research shows that nursing home residents with dementia can safely take part in intensive exercise," she says.
"We must remember that all people have a basic need for movement, even people with dementia. It is likely that a more active approach to this group, in combination with other milieu measures, can prevent and treat depression."
Kvæl calls for services for frail elderly people that address this matter seriously.
"The reforms and guidelines are full of fancy words, but there is still a gap between the intentions and what actually takes place in practice," she points out.
- Kvæl LAH, Bergland A, Telenius EW (2017). Associations between physical function and depression in nursing home residents with mild and moderate dementia: a cross-sectional study. BMJ Open. Vol. 7. doi: 10.1136/bmjopen-2017-016875