TY  - JOUR
PY  - 2018//
TI  - Relationship of neuropsychiatric symptoms with falls in Alzheimer's disease - does exercise modify the risk?
JO  - Journal of the American Geriatrics Society
A1  - Roitto, Hanna-Maria
A1  - Kautiainen, Hannu
A1  - Öhman, Hannareeta
A1  - Savikko, Niina
A1  - Strandberg, Timo E.
A1  - Raivio, Minna
A1  - Laakkonen, Marja-Liisa
A1  - Pitkälä, Kaisu H.
SP  - 2377
EP  - 2381
VL  - 66
IS  - 12
N2  - OBJECTIVES: To explore how neuropsychiatric symptoms (NPS) are associated with number of falls and how exercise modifies the risk of falling in community-dwelling people with Alzheimer's disease (AD) and NPS. <br><br>DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Community. PARTICIPANTS: Community-dwelling individuals with AD (N=210) who completed the Neuropsychiatric Inventory (NPI) (N = 179). INTERVENTION: Participants were randomized into 3 groups: group-based exercise (4-hour sessions with approximately 1 hour of training) and tailored home-based exercise (1 hour of training) twice a week for 1 year and a control group receiving usual community care. In this secondary analysis, we merged the home-based and group-based exercise groups and compared this group with the control group. MEASUREMENTS: NPS were measured using the NPI at baseline, and spousal caregivers recorded falls in daily fall diaries during 1 year of follow-up. <br><br>RESULTS: The number of falls increased linearly with NPI score in the control group. Fall rates were 1.48 (95% confidence interval (CI)=1.26-1.73) per person-year in the intervention group and 2.87 (95% CI=2.43-3.35) in the control group. Adjusted for age, sex, Mini-Mental State Examination (MMSE) score, and Short Physical Performance Battery (SPPB) score, incidence rate ratio (IRR) was 0.48 (95% Cl=0.39-0.60, p <.001). Main effects for fall rate were significant for group (p <.001) and NPI total (p <.02); the interaction effect was also significant (p =.009) (adjusted for sex, age, MMSE score, SPPB score, and psychotropic medication use). <br><br>CONCLUSION: Exercise may decrease the risk of falling in community-dwelling individuals with AD and NPS. Future exercise trials should confirm this finding in participants with significant NPS. TRIAL REGISTRATION: ACTRN12608000037303.<br><br>© 2018, Copyright the Author Journal compilation © 2018, The American Geriatrics Society.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-8614
UR  - http://dx.doi.org/10.1111/jgs.15614
ID  - ref1
ER  -