Thesis defense Esther Karssemeijer (Donders series 377)

6 June 2019

Promotors: prof. dr. M. Olde Rikkert, prof. dr. R. Kessels
Co-promotors: dr. J. Aaronson, dr. W. Bossers (Lifelines Groningen)

Brain in motion: combined cognitive and physical exercise training in people with dementia

People with dementia are more sedentary and perform less physical activity compared to cognitively healthy older adults. This may have clinically important consequences, given the observation that sedentary behaviour and little physical activity independently predict all-cause mortality and morbidity. Therefore, the main objective of this thesis was to investigate the role of physical activity, with or without cognitive stimulation, in reducing the rate of cognitive decline in people with dementia. Exergaming was used as a method to combine physical exercise and cognitive stimulation in a virtual environment. The study design was a three-armed RCT with two experimental intervention groups (exergame and aerobic training) and one active control group (stretching and toning). One hundred fifteen community-dwelling people with dementia (mean age 79 years) were trained 3 times a week during 12 weeks.  Cognitive functioning was measured at baseline and after 12 weeks. A significant improvement in psychomotor speed was found in the aerobic and exergame groups compared to the active control group after 12-weeks, with a moderate effect size. This finding may be clinically relevant, as psychomotor speed is an important predictor for functional decline. No significant differences between the intervention and control groups were found for executive functioning, episodic memory and working memory. In this study we  also demonstrated that exergaming is a feasible  and positively rated exercise method for people with dementia, resulting in higher training adherence in the exergame group compared to the aerobic group (87.3 versus 81.1%). Accordingly, exergaming seems to be an effective method to engage people with dementia in physical exercise.