Motivation to participate in high-intensity functional exercise compared with a social activity in older people with dementia in nursing homes

PLoS One. 2018 Nov 14;13(11):e0206899. doi: 10.1371/journal.pone.0206899. eCollection 2018.

Abstract

Background: Motivation to participate in exercise among people with dementia has not been well studied. The symptoms of dementia, including apathy, may lead to low motivation to participate in exercise. The aim of this study was to evaluate the motivation of older people with dementia to participate in a high-intensity exercise program compared with motivation of those participating in a social group activity.

Methods: The Umeå Dementia and Exercise Study (UMDEX) was a cluster-randomized controlled intervention trial including 186 people (mean age; 85, 75% female) with dementia in nursing homes. Participants were randomized to participate in the High-Intensity Functional Exercise (HIFE) Program (n = 93) or a seated social group activity (n = 93). The activities were conducted in groups of 3-8 participants for 45 minutes, five times per two-week period, for 4 months (40 sessions in total). Participants' motivation to go to and during activity sessions were assessed by the activity leaders and nursing homes staff using a five-point Likert scale. Data were analyzed using cumulative link mixed models.

Results: Motivation was high or very high during 61.0% of attended sessions in the exercise group and 62.6% in the social activity group. No overall significant difference between groups was observed, but motivation increased over time in the exercise group and decreased in the social activity group (p < 0.05). Motivation during the sessions was significantly higher than motivation to go to the sessions, especially in the exercise group [OR 2.39 (95% CI 2.38-2.40) and 1.50 (95% CI 1.32-1.70), respectively].

Conclusions: Among older people with dementia in nursing homes, motivation to participate in a high-intensity functional exercise program seems to be high, comparable to motivation to participate in a social activity, and increase over time. Since motivation during activity sessions was higher than motivation to go to sessions the promotion of strategies to encourage people with dementia to join exercise groups is of great importance.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Apathy
  • Dementia / psychology*
  • Dementia / rehabilitation
  • Exercise Therapy / psychology*
  • Female
  • Homes for the Aged / statistics & numerical data
  • Humans
  • Male
  • Motivation*
  • Nursing Homes / statistics & numerical data
  • Social Participation / psychology*
  • Sweden

Grants and funding

This work was supported by the Swedish Research Council (grant numbers K2009-69P-21298-01-4, K2009-69X-21299-01-1, K2009-69P-21298-04-4, K2014-99X-22610-01-6) www.vr.se; Forte – Swedish Research Council for Health, Working Life and Welfare (formerly FAS – Swedish Council for Working Life and Social Research) www.forte.se; the Vårdal Foundation; the Swedish Dementia Association www.demensforbundet.se; the Promobilia Foundation https://www.promobilia.se/; the Swedish Society of Medicine www.slf.se; the Swedish Alzheimer Foundation; the County Council of Västerbotten www.vll.se, the Umeå University Foundation for Medical Research www.umu.se; the Ragnhild and Einar Lundström’s Memorial Foundation; and the Erik and Anne-Marie Detlof´s Foundation.