Aging Clinical and Experimental Research
Six-month observational follow-up on activities of daily living
in people with dementia living in nursing homes after a 6-month
group based on either exercise or social activities
· Yves Rolland
· Paul‑Emile Haÿ
· Didier Armaingaud
· Bruno Vellas
Philipe de Souto Barreto
Received: 10 April 2018 / Accepted: 1 June 2018
© Springer International Publishing AG, part of Springer Nature 2018
Background Studies have demonstrated changes in activities of daily living after an exercise intervention in people with
dementia (PWD) living in nursing homes (NH). However, some discrepancies are shown during follow-up.
Aims Our objective was to measure activities of daily living (ADL) performance during a 6-month observational follow-up
after a 6-month exercise or social activity intervention in PWD living in NH.
Methods After cluster randomisation, 91 PWD living in NH performed a 6-month structured exercise intervention (n = 44)
or a social activity intervention (n = 47). After the intervention, 85 PWD were assessed for post-intervention follow-up.
Instrumental and basic activities of daily living (IADL, ADL) were measured at 6-month observational follow-up after the
intervention using the Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory for Severe Alzheimer’s
Disease (ADCS-ADL-sev) scale (scores ranging from 0 to 51, higher is better).
Results Compared to participants in the social activity, those who participated to the exercise intervention had a signiﬁcant
decrease of their ADCS-ADL-sev score (between-group adjusted mean diﬀerence: 4.6 points, p = 0.001) with IADL having
the most decrease (2.8 points, p = 0.004).
Discussion Unexpectedly, exercisers declined sharply in the performance of ADLs and IADLs, whereas participants in
the social intervention group maintained their levels. The potential mechanisms to explain these ﬁndings remain still to be
Keywords Physical function · Follow-up · Dementia · Institution · Detraining
Nonpharmacological interventions have been used to slow
the progression of dementia and its impact on disability
in older adults living in nursing homes [1, 2]. Performing
physical and social activities in this population has been
shown to be beneﬁcial for their quality of life . For exam-
ple, our group has shown that exercise can slow down the
progression of decline on physical function after a 1-year
randomized controlled trial in Alzheimer’s disease patients
living in NH . From a clinical standpoint, these interven-
tions are necessary, because it may decrease medication con-
sumption, fatigue, caregiver burden, and improve activities
of daily living (ADL) .
Research also indicates that exercise can improve ADL
in a cohort of people with dementia living in nursing homes
(NH) [5–8]. Intervention that lasts more than 3 months
Electronic supplementary material The online version of this
article (https ://doi.org/10.1007/s4052 0-018-0984-z) contains
supplementary material, which is available to authorized users.
* Mathieu Maltais
Gérontopôle de Toulouse, Institut du Vieillissement,
Bâtiment B, Centre Hospitalo-Universitaire de Toulouse, 37
Allée Jules Guesdes, 31000 Toulouse, France
UMR INSERM, 1027 University of Toulouse III, Toulouse,
Fondation Bien Vieillir Korian, Paris, France