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Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Dementia | Research article

Physical exercise for individuals with dementia: potential benefits perceived by formal caregivers

Authors: A. Sampaio, I. Marques-Aleixo, A. Seabra, J. Mota, J. Carvalho

Published in: BMC Geriatrics | Issue 1/2021

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Abstract

Background

The social and economic impact of dementia for the development of accessible and sustainable care for individuals with dementia (IwD). Physical exercise has been seen as a beneficial non-pharmacological therapy in the prevention and management of dementia, and possible benefits may not only impact on participants, but also indirectly on their caregivers. Thus, this quasi-experimental non-randomized study aimed to analyze the effects of an exercise intervention on functional capacity, behavioural and psychological symptoms in dementia (BPSD) and quality of life of institutionalized older adults with dementia, perceived by their formal caregivers.

Methods

Sixty-four institutionalized older adults (from both genders, aged 65–93 yrs. old), clinically diagnosed with dementia, were divided into two groups: control group (CG, continued with usual care, n = 26) and exercise group (EG, 6-month supervised multicomponent exercise intervention, n = 38). Nine caregivers (female, aged 28–47 yrs. old) from nine different nursing homes, reported about their distress related to BPSD and proxy-reported about participants’ functional capacity (Katz index), quality of life (QoL-AD), BPSD (NPI) before and after 6 months of an exercise intervention (aerobic, muscular resistance, flexibility and postural exercises).

Results

A two-way ANOVA, with repeated measures, revealed significant group and time interactions on Total Katz index and QoL-AD. The CG’s performance functional capacity and quality of life score worsen over time while in EG maintains these values after the exercise intervention. Moreover, formal caregiver’s distress triggered by apathy and disinhibition increased in CG while after 6 months of an exercise intervention no alterations were seen regarding these distress causes in EG. No significant main effects were observed for total NPI score or NPI distress.

Conclusions

Overall results show that after the exercise intervention, IwD from the EG, was capable of preserving the functional capacity, quality of life and neuropsychiatric symptoms were attenuate, contributing to a lower load of distress for the caregivers.

Trial registration

clinicaltrials.​gov, NCT04095962. Retrospectively registered on 19 September 2019
Literature
1.
go back to reference Prince M, Wimo A, Guerchet M, Ali G, Wu Y, Prina M. Alzheimer’s Disease International: World Alzheimer Report 2015: The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends; London 2015. Prince M, Wimo A, Guerchet M, Ali G, Wu Y, Prina M. Alzheimer’s Disease International: World Alzheimer Report 2015: The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends; London 2015.
2.
go back to reference World Health Organization. Dementia: a public health priority. Geneva: World Health Organization; 2012. World Health Organization. Dementia: a public health priority. Geneva: World Health Organization; 2012.
3.
go back to reference Turten Kaymaz T, Ozdemir L. Effects of aromatherapy on agitation and related caregiver burden in patients with moderate to severe dementia: a pilot study. Geriatr Nurs. 2017;38(3):231–7.PubMedCrossRef Turten Kaymaz T, Ozdemir L. Effects of aromatherapy on agitation and related caregiver burden in patients with moderate to severe dementia: a pilot study. Geriatr Nurs. 2017;38(3):231–7.PubMedCrossRef
4.
go back to reference Sopina E, Sorensen J, Beyer N, Hasselbalch SG, Waldemar G. Cost-effectiveness of a randomised trial of physical activity in Alzheimer's disease: a secondary analysis exploring patient and proxy-reported health-related quality of life measures in Denmark. BMJ Open. 2017;7(6):e015217.PubMedPubMedCentralCrossRef Sopina E, Sorensen J, Beyer N, Hasselbalch SG, Waldemar G. Cost-effectiveness of a randomised trial of physical activity in Alzheimer's disease: a secondary analysis exploring patient and proxy-reported health-related quality of life measures in Denmark. BMJ Open. 2017;7(6):e015217.PubMedPubMedCentralCrossRef
5.
go back to reference Chapman KR, Tremont G, Malloy P, Spitznagel MB. The role of sexual Disinhibition to predict caregiver burden and desire to institutionalize among family dementia caregivers. J Geriatr Psychiatry Neurol. 2020;33(1):42–51. Chapman KR, Tremont G, Malloy P, Spitznagel MB. The role of sexual Disinhibition to predict caregiver burden and desire to institutionalize among family dementia caregivers. J Geriatr Psychiatry Neurol. 2020;33(1):42–51.
6.
go back to reference From I, Wilde-Larsson B, Nordstrom G, Johansson I. Formal caregivers' perceptions of quality of care for older people: associating factors. BMC Res Notes. 2015;8:623.PubMedPubMedCentralCrossRef From I, Wilde-Larsson B, Nordstrom G, Johansson I. Formal caregivers' perceptions of quality of care for older people: associating factors. BMC Res Notes. 2015;8:623.PubMedPubMedCentralCrossRef
7.
go back to reference Miyamoto Y, Tachimori H, Ito H. Formal caregiver burden in dementia: impact of behavioral and psychological symptoms of dementia and activities of daily living. Geriatr Nurs. 2010;31(4):246–53.PubMedCrossRef Miyamoto Y, Tachimori H, Ito H. Formal caregiver burden in dementia: impact of behavioral and psychological symptoms of dementia and activities of daily living. Geriatr Nurs. 2010;31(4):246–53.PubMedCrossRef
8.
go back to reference Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Database Syst Rev. 2015(4):CD006489. Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S. Exercise programs for people with dementia. Cochrane Database Syst Rev. 2015(4):CD006489.
9.
go back to reference Marques-Aleixo I, Beleza J, Sampaio A, Stevanovic J, Coxito P, Gonçalves I, Ascensão A, Magalhães J. Preventive and therapeutic potential of physical exercise in neurodegenerative diseases. Antioxid Redox Signal. 2020; https://doi.org/10.1089/ars.2020.8075. [Epub ahead of print]. Marques-Aleixo I, Beleza J, Sampaio A, Stevanovic J, Coxito P, Gonçalves I, Ascensão A, Magalhães J. Preventive and therapeutic potential of physical exercise in neurodegenerative diseases. Antioxid Redox Signal. 2020; https://​doi.​org/​10.​1089/​ars.​2020.​8075. [Epub ahead of print].
10.
go back to reference Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the lancet commission. Lancet. 2020;396(10248):413–46.PubMedPubMedCentralCrossRef Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the lancet commission. Lancet. 2020;396(10248):413–46.PubMedPubMedCentralCrossRef
11.
go back to reference Sampaio A, Marques EA, Mota J, Carvalho JJD. Effects of a multicomponent exercise program in institutionalized elders with Alzheimer’s disease; 2016. p. 1471301216674558. Sampaio A, Marques EA, Mota J, Carvalho JJD. Effects of a multicomponent exercise program in institutionalized elders with Alzheimer’s disease; 2016. p. 1471301216674558.
12.
go back to reference Blondell SJ, Hammersley-Mather R, Veerman JL. Does physical activity prevent cognitive decline and dementia?: a systematic review and meta-analysis of longitudinal studies. BMC Public Health. 2014;14:510.PubMedPubMedCentralCrossRef Blondell SJ, Hammersley-Mather R, Veerman JL. Does physical activity prevent cognitive decline and dementia?: a systematic review and meta-analysis of longitudinal studies. BMC Public Health. 2014;14:510.PubMedPubMedCentralCrossRef
13.
go back to reference Barreto PD, Demougeot L, Pillard F, Lapeyre-Mestre M, Rolland Y. Exercise training for managing behavioral and psychological symptoms in people with dementia: a systematic review and meta-analysis. Ageing Res Rev. 2015;24:274–85.CrossRef Barreto PD, Demougeot L, Pillard F, Lapeyre-Mestre M, Rolland Y. Exercise training for managing behavioral and psychological symptoms in people with dementia: a systematic review and meta-analysis. Ageing Res Rev. 2015;24:274–85.CrossRef
14.
go back to reference Morris JC. The clinical dementia rating (CDR): current version and scoring rules. Neurology. 1993;43(11):2412–4.PubMedCrossRef Morris JC. The clinical dementia rating (CDR): current version and scoring rules. Neurology. 1993;43(11):2412–4.PubMedCrossRef
15.
go back to reference World Medical Association I. Declaration of Helsinki. Ethical principles for medical research involving human subjects. J Indian Med Assoc. 2009;107(6):403–5. World Medical Association I. Declaration of Helsinki. Ethical principles for medical research involving human subjects. J Indian Med Assoc. 2009;107(6):403–5.
16.
go back to reference ACSM R, D, Ehrman JK, Liguori G, Magal M. ACSM's guidelines for exercise testing and prescription. 10th ed. Philadelphia: Wolters Kluwer; 2018. ACSM R, D, Ehrman JK, Liguori G, Magal M. ACSM's guidelines for exercise testing and prescription. 10th ed. Philadelphia: Wolters Kluwer; 2018.
17.
go back to reference Rikli RE, Jones CJ. Senior fitness test manual. Champaign: Human Kinetics; 2013. Rikli RE, Jones CJ. Senior fitness test manual. Champaign: Human Kinetics; 2013.
18.
go back to reference Hesseberg K, Bentzen H, Bergland A. Reliability of the senior fitness test in community-dwelling older people with cognitive impairment. Physiother Res Int. 2015;20(1):37–44.PubMedCrossRef Hesseberg K, Bentzen H, Bergland A. Reliability of the senior fitness test in community-dwelling older people with cognitive impairment. Physiother Res Int. 2015;20(1):37–44.PubMedCrossRef
19.
go back to reference Folstein MF, Folstein SE, McHugh PR. "mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.PubMedCrossRef Folstein MF, Folstein SE, McHugh PR. "mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.PubMedCrossRef
20.
go back to reference Morgado J, Rocha CS, Maruta C, Guerreiro M, Martins IP. Cut-off scores in MMSE: a moving target? Eur J Neurol. 2010;17(5):692–5.PubMedCrossRef Morgado J, Rocha CS, Maruta C, Guerreiro M, Martins IP. Cut-off scores in MMSE: a moving target? Eur J Neurol. 2010;17(5):692–5.PubMedCrossRef
21.
go back to reference Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–9.PubMedCrossRef Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914–9.PubMedCrossRef
22.
go back to reference Sequeira C. Cuidar de idosos dependentes. Coimbra: Quarteto Editora; 2007. Sequeira C. Cuidar de idosos dependentes. Coimbra: Quarteto Editora; 2007.
23.
go back to reference Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002;64(3):510–9.PubMedCrossRef Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosom Med. 2002;64(3):510–9.PubMedCrossRef
24.
go back to reference Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308–14.PubMedCrossRef Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308–14.PubMedCrossRef
25.
go back to reference Kaufer DI, Cummings JL, Christine D, Bray T, Castellon S, Masterman D, et al. Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the neuropsychiatric inventory caregiver distress scale. J Am Geriatr Soc. 1998;46(2):210–5.PubMedCrossRef Kaufer DI, Cummings JL, Christine D, Bray T, Castellon S, Masterman D, et al. Assessing the impact of neuropsychiatric symptoms in Alzheimer's disease: the neuropsychiatric inventory caregiver distress scale. J Am Geriatr Soc. 1998;46(2):210–5.PubMedCrossRef
26.
go back to reference GEECD EdECeD. Escalas e testes na demência. 2nd ed. Lisboa: Novartis; 2008. GEECD EdECeD. Escalas e testes na demência. 2nd ed. Lisboa: Novartis; 2008.
27.
go back to reference Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60.PubMedCrossRef Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G*power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149–60.PubMedCrossRef
28.
go back to reference Moon H, Dilworth-Anderson P, Gräske J. The effects of placement on dementia care recipients’ and family caregivers’ quality of life: a literature review. Qual Ageing Older Adults. 2017;18(1):44–57.CrossRef Moon H, Dilworth-Anderson P, Gräske J. The effects of placement on dementia care recipients’ and family caregivers’ quality of life: a literature review. Qual Ageing Older Adults. 2017;18(1):44–57.CrossRef
29.
go back to reference Nakayama N, Suzuki M, Hamaguchi T. Relationship between knee extension strength and gait styles in patients with dementia. Medicine. 2019;98(12):e14958.PubMedPubMedCentralCrossRef Nakayama N, Suzuki M, Hamaguchi T. Relationship between knee extension strength and gait styles in patients with dementia. Medicine. 2019;98(12):e14958.PubMedPubMedCentralCrossRef
30.
go back to reference Rolland Y, Pillard F, Klapouszczak A, Reynish E, Thomas D, Andrieu S, et al. Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial. J Am Geriatr Soc. 2007;55(2):158–65.PubMedCrossRef Rolland Y, Pillard F, Klapouszczak A, Reynish E, Thomas D, Andrieu S, et al. Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial. J Am Geriatr Soc. 2007;55(2):158–65.PubMedCrossRef
31.
go back to reference Chen YM. Perceived barriers to physical activity among older adults residing in long-term care institutions. J Clin Nurs. 2010;19(3–4):432–9.PubMedCrossRef Chen YM. Perceived barriers to physical activity among older adults residing in long-term care institutions. J Clin Nurs. 2010;19(3–4):432–9.PubMedCrossRef
32.
go back to reference Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2018;52(3):154–60.PubMedCrossRef Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B. Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. Br J Sports Med. 2018;52(3):154–60.PubMedCrossRef
33.
go back to reference Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003;14(2):125–30.PubMedCrossRef Colcombe S, Kramer AF. Fitness effects on the cognitive function of older adults: a meta-analytic study. Psychol Sci. 2003;14(2):125–30.PubMedCrossRef
34.
go back to reference Lautenschlager NT, Cox KL. Can participation in mental and physical activity protect cognition in old age?: comment on "the mental activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults". JAMA Intern Med. 2013;173(9):805–6.PubMedCrossRef Lautenschlager NT, Cox KL. Can participation in mental and physical activity protect cognition in old age?: comment on "the mental activity and eXercise (MAX) trial: a randomized controlled trial to enhance cognitive function in older adults". JAMA Intern Med. 2013;173(9):805–6.PubMedCrossRef
35.
go back to reference Turner S. Behavioural symptoms of dementia in residential settings: a selective review of non-pharmacological interventions. Aging Ment Health. 2005;9(2):93–104.PubMedCrossRef Turner S. Behavioural symptoms of dementia in residential settings: a selective review of non-pharmacological interventions. Aging Ment Health. 2005;9(2):93–104.PubMedCrossRef
36.
go back to reference Thune-Boyle IC, Iliffe S, Cerga-Pashoja A, Lowery D, Warner J. The effect of exercise on behavioral and psychological symptoms of dementia: towards a research agenda. Int Psychogeriatr. 2012;24(7):1046–57.PubMedCrossRef Thune-Boyle IC, Iliffe S, Cerga-Pashoja A, Lowery D, Warner J. The effect of exercise on behavioral and psychological symptoms of dementia: towards a research agenda. Int Psychogeriatr. 2012;24(7):1046–57.PubMedCrossRef
37.
go back to reference Cerga-Pashoja A, Lowery D, Bhattacharya R, Griffin M, Iliffe S, Lee J, et al. Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial. Trials. 2010;11:53.PubMedPubMedCentralCrossRef Cerga-Pashoja A, Lowery D, Bhattacharya R, Griffin M, Iliffe S, Lee J, et al. Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial. Trials. 2010;11:53.PubMedPubMedCentralCrossRef
38.
go back to reference Zacharopoulou G, Zacharopoulou V, Lazakidou A. Quality of life for caregivers of elderly patients with dementia and measurement tools: a review. Int J Health Res Innov. 2015;3:49–64. Zacharopoulou G, Zacharopoulou V, Lazakidou A. Quality of life for caregivers of elderly patients with dementia and measurement tools: a review. Int J Health Res Innov. 2015;3:49–64.
40.
go back to reference Lintern T, Woods B, Phair L. Training is not enough to change care practice. J Dementia Care. 2000;8(2):15–7. Lintern T, Woods B, Phair L. Training is not enough to change care practice. J Dementia Care. 2000;8(2):15–7.
41.
go back to reference Fried L, Walston J, Hazzard W, Blass J, Halter J, Ouslander J, et al. Principles of geriatric medicine and gerontology. Chapter 116, frailty and failure to thrive. New York: McGraw Hill; 2003. p. 1487–502. Fried L, Walston J, Hazzard W, Blass J, Halter J, Ouslander J, et al. Principles of geriatric medicine and gerontology. Chapter 116, frailty and failure to thrive. New York: McGraw Hill; 2003. p. 1487–502.
42.
go back to reference Scocco P, Rapattoni M, Fantoni G. Nursing home institutionalization: a source of eustress or distress for the elderly? Int J Geriatr Psychiatry. 2006;21(3):281–7.PubMedCrossRef Scocco P, Rapattoni M, Fantoni G. Nursing home institutionalization: a source of eustress or distress for the elderly? Int J Geriatr Psychiatry. 2006;21(3):281–7.PubMedCrossRef
43.
go back to reference Secker J, Membrey H. Promoting mental health through employment and developing healthy workplaces: the potential of natural supports at work. Health Educ Res. 2003;18(2):207–15.PubMedCrossRef Secker J, Membrey H. Promoting mental health through employment and developing healthy workplaces: the potential of natural supports at work. Health Educ Res. 2003;18(2):207–15.PubMedCrossRef
44.
go back to reference den Ouden M, Bleijlevens MH, Meijers JM, Zwakhalen SM, Braun SM, Tan FE, et al. Daily (in) activities of nursing home residents in their wards: an observation study. J Am Med Dir Assoc. 2015;16(11):963–8.CrossRef den Ouden M, Bleijlevens MH, Meijers JM, Zwakhalen SM, Braun SM, Tan FE, et al. Daily (in) activities of nursing home residents in their wards: an observation study. J Am Med Dir Assoc. 2015;16(11):963–8.CrossRef
45.
go back to reference Pasanen T, Tolvanen S, Heinonen A, Kujala UM. Exercise therapy for functional capacity in chronic diseases: an overview of meta-analyses of randomised controlled trials. Br J Sports Med. 2017;51(20):1459–65.PubMedCrossRef Pasanen T, Tolvanen S, Heinonen A, Kujala UM. Exercise therapy for functional capacity in chronic diseases: an overview of meta-analyses of randomised controlled trials. Br J Sports Med. 2017;51(20):1459–65.PubMedCrossRef
46.
go back to reference Holthoff VA, Marschner K, Scharf M, Steding J, Meyer S, Koch R, et al. Effects of physical activity training in patients with Alzheimer's dementia: results of a pilot RCT study. PLoS One. 2015;10(4):e0121478.PubMedPubMedCentralCrossRef Holthoff VA, Marschner K, Scharf M, Steding J, Meyer S, Koch R, et al. Effects of physical activity training in patients with Alzheimer's dementia: results of a pilot RCT study. PLoS One. 2015;10(4):e0121478.PubMedPubMedCentralCrossRef
47.
go back to reference Pijl-Zieber EM, Awosoga O, Spenceley S, Hagen B, Hall B, Lapins J. Caring in the wake of the rising tide: moral distress in residential nursing care of people living with dementia. Dementia (London). 2018;17(3):315–36.CrossRef Pijl-Zieber EM, Awosoga O, Spenceley S, Hagen B, Hall B, Lapins J. Caring in the wake of the rising tide: moral distress in residential nursing care of people living with dementia. Dementia (London). 2018;17(3):315–36.CrossRef
48.
go back to reference Westerhof GJ, Bohlmeijer ET, van Beljouw IM, Pot AM. Improvement in personal meaning mediates the effects of a life review intervention on depressive symptoms in a randomized controlled trial. Gerontologist. 2010;50(4):541–9.PubMedCrossRef Westerhof GJ, Bohlmeijer ET, van Beljouw IM, Pot AM. Improvement in personal meaning mediates the effects of a life review intervention on depressive symptoms in a randomized controlled trial. Gerontologist. 2010;50(4):541–9.PubMedCrossRef
49.
go back to reference Smit D, de Lange J, Willemse B, Twisk J, Pot AM. Activity involvement and quality of life of people at different stages of dementia in long term care facilities. Aging Ment Health. 2016;20(1):100–9.PubMedCrossRef Smit D, de Lange J, Willemse B, Twisk J, Pot AM. Activity involvement and quality of life of people at different stages of dementia in long term care facilities. Aging Ment Health. 2016;20(1):100–9.PubMedCrossRef
50.
go back to reference Yang SY, Shan CL, Qing H, Wang W, Zhu Y, Yin MM, et al. The effects of aerobic exercise on cognitive function of Alzheimer's disease patients. CNS Neurol Disord Drug Targets. 2015;14(10):1292–7.PubMedCrossRef Yang SY, Shan CL, Qing H, Wang W, Zhu Y, Yin MM, et al. The effects of aerobic exercise on cognitive function of Alzheimer's disease patients. CNS Neurol Disord Drug Targets. 2015;14(10):1292–7.PubMedCrossRef
51.
go back to reference Feast A, Orrell M, Charlesworth G, Melunsky N, Poland F, Moniz-Cook E. Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review. Br J Psychiatry. 2016;208(5):429–34.PubMedPubMedCentralCrossRef Feast A, Orrell M, Charlesworth G, Melunsky N, Poland F, Moniz-Cook E. Behavioural and psychological symptoms in dementia and the challenges for family carers: systematic review. Br J Psychiatry. 2016;208(5):429–34.PubMedPubMedCentralCrossRef
52.
go back to reference Cheung C-K, Chow EO-W. Spilling over strain between elders and their caregivers in Hong Kong. Int J Aging Hum Dev. 2006;63(1):73–93.PubMedCrossRef Cheung C-K, Chow EO-W. Spilling over strain between elders and their caregivers in Hong Kong. Int J Aging Hum Dev. 2006;63(1):73–93.PubMedCrossRef
Metadata
Title
Physical exercise for individuals with dementia: potential benefits perceived by formal caregivers
Authors
A. Sampaio
I. Marques-Aleixo
A. Seabra
J. Mota
J. Carvalho
Publication date
01-12-2021
Publisher
BioMed Central
Keywords
Dementia
Dementia
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01938-5

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