Care Partner Training: Reducing Falls and Improving Cognition with Exercise

“In older adults, the major determinants of independence are mobility and cognition,” said Dr. Kiernan F. Reid.

Reid, the director of exercise physiology and physical performance at Brigham and Women’s Hospital in Boston, shared the results of recent studies of the effects of physical activity in older adults during a program presented by Insight Memory Care, in coordination with AARP Virginia.

Studies show that adults age 70 and older are the most sedentary segment of the population in the U.S. , said Reid. Working on the premise that this population could benefit from physical activity, several recent studies have sought to reach older adults where they spend time.

Reid’s group recently conducted two different yet similar studies in the Boston area, comparing a group of older adults engaging in physical activity with a control group who received general health education.

The target of the first study was a senior center in the Somerville suburb of Boston. Participants, who were between 65 and 89 years old, lived in the community and had some degree of mobility limitations. Researchers trained community center staff to facilitate the program.

The physical activity participants walked a set course around the center’s corridors and performed chair exercises, including the use of ankle weights. They were assessed at the program’s midpoint as well as its conclusion.

After six weeks, the average walking time increased from 15 to 21 minutes. The intensity of the walks also increased.

After six months, participants demonstrated a maintenance or, in some cases, an increase in mobility, compared to the control group. The number of falls also decreased, and participants showed an increase in executive cognitive functionality, likely caused by physical activity.

Reid said the study was smaller than anticipated because participants were affected by COVID-19 restrictions, but overall, the study shows that exercise and strength training in a supervised program can be effective for older adults. Reid acknowledged that more studies with larger samples are needed.

A second study focused on a multi-component digital fall prevention program conducted in participants’ homes. Participants were given a tablet with instructional videos. They performed moderate intensity exercise on their own three times a week and connected regularly with motivational coaches.

Post-study assessment showed a reduction in fear of falling, a decrease in the occurrence of falls, an increase in cognitive functions, and an increase in balance and strength.

Another positive result of the study, said Reid, was participants’ meaningful engagement with the tablets.

While the home-based study had positive results, Reid believes group studies like the senior center model can be more effective in motivating participants.

“Many older adults are not aware of the types of exercise they should do,” said Reid, which is why education and supervision are important.

Some of the benefits of physical exercise are increased strength, balance, mobility, and flexibility; improved cardiovascular and respiratory strength; reduced feelings of anxiety and depression; and improved brain health, delaying the onset of cognitive decline and dementia.

For substantial health benefits, the U.S. Department of Health and Human Services recommends 150 to 300 minutes of moderate activity weekly for adults, or about 20 minutes a day. The activity does not have to take place all at once. Some examples of small bouts of activity are walking a dog, gardening, going up and down stairs, or grocery shopping.

Care partners should talk to the person’s doctor before engaging with the person in any exercise program.

The best approach is to start with moderate activities that the person enjoys and that involve both aerobics and strength building, such as walking, yoga, tai chi, or dancing, which the care partner can perform with the person.

Some senior centers have suitable programs, such as seated aerobics or yoga and similar group activities.

One 80-year-old participant in the senior center study provided the following feedback: “The pain in my knee is gone, and I feel better and happy now, and I’m ready to get a boyfriend.”

^{Additional information for this article is from Insight Memory Care and The National Institute on Aging.}