Skip to main content
SpringerLink
Log in

Körperliche Aktivität zur Stärkung kognitiver Ressourcen

Systematische Übersicht der Wirksamkeit in Pflegeheimen

Physical activity to improve cognitive resources

Systematic review of the effectiveness in nursing homes

  • Originalarbeit
  • Published:
Prävention und Gesundheitsförderung Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Pflegekassen sollen Leistungen zur Prävention in der stationären Pflege erbringen. Ein Handlungsfeld ist die Stärkung kognitiver Ressourcen.

Zielsetzung

Die präventive Wirksamkeit von körperlicher Aktivität auf die kognitive Leistungsfähigkeit bei Pflegebedürftigen in der stationären Pflege soll bewertet werden.

Methodik

Es erfolgte eine systematische Recherche in den Datenbanken MEDLINE, The Cochrane Library, EMBASE, CINAHL, PsycINFO und PEDro. Die Ergebnissynthesen beruhen auf Metaanalysen mit Random-effects-Modellen.

Ergebnisse

Unter Einbezug von 13 Primärstudien weisen stationär Pflegebedürftige nach Teilnahme an körperlichen Aktivitäten im Vergleich zu verschiedenen Kontrollbedingungen eine statistisch signifikant bessere kognitive Leistungsfähigkeit auf (SMD = 0,43, 95 %-KI 0,20–0,66, p = 0,0002). Subgruppenanalysen lassen vermuten, dass stationär Pflegebedürftige mit unterschiedlichen kognitiven Einbußen von langandauernden Angeboten körperlicher Aktivitäten profitieren können. Infolge des insgesamt hohen Verzerrungsrisikos der Studien ist die Aussagekraft der Ergebnisse jedoch limitiert.

Schlussfolgerung

Die Ergebnisse geben einen Hinweis auf eine Effektivität von körperlicher Aktivität im Setting der stationären Pflege. Weitere Studien mit längeren Interventionsdauern sind erforderlich.

Abstract

Background

Nursing care insurance funds are supposed to deliver preventive services in nursing homes. The strengthening of cognitive resources is considered as one field of action.

Aim

The preventive effectiveness of physical activity on cognitive performance in nursing home residents shall be evaluated.

Methods

A systematic search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL, PsycINFO and PEDro. Results were combined in random-effects meta-analyses.

Results

Taking into account 13 primary studies, it was shown that those participating in physical activity showed statistically significant greater cognitive performance compared to controls (SMD = 0.43, 95% CI 0.20–0.66, p = 00002). Subgroup analyses suggest that nursing home residents with different cognitive impairments might benefit from long-lasting physical activity interventions. Due to the high risk of bias in included studies, the results must be interpreted with caution.

Conclusion

Physical activity might be effective in the inpatient care setting. Further studies with longer intervention periods are required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Auffray C, Juhel J (2001) Effets généraux et différentials d’un programme d’entraînement cognitif multimodal chez la personne âgée. L’année Psychollogique 101:65–89

    Article  Google Scholar 

  2. Barbe C, Morrone I, Novella JL et al (2016) Predictive factors of rapid cognitive decline in patients with Alzheimer disease. Dement Geriatr Disord Extra 6:549–558

    Article  Google Scholar 

  3. Borenstein M, Hedges LV, Higgins JPT et al (2009) Introduction to meta-analysis. John Wiley & Sons, Chichester

    Book  Google Scholar 

  4. Bossers WJR, Scherder EJA, Boersma F et al (2014) Feasibility of a combined aerobic and strength training program and its effects on cognitive and physical function in institutionalized dementia patients. a pilot study. PLOS ONE 9:e97577

    Article  PubMed  PubMed Central  Google Scholar 

  5. Bossers WJR, van der Woude LHV, Boersma F et al (2015) A 9‑week aerobic and strength training program improves cognitive and motor function in patients with dementia: a randomized, controlled trial. Am J Geriatr Psychiatry 23:1106–1116

    Article  PubMed  Google Scholar 

  6. Carlson KD, Herdman AO (2012) Understanding the impact of convergent validity on research results. Organ Res Methods 15:17–32

    Article  Google Scholar 

  7. de Carvalho Bastone A, Filho WJ (2004) Effect of an exercise program on functional performance of institutionalized elderly. J Rehabil Res Dev 41:659–668

    Article  Google Scholar 

  8. Cheng ST, Chow PK, Song YQ et al (2014) Can leisure activities slow dementia progression in nursing home residents? A cluster-randomized controlled trial. Int Psychogeriatr 26:637–643

    Article  PubMed  Google Scholar 

  9. Cheng ST, Chow PK, Song YQ et al (2014) Mental and physical activities delay cognitive decline in older persons with dementia. Am J Geriatr Psychiatry 22:63–74

    Article  CAS  PubMed  Google Scholar 

  10. Dechamps A, Diolez P, Thiaudière E et al (2010) Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons. Arch Intern Med 170:162–169

    Article  PubMed  Google Scholar 

  11. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  CAS  PubMed  Google Scholar 

  12. Deutsche Gesellschaft für Neurologie, Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (2016) Demenzen. Entwicklungsstufe: S 3. Aktualisierung 2016. AMWF-Register-Nummer: 038–013

  13. Dorner T, Kranz A, Zettl-Wiedner K et al (2007) The effect of structured strength and balance training on cognitive function in frail, cognitive impaired elderly long-term care residents. Aging Clin Exp Res 19:400–405

    Article  PubMed  Google Scholar 

  14. Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Folstein MF, Folstein SE, McHugh PR (1975) „Mini-Mental State“. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  16. Forbes D, Forbes SC, Blake CM et al (2015) Exercise programs for people with dementia. Cochrane Database Syst Rev 4:CD648

    Google Scholar 

  17. GKV-Spitzenverband (2016) Leitfaden Prävention in stationären Pflegeeinrichtungen nach § 5 SGB XI. Berlin

  18. Gordon RS (1983) An operational classification of disease prevention. Public Health Rep 98:107–109

    PubMed  PubMed Central  Google Scholar 

  19. Han JW, Seo JY, So Y et al (2014) Physical activity in individuals with dementia or mild cognitive impairment: a meta-analysis study. Alzheimers Dementia 10:P457

    Article  Google Scholar 

  20. Higgins JPT, Green S (2011) Cochrane handbook for systematic reviews of interventions. Version 5.1.0. Aktualisierung 2011. The Cochrane Collaboration. http://handbook-5-1.cochrane.org/. Zugegriffen: 10. Juni 2017

    Google Scholar 

  21. Kemoun G, Thibaud M, Roumagne N et al (2010) Effects of a physical training programme on cognitive function and walking efficiency in elderly persons with dementia. Dement Geriatr Cogn Disord 29:109–114

    Article  PubMed  Google Scholar 

  22. Kolassa IT, Glöckner F, Leirer V et al (2010) Neuronale Plastizität bei gesundem und pathologischem Altern. In: Häfner H, Beyreuther K, Schlicht W (Hrsg) Altern gestalten. Springer, Berlin Heidelberg, S 41–67

    Chapter  Google Scholar 

  23. Schoenfelder DP, Rubenstein LM (2004) An exercise program to improve fall-related outcomes in elderly nursing home residents. Appl Nurs Res 17:21–31

    Article  PubMed  Google Scholar 

  24. Telenius EW, Engedal K, Bergland A (2015a) Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial. PLOS ONE 10:1–18

    Article  Google Scholar 

  25. Telenius EW, Engedal K, Bergland A (2015b) Long-term effects of a 12 weeks high-intensity functional exercise program on physical function and mental health in nursing home residents with dementia: a single blinded randomized controlled trial. BMC Geriatr 15:158–169

    Article  PubMed  PubMed Central  Google Scholar 

  26. Thurm F, Scharpf A, Liebermann N et al (2011) Improvement of cognitive function after physical movement training in institutionalized very frail older adults with dementia. GeroPsych (Bern) 24:197–208

    Article  Google Scholar 

  27. Varela S, Ayán C, Cancela JM et al (2011) Effects of two different intensities of aerobic exercise on elderly people with mild cognitive impairment: a randomized pilot study. Clin Rehabil 26:442–450

    Article  PubMed  Google Scholar 

  28. Venturelli M, Scarsini R, Schena F (2011) Six-month walking program changes cognitive and ADL performance in patients with Alzheimer. Am J Alzheimers Dis Other Demen 26:381–388

    Article  PubMed  Google Scholar 

  29. Wei XH, Ji LL (2014) Effect of handball training on cognitive ability in elderly with mild cognitive impairment. Neurosci Lett 566:98–101

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fachbereich Pflege und Gesundheit, Hochschule Fulda, Leipziger Straße 123, 36037, Fulda, Deutschland

    C. Wöhl, H. Siebert & B. Blättner

Authors
  1. C. Wöhl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Siebert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Blättner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C. Wöhl.

Ethics declarations

Interessenkonflikt

C. Wöhl, H. Siebert und B. Blättner geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Studienregistrierung: PROSPERO CRD42016050641.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wöhl, C., Siebert, H. & Blättner, B. Körperliche Aktivität zur Stärkung kognitiver Ressourcen. Präv Gesundheitsf 13, 32–38 (2018). https://doi.org/10.1007/s11553-017-0612-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11553-017-0612-3

Schlüsselwörter

Keywords

Search

Navigation