Physical Exercise with Music Maintains Activities of Daily Living in Patients with Dementia: Mihama-Kiho Project Part 21.

Author: Satoh M1, Ogawa JI2, Tokita T3, Nakaguchi N4, Nakao K5, Kida H1, Tomimoto H1,6
1Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Tsu, Mie University, Mie, Japan.
2YAMAHA Music Foundation, Tokyo, Japan.
3Department of Health and Welfare, Mihama Town Hall, Mihama, Mie, Japan.
4Department of Health and Welfare, Kiho Town Hall, Kiho, Mie, Japan.
5Department of Neurosurgery, Kinan Hospital, Tanabe, Japan.
6Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Mie, Japan.
Conference/Journal: J Alzheimers Dis.
Date published: 2017 Feb 7
Other: Special Notes: doi: 10.3233/JAD-161217. [Epub ahead of print] , Word Count: 274

BACKGROUND: Recent studies suggest that combined non-pharmacological interventions are more beneficial than single interventions for primary and secondary prevention of dementia. We previously reported enhanced effects of physical exercise with music (ExM) on cognitive function in normal elderly people compared to exercise alone.

OBJECTIVE: To identify if ExM improves cognitive function and activities of daily living (ADLs) in dementia patients over cognitive stimulation (CS).

METHODS: We enrolled 85 patients with mild to moderate dementia. Forty-three subjects performed ExM developed by the Yamaha Music Foundation, and 42 subjects performed cognitive stimulation using portable game consoles and drills involving easy calculations, mazes, and mistake-searching in pictures. Interventions were performed once a week for 40 minutes. Before and after the six-month intervention, patients were assessed using neuropsychological batteries, and ADLs were assessed by patients' caregivers using the functional independence measure (FIM). Voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) was used to assess medial temporal lobe atrophy.

RESULTS: Twenty-three subjects dropped out during the intervention. Thirty-one patients from each group were analyzed. Post-intervention, both groups showed significantly improved visuospatial function. Significant benefits were observed in psychomotor speed or memory in the ExM or CS groups, respectively. FIM scores, reflecting ADLs, and VSRAD scores were significantly preserved in the ExM group, but significantly worsened in the CS group.

CONCLUSIONS: ExM produced greater positive effects on cognitive function and ADLs in patients with mild to moderate dementia than CS, excluding memory. Optimal interventions for dementia will likely be achieved by combining ExMand CS.

KEYWORDS: Activities of daily living; Voxel-based specific regional analysis system for Alzheimer’s disease; functional independence measure; neuropsychological assessments; physical exercise with music; psychomotor speed

PMID: 28222531 DOI: 10.3233/JAD-161217