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Declining Physical Capacity But Maintained Aerobic Activity in Early Alzheimer's Disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
2012 (English)In: American Journal of Alzheimer’s Disease and Other Dementia, ISSN 1533-3175, E-ISSN 1938-2731, Vol. 27, no 3, 180-187 p.Article in journal (Refereed) Published
Abstract [en]

The longitudinal influences on physical capacity and habitual aerobic activity level in the early stages of Alzheimer's disease (AD) are unclear. Therefore, changes in physical capacity and aerobic activity level were evaluated. Twenty-five individuals with AD were assessed annually for 2 years, by 10-m walk test, 6-minute walk test, and timed up-and-go (TUG) single/dual tasks. Habitual aerobic activity was assessed by diary registrations. The AD group showed a lower physical capacity than controls at baseline but comparable levels of aerobic activity. During the follow-up period, physical capacity declined in the AD group, but the aerobic activity levels changed only marginally. Our results show that in the early stages of AD, people are capable of maintaining health-promoting aerobic activity levels, despite a decline in their physical capacity. Additionally, it appears that cognitive dysfunction contributes to an impaired physical capacity. The TUG tasks might, therefore, be useful for detecting early signs of cognitive impairment.

Place, publisher, year, edition, pages
2012. Vol. 27, no 3, 180-187 p.
Keyword [en]
dementia, longitudinal, physical activity, timed up-and-go, walking
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-175200DOI: 10.1177/1533317512442996ISI: 000303831300007PubMedID: 22573284OAI: oai:DiVA.org:uu-175200DiVA: diva2:531557
Available from: 2012-06-07 Created: 2012-06-04 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Physical Activity and Alzheimer's Disease: Measurements, Observations and Subjective Experiences
Open this publication in new window or tab >>Physical Activity and Alzheimer's Disease: Measurements, Observations and Subjective Experiences
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Gait disturbances such as slow walking speed and step-to-step variability have been reported among people with mild Alzheimer’s disease (AD) and as risk factors for functional decline, dependency, and falls. Additionally, AD-related emotional reactions and decreased initiative can lead to physical inactivity. The aims of this thesis, therefore, were to explore how the ability to be physically active is affected in the early years of AD, and how people with mild AD and their cohabitants reason about physical activity as part of their everyday life.

To meet the aims, an approach inspired by mixed methods research was used, covering measurements, observations and subjective experiences. Data were collected from different sources in parallel. Participants with mild AD were recruited at the Memory Clinic, Uppsala University Hospital. In Study I, a case study with two couples in which one member had AD, in-depth interviews and participating interviews were performed. Physical activity such as walking was viewed as a meaningful routine improving well-being. Participants were positive about making adjustments to enable physical activity. In Study II, the 25 participants with AD showed a significant lower walking capacity (10 m comfortable walk test, 6-minute walk test, Timed-up-and-Go test) at baseline compared to controls. The decline continued during the subsequent two years. The influence of a cognitive task on walking was distinct, despite this, participants maintained a health-promoting level of physical activity during the two-year study-period. In Study III, gait testing in the motor laboratory of 21 participants with AD showed a marked impact on gait parameters (e.g. slowed speed, decreased step length) by a cognitive task. Additionally, specific dual-task gait disturbances were frequent. In Study IV, in-depth interviews with 14 participants with AD indicated that physical activity was viewed as a meaningful activity, used as a means to maintain well-being and selfhood, and contributed to continuity in life.

In conclusion, walking capacity deteriorates and declines in the early stages of AD. A simple cognitive task can have a substantially negative impact on walking already in mild AD. In contrast, people with AD can also gain “self-promoting benefits” from physical activity beyond the common health-promoting benefits.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 82 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1008
Keyword
Caregiver, continuity theory, dementia, dual-task, gait analysis, in-depth interview, mixed methods research, participant observation, physical capacity, qualitative, selfhood, walking
National Category
Physiotherapy
Research subject
Physiotherapy; Geriatrics
Identifiers
urn:nbn:se:uu:diva-223687 (URN)978-91-554-8967-0 (ISBN)
Public defence
2014-06-13, Gunnesalen, Akademiska sjukhuset ing 10, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-05-21 Created: 2014-04-23 Last updated: 2014-06-30

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Cedervall, YlvaKilander, LenaÅberg, Anna Cristina

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