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Objectives To examine whether a regular, long-term exercise program performed by individuals with Alzheimer's disease ( AD) at home or as group-based exercise at an adult daycare center has beneficial effects on cognition; to examine secondary outcomes of a trial that has been published earlier. Design Randomized, controlled trial. Setting Community. Participants Community-dwelling dyads (N = 210) of individuals with AD and their spousal caregivers randomized into three groups. Intervention Two types of intervention comprising customized home-based exercise ( HE) and group-based exercise ( GE), each twice a week for 1 year, were compared with a control group ( CG) receiving usual community care. Measurements Cognitive function was measured using the Clock Drawing Test ( CDT), Verbal Fluency ( VF), Clinical Dementia Rating ( CDR), and Mini-Mental State Examination ( MMSE) at baseline and 3, 6, and 12 months of follow-up. Results Executive function, measured using CDT, improved in the HE group, and changes in the score were significantly better than those of the CG at 12 months (adjusted for age, sex, and CDR, P = .03). All groups deteriorated in VF and MMSE score during the intervention, and no significant differences between the groups were detected at 12-month follow-up when analyses were adjusted for age, sex, and CDR. Conclusion Regular, long-term, customized HE improved the executive function of community-dwelling older people with memory disorders, but the effects were mild and were not observed in other domains of cognition. [ABSTRACT FROM AUTHOR]

Objectives To investigate the effects of multimodal supervised exercise on physical functioning, falls, and related injuries in older women. Design Two-year randomized controlled trial. Setting Tampere, Finland. Participants Women aged 70 to 80 who had fallen in the previous year (n = 409). Intervention Participants were randomly assigned to an exercise or control group ( NCT00986466). Exercisers participated in group exercise classes twice a week for 12 months and once a week for the subsequent 12 months and home exercises. Controls maintained their current physical activity. Measurements Physical functioning assessed at baseline and at 6-month intervals during the intervention. Falls and related injuries monitored with fall diaries. Results Intention-to-treat analyses showed that exercise led to significant improvements in physical functioning. Leg strength differed significantly between the groups (mean change: 14.1%, 95% confidence interval (CI) = 8.0 to 20.2 in exercisers; 1.6%, 95% CI = −4.5 to 7.7 in controls; P < .001). Chair stand time also differed significantly between groups (7.4%, 95% CI 3.8 to 10.8% in exercisers; 2.4%, 95% CI = −1.6 to 6.2) in controls; P = .02). Between-group differences were significant for fast walking speed ( P = .003) and probability of completing the backward walking test ( P < .001), favoring exercisers. Timed Up-and-Go and grip strength did not differ between groups. There was no difference in the total falls incidence rate ratio (IRR = 1.0, 95% CI = 0.79 to 1.26), but exercisers were less likely to have medically attended injurious falls (IRR = 0.45, 95% CI = 0.27 to 0.78; P = .004). Conclusion Twenty-four months of multimodal exercise enhanced physical functioning in women aged 70 to 80 with a history of falls. Although the total number of falls was not lower than in controls, the rate of medically attended injurious falls was more than 50% lower. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of cognitive training on cognition and health-related quality of life (HRQoL) in community-dwelling persons with dementia., Design: Single-blind randomized controlled trial with 3- and 9-month follow-up., Setting: Adult day care centers in Helsinki, Finland., Participants: Older individuals with mild to moderate dementia living at home and attending adult day care twice a week (N = 147; mean age 83, 72% female, 63% at mild stage of dementia)., Intervention: A systematic 12-week training program focused on subskills of executive function: attention, working memory, cognitive flexibility, and planning. The intervention group (n = 76) underwent cognitive training twice a week for 45 minutes, and the control group (n = 71) attended day care as usual., Measurements: Primary outcomes were the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) for global cognition and the 15-dimensional instrument (15D) for HRQoL. The outcomes were measured at baseline and 3 and 9 months., Results: Both groups deteriorated in global cognition and HRQoL during follow-up, and there were no differences between the two groups in change on the ADAS-Cog (P = .43) or 15D (P = .61) over time (adjusted for age and sex). At 3 months, changes were 0.8 (95% confidence interval (CI) = -0.2-1.8) for the intervention group and 1.7 (95% CI = 0.6-2.7) for the control group on the ADAS-Cog and -0.040 (95% CI = -0.058 to -0.021) for the intervention group and -0.037 (95% CI = -0.056 to -0.018) for the control group on the 15D., Conclusion: Systematic cognitive training had no effect on global cognition or HRQoL in community-living persons with mild to moderate dementia., (© 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.)