Date Presented 03/26/20
An exploratory cross-sectional research design investigated group differences between family caregivers (FCGs) and people with dementia (PWD) in measures of fitness and cognition. Findings showed at least 40% of PWD performed below the threshold of functional mobility in every measure tested. At least 6.7% of FCGs performed below the threshold for functional mobility in five of the six measures. Despite being younger than 60 years old, FCGs still showed a risk for loss of functional mobility.
Primary Author and Speaker: Rosanne DiZazzo-Miller
Additional Authors and Speakers: Fredrick Pociask, Diane Adamo
PURPOSE: Six million individuals are currently living with an Alzheimer’s dementia diagnosis in the U.S., which is expected to grow as the population over the age of 65 rises. In response, the number of family care partners (FCPs) will also increase to meet the caregiving needs of the family member. Caring for persons with dementia (PWD) compromises the physical health of FCPs, putting both FCPs and PWD at risk for loss of functional independence. The purpose of this study was to investigate the relationship between physical markers of functional fitness, using the Senior Fitness Test (SFT) and Mini Mental State Exam (MMSE) scores for FCPs and PWD to determine group differences and deviations from clinical thresholds for loss of functional independence.
DESIGN: This study used an exploratory cross-sectional research design to investigate group differences between FCPs and PWD in measures of SFT performance, grip strength, and memory impairment.
METHOD: Findings were compared to normative data and clinical thresholds for loss of functional mobility. Fifteen FCPs without dementia (mean age ± SD = 60.4 ± 13.7 years) and PWD (mean age ± SD = 76.9 ± 8.3 years) participated in the study. Cognitive status was assessed using the MMSE. Physical fitness was measured using the SFT. The six components of the SFT completed were the chair stand test, arm curl test, 6-minute walk test (6MWT), chair sit and reach test, back scratch test, and 8-foot up and go test. An independent t-test was used to determine differences between FCPs and PWD groups for SFT and grip strength measures. Correlations between MMSE scores and SFT items were determined. Performance of SFT tasks was compared to normative data and the percentage of individuals at risk for loss of functional independence was determined.
RESULTS: Significant group differences were found for the sit and reach test [mean (SD) in. = FCPs: 1.01 (4.40), PWD: -2.49 (2.98)], the 6MWT [mean (SD) yds. = FCPs: 430.29 (116.43), PWD: 284.51 (119.14)], the 8-foot up and go test [mean (SD) = FCPs: 6.78 (1.80), PWD: 13.48 (6.42)], and average grip strength bilaterally [mean R/L (SD) kg. = FCPs: 31.73 (11.29)/28.73 (8.37), PWD: 18.92 (6.48)/18.33 (7.50)]. MMSE scores were associated with the 6MWT for the PWD group (r = .672, p < .01). MMSE scores were associated with the 8-foot up and go test for all participants (r = -.652, p < .01). The percentage of participants in each group who performed below the level for loss of functional mobility for each SFT task are as follows: chair stand; FCPs (0%), PWD (46.7%), arm curl; FCPs (20%), PWD (40%), back scratch; FCPs (33.3%), PWD (53.3%), sit and reach; FCPs (6.7%), PWD (40%), 6MWT; FCPs (26.7%), PWD (80%), 8-foot up and go; FCPs (13.3%), PWD (73.3%).
DISCUSSION & CONCLUSIONS: Findings showed that at least 40% of PWD participants performed below the threshold for loss of functional mobility in every SFT measure tested. There were at least 6.7% of FCPs who performed below the threshold for loss of functional mobility in five of the six SFT measures used. The age range of the FCPs group included participants under the age of 60. When the FCPs sample was adjusted for age, only including participants who were over 60 years old, differences between groups were noted for grip strength, chair stand, 8-foot up and go, and the 6MWT. Despite being younger than 60 years old, FCPs still showed a risk for loss of functional mobility based on the thresholds for the 60+ group. This suggests physical function is compromised in the FCPs group even when they are younger than the average age of FCPs.
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