Does six months of structured group exercise improve physical activity, sedentary behavior, and sleep in people living with dementia? A pilot randomized controlled trial
Bibliographic record
Abstract
Abstract Background People living with dementia (PWD) often have inactivity‐induced muscle atrophy, increased sedentary behavior, and circadian rhythm disorders. Exercise may improve physical activity, sedentary behavior, and sleep in PWD, but further research is needed. The purpose of this pilot randomized controlled trial (RCT) was to examine whether a structured exercise program improves physical activity, sedentary behavior, and sleep in PWD. Method PWD were randomized (1:1) to exercise (n = 21) or usual care (n = 21) at two residential care facilities (NCT05488951; age = 82.1±8.05 years; Montreal Cognitive Assessment (MOCA) = 10.2 points; female = 35.7%; mobility device = 61.9%). Participants wore an actigraphy monitor on their non‐dominant wrist for 7 days (minimum of 4 days to be included in the analysis) at baseline and 6 months. The adapted Otago Exercise Program involved a physical therapist‐led strength, balance, and walking program for 1 hour, 3x/week for 6 months in groups of 5‐7. We controlled for age, race, sex, and the MOCA in the intent‐to‐treat (ITT; n = 42) and per protocol analyses (PPA; n = 21 usual care; n = 9 exercisers with 2/3 adherence). Result The ITT analysis revealed that the exercise group (pre = 78.8%, post = 83.7%) had a greater percentage of sedentary activity than the usual care group (pre = 68.2%, post = 67.7%) at 6 months (p = 0.01). The PPA disclosed that the average length of sedentary bouts decreased in the usual care group (pre = 22.2, post = 20.1 minutes) compared to exercise group (pre = 46.9, post = 54.1 minutes) from baseline to 6 months (p = 0.01). Adherence to wearing the actigraphy monitor for ≥4 days was poor (pre: n = 25/42 PWD, post: n = 13/42 PWD). Conclusion This RCT provides insufficient evidence to suggest that exercise impacts physical activity, sedentary behavior, or sleep among PWD. The results suggesting that usual care improves sedentary behavior over exercise should be interpreted with caution because this is a pilot RCT and adherence to wearing the actigraphy monitor was poor in both groups due to cognitive impairment. Future work is still needed to determine the effects of exercise on physical activity, sedentary behavior, and sleep, and should consider alternative placements of the actigraphy monitors, such as the back or lower leg, to increase adherence.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.007 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.006 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".