Tai Chi exercise to improve balance and prevent falls among older people with dementia
- Authors: Barrado-Martín, Yolanda , Polman, Remco , Nyman, Samuel
- Date: 2022
- Type: Text , Book chapter
- Relation: Exercise to Prevent and Manage Chronic Disease Across the Lifespan Chapter 27 p. 363-372
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- Description: The number of people affected by dementia across the world is estimated to grow over the coming decades. It is a condition that leads to global and nonreversible cognitive impairment. As well as creating dependency in everyday activities, dementia increases the risk of older people experiencing a fall. Falls are globally recognized as a public health problem, given their high prevalence and severe consequences among older people. Several interventions have been developed to prevent falls, with robust evidence to support exercise-based interventions and in particular Tai Chi. Tai Chi exercise is a mind-body exercise that has evidence to support its potential to improve physical, cognitive, and mental health more generally as well as prevent falls. Most exercise trials to date have excluded people with dementia, and so there is little evidence to guide the use of Tai Chi for this patient group. Further, the methodological quality and heterogeneity of approaches used in Tai Chi studies such as the exercise dose, outcomes measured, and how adherence was reported, makes it difficult to make firm conclusions. Emergent evidence suggests Tai Chi is an enjoyable and safe form of exercise for community-dwelling older people with mild to moderate dementia and their informal carers. It has strong potential to improve quality of life and prevent falls among this patient group. The mechanism for its effectiveness is not clear but it is potentially via a positive impact on both cognitive and physical functioning. Clinical practice recommendations for exercise prescribers are provided with an emphasis on how to attract and sustain high levels of adherence. © 2022 Elsevier Inc. All rights reserved.
Reliability of the ICECAP-O quality of life scale with community-dwelling people with dementia
- Authors: Bibi, Iram , Polman, Remco , Nyman, Samuel
- Date: 2022
- Type: Text , Journal article
- Relation: Gerontology and Geriatric Medicine Vol. 8, no. (2022), p.
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- Description: Currently, measures of quality of life used with older people with dementia (PWD) are mainly health related. Health is not an actual attribute of but a means to attain quality of life. The Investigating Choice Experiments for the Preferences of Older People - CAPability index (ICECAP-O) measures attributes of quality of life. While its construct validity has been tested with PWD, no study has yet published data on the reliability of this scale used directly with PWD. In this study, we tested the external (test-retest) reliability of the ICECAP-O with 54 community-dwelling older PWD from the south of England. The ICECAP-O had acceptable test-retest reliability (r =.68, p <.01 and r =.56, p <.01 for raw and tariff scores, respectively). This suggests that the ICECAP-O is both a reliable and valid measure of quality of life for use directly with community-dwelling PWD. © The Author(s) 2022.
Psychometric properties of the ICECAP-O quality of life measurement tool when self-reported by community-dwelling older people with mild and moderate dementia
- Authors: Nyman, Samuel , Casey, Chloe , Polman, Remco
- Date: 2021
- Type: Text , Journal article
- Relation: Alzheimer Disease & Associated Disorders Vol. 35, no. 4 (2021), p. 356-359
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- Description: To evaluate interventions designed to improve the quality of life of people with dementia (PWD), there is a need for psychometrically validated instruments. We tested the psychometric properties of the ICEpop CAPability measure for Older people (ICECAP-O) as a self-report measure of quality of life with PWD. We used data from a randomized controlled trial of Tai Chi with 83 community-dwelling older people with mild and moderate dementia. The ICECAP-O was found to be valid with correlations in the expected directions for fear of falls (r=-0.36, P=0.001) and age (r=0.12, P=0.29), sensitive to change (mean difference=0.051, P=0.04, d=0.51), and have an adequate factorial structure. The ICECAP-O is a valid, generic measure of quality of life for use with PWD without a proxy.
Acceptability of a Dyadic Tai Chi intervention for older people living with dementia and their informal carers
- Authors: Barrado-Martín, Yolanda , Heward, Michelle , Polman, Remco , Nyman, Samuel
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Aging and Physical Activity Vol. 27, no. 2 (2019), p. 166-183
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- Description: Exercise is effective in preventing falls among older adults. However, few studies have included people living with dementia and their carers and explored their experiences. The aim of this study is to explore what affects the acceptability of exercise interventions to better meet the needs of people with dementia and their carers as a dyad. Observations, field notes containing participant's and instructor's feedback, and focus groups with 10 dyads involved in Tai Chi classes for 3 or 4 weeks in two sites in the South of England were thematically analyzed to understand their experiences. Findings suggest that dyads' determination to achieve the benefits of Tai Chi facilitated their adherence, whereas a member of the dyad's low sense of efficacy performing the movements during classes was a barrier. Simplifying class content and enhancing the clarity of instructions for home-based practice will be key to support the design of future exercise interventions. © 2019 The Authors.
People living with dementia and their family carers’ adherence to home-based Tai Chi practice
- Authors: Barrado-Martín, Yolanda , Heward, Michelle , Polman, Remco , Nyman, Samuel
- Date: 2021
- Type: Text , Journal article
- Relation: Dementia Vol. 20, no. 5 (2021), p. 1586-1603
- Relation: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The TACIT Trial and PhD studentship awarded to Dr Yolanda Barrado-Martín are funded by a National Institute for Health Research (NIHR) Career Development Fellowship awarded to Dr Samuel R. Nyman, Bournemouth University. This article presents independent research funded by the NIHR’s Career Development Fellowship Program [grant number CDF-2015-08-030].
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- Description: Objectives: The aim of this study was to understand what influenced people living with dementia and their family carers’ adherence to the home-based component of a Tai Chi exercise intervention. Method: Dyads, of people living with dementia and their family carers, who participated in the intervention arm of the Tai Chi for people living with dementia trial, were invited to join weekly Tai Chi classes for 20 weeks and practice at home. Semi-structured dyadic home interviews were conducted on average after 16 weeks of classes. The views of 15 dyads with a range of home practice adherence were sought in semi-structured interviews. The interviews were analysed using an inductive thematic approach. Results: Most participants found time to practise Tai Chi at home and practised for 18 hours on average. Amongst the barriers to adherence were participants’ competing commitments and a booklet not sufficiently conveying the Tai Chi movements. Hence, a video or DVD was requested by participants. Facilitators of their adherence to the home-based component of the intervention were their enjoyment of the practice and the development of a habit, which was supported by their commitment to the study and their willingness to benefit from Tai Chi. Conclusion: Enjoyment and perceived benefits had a great impact on participants living with dementia and their carers’ adherence to home-based Tai Chi practice. However, difficulties to perceive the Tai Chi movements through images might be hindering sustained participation. Hence, alternative aids such as videos and DVDs should be explored to facilitate adherence. © The Author(s) 2020.
Adherence to the class-based component of a tai chi exercise intervention for people living with dementia and their informal carers
- Authors: Barrado-Martín, Yolanda , Heward, Michelle , Polman, Remco , Nyman, Samuel
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Aging and Physical Activity Vol. 29, no. 5 (2021), p. 721-734
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- Description: The objective of this study was to understand the experiences of people living with dementia and their informal carers' taking part together (in dyads) in Tai Chi classes and the aspects influencing their adherence. Dyads' experiences of taking part in Tai Chi classes for 20 weeks within the TACIT Trial were explored through class observations (n = 22 dyads), home-interviews (n = 15 dyads), and feedback. Data were inductively coded following thematic analysis. Tai Chi classes designed for people with dementia and their informal carers were enjoyable and its movements, easy to learn. Facilitators of participants' adherence were the socializing component and their enjoyment of the classes, whereas unexpected health problems were the main barrier. Finding the optimal level of challenge in the class setting might be crucial for people with dementia to feel satisfied with their progression over sessions and enable their continued participation. © 2021 Human Kinetics, Inc.