Paper
Saturday, 22 July 2006
This presentation is part of : Initiatives for Persons with Dementia
The Effects of a Tripartite Intervention on Physical, Cognitive, and Emotional Functioning of Persons with Dementia
Sandy C. Burgener, RNC, PhD, FAAN, College of Nursing, University of Illinois, Urbana, IL, USA and Ruth Gilbert, Kinesiology, University of Illinois, Urbana, IL, USA.
Learning Objective #1: Identify interventions to promote cognitive and physical functioning and quality of life in persons with dementia.
Learning Objective #2: Describe methodologies appropriate to persons with dementia for the delivery of wellness-based interventions including exercise, cognitive therapies, and support group interventions.
Systematic studies are lacking that demonstrate the effects of interventions on broad outcomes in persons with dementia (PWD). Using brain plasticity theory as a basis for the tested interventions, this study purpose was to test the effectiveness of a tripartite intervention on cognitive, physical, and emotional functioning in PWD. The tested intervention included: 1) Taiji exercises focusing on strength, balance, and fall prevention; 2) Cognitive-behavioral therapies addressing memory, social functioning, and mental and emotional well-being; and 3) Support group participation addressing socialization and self-esteem. PWD willing to commit to at least a 20-week intervention were randomized into either the treatment (n=24) or comparison (n=18, wait) group. Criteria for participation of the PWD include: 1) a confirmed, recent (within one year) diagnosis of irreversible dementia (Alzheimer, Lewy Body, vascular, frontal lobe, or mixed dementia); and 2) a score < 2.0 on the Clinical Dementia Rating Scale indicating an early to early-middle disease stage. Outcome variables included: muscle strength, balance, fear of falling and actual falls, cognitive functioning, self-esteem, sleep quality, physical illness, activity participation, and depression. The two groups did not vary on any demographic or outcome variables on the baseline assessment, indicating equivalence of groups. After the 20-week intervention, treatment group participants evidenced increased cognitive functioning (MMSE: Treatment: 50% increased scores, mean: +1.2; Comparison: 15% increased scores, mean: -.8), physical functioning and balance (Single Leg Stance: Treatment: +6.2 seconds, Comparison: -1.8 seconds; Single Leg Stance, Eyes Closed: Treatment: +2.3, Comparison: +.2; Berg Balance Scale: Treatment: +1.8; Comparison: -.5), increased self-esteem (Rosenberg’s Self-Esteem Scale: Treatment: +3.0; Comparison: -3.0; paired t-test: t=2.7, p=.01), and stability in depression (Geriatric Depression Scale: Treatment: +.3; Comparison: +1.2). Overall, the findings of this pilot study support the effectiveness of the intervention in producing positive effects on physical, cognitive, and emotional functioning in PWD.

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