This research is supported by the Alaska Mental Health Trust Authority, grant #4743.
In 2010, the prevalence of Alzheimer's disease (AD) and related disorders in Alaska was estimated at about 7,600 and is increasing exponentially every year. Adult day services offer an opportunity for individuals with AD to participate in activities that will help prolong their functional mobility and skills and prevent or slow the need for skilled nursing care.
CBHRS is collaborating with the Salvation Army of Alaska, Serendipity Adult Day Services, to evaluate the Enhance Mobility program. Enhance Mobility (EM) is an exercise program for individuals with dementia that was developed by Rebecca Logsdon, Ph.D., at the University of Washington. The program draws on evidence-based interventions and includes two components: group exercise and walking. Exercises are designed to focus on flexibility, strength, balance, and endurance.
In May 2013, Serendipity replaced their routine exercise activities with EM. Dr. Logsdon trained Serendipity staff and CBHRS researchers to conduct the EM program. EM group exercise is now offered to guests (people enrolled in Serendipity services) 5 times per week, and the walking program is offered 4 times per week.
Results To Date
Guests enrolled in the study completed physical and psychological assessments before the start of the EM program (baseline), and again four and eight months after the start of the program. Performance measures included a timed 10 meter walk test, to evaluate gait speed- a predictor of falls risk, standing balance assessments, and chair stands - to measure endurance. Researchers conducted interviews with caregivers and Serendipity staff to learn more about how the EM program is affecting guests.
- Since implementing EM, the number of repetitions for each exercise that guests were able to complete increased from three to five times per exercise, demonstrating an increase in strength and confidence performing the exercises.
- Guest mental state, quality of life, balance, and endurance remained stable over time.
- Participant gait speed has improved from baseline (limited community ambulation), to four-month follow-up (community ambulation) and improvements were maintained at eight month follow-up.
Based on results from key informant interviews and researcher observations at Serendipity, Enhance Mobility continues to be viewed as a positive program and staff report physical, psychological, and social benefits for guests. Our assessments indicate increased ability among guests to perform the exercises: however there were few measurable changes in physical or functional performance from baseline to four-month and eight-month follow-up, based on guest assessments and caregiver quantitative reports. Given the population and the four-month and eight-month follow-up time frames, a finding of sustained performance over time may be positive, given the importance of slowing the rate of decline and sustaining functional ability as long as possible.
"Jill* has fun doing exercises, and doing them in a group is a motivator for her." -- Guest caregiver
"Bob* is just so much more stable and independent and in a better frame of mind...he has been able to do other programs with us. He dances better and some of our bowling and soccer and things like that, he is more capable of participating in. And he is just a happier person." --Serendipity staff
"I've seen people maintain their body strength for helping transfer themselves with another person from off their chair for toileting which is really a big deal. That's been really cool to see." --Serendipity staff
*pseudonyms used to protect guest confidentiality