The Effects of Whole-body Exercise to Improve Swallowing Function in Older Adults With Dementia

Study Overview
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Brief Summary
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Swallowing impairment (dysphagia) is extremely common in older adults living with dementia due to age-related changes in swallowing and other disease-specific impairments. Dysphagia is commonly managed by modifying diet textures rather than engaging in rehabilitative swallowing therapy. This means that countless people with dementia are left to eat pureed foods and drink thickened liquids, which are unpalatable and lead to malnutrition. As the disease progresses, many are transferred to nursing homes. In Canada, speech-language pathologists, who manage dysphagia, are consultants within nursing homes; therefore, swallowing therapy is non-existent. However, exercise therapy is more commonly available. Rodent models have demonstrated that physical exercise strengthens tongue and vocal-fold musculature, which are critical components of swallowing. Therefore, it is possible that whole-body physical exercise, which increases rate of respiration, will help to strengthen swallowing-related musculature in older adults with dementia. In this study, older adults (65+) with early-stage dementia will complete a 12-week physical exercise program to determine improvement of swallowing function.

Official Title
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The Effects of Whole-body Exercise to Improve Swallowing Function in Older Adults With Dementia

Conditions
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Cough, Old Age; Dementia, Swallowing Disorder, Parkinson Disease, Neuro-Degenerative Disease

Intervention / Treatment
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* Behavioral: Whole-body exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: > 59 years of age able to walk independently with or without an assistive device for a distance of at least 10 meters able to be active for 60 minutes with rest breaks abe to independently follow directions not involved in active rehabilitation a diagnosis of a progressive neurologic disease a maximum value for tongue strength <40 kPa Exclusion Criteria: neurological conditions other than a progressive neurologic disease significant cardiovascular conditions severe aphasia pain, other medical conditions or behavioural issues that would limit safe participation in the exercise program individuals with known structural causes of dysphagia individuals with known allergies to latex individuals receiving swallowing rehab

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Whole-body exercise<br> | Behavioral: Whole-body exercise<br>* 10-week one-on-one, virtual, whole-body exercise class, 3x/week, focused on increasing respiratory rate through moderate-intensity aerobic exercises.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in respiratory function from baseline to end of intervention | Measure via peak cough flow using a peak flow meter | baseline, week 4, week 14 and week 16 | 
| Change in swallowing function from baseline to end of intervention | Measure via isometric tongue strength using an Iowa Oral Performance Instrument | baseline, week 4, week 14 and week 16 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in aerobic fitness from baseline to end of intervention | Measure via physical capacity using the 6-minute walk test | baseline, week 4, week 14 and week 16 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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dementia, swallowing, physical exercise, parkinson disease