Multidisciplinary Interventions for People with Diverse Needs - A Training Guide for Teachers, Students, and Professionals

Samuel Honório, Marco Batista, Helena Mesquita, Samuel Honório, Marco Batista, Helena Mesquita

• Publisher: Bentham Science Publishers
• Year: 2020
• Print ISBN: 9789811446764
• eBook ISBN: 9789811446771
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Multidisciplinary Interventions for People with Diverse Needs - A Training Guide for Teachers, Students, and Professionals

Exercise and Physical Activity - Contributions to Intervention in People with Dementia

Jaime Ribeiro^{1, 2, *}, Marco Batista³, Samuel Honório³, João Serrano³, Helena Mesquita⁴

¹ School of Health Sciences & ciTechCare - Center for Innovative Care and Health Technology, Polytechnic of Leiria, Portugal

² CIDTFF - Research Centre on Didactics and Technology in the Education of Trainers - University of Aveiro, Portugal

³ SHERU - Sports, Health and Exercise Research Unit, Polytechnic Institute of Castelo Branco, Portugal

⁴ Instituto Politécnico de Castelo Branco/Centro Interdisciplinar de Ciências Sociais (CICS.NOVA)/Sport, Health & Exercise Reseach Unit (SHERU), Portugal

Abstract

In the last few decades, the world has undergone profound demographic changes, reflected in life expectancy. We live for much longer, but we cannot say that these growing years are directly proportional to the quality of life. Dementia, in its different aetiologies, is more and more frequent with a consequent decline in the quality of life. However, cognitive decline and the onset of dementia may be delayed with the adoption of healthy lifestyle habits and therapeutic combinations that use non-pharmacological approaches such as activity and physical exercise. This chapter integrates a thorough review of the literature that characterizes ageing, cognitive decline and dementia, and it summarizes scientific evidence on the effects of physical activity on cognitive functions. Finally, recommendations are presented on the prescription of exercise for older people and elderly people with dementia. It is known that there are direct benefits (action on neurotrophic factors and neurotransmitters, among others), as well as indirect ones such as those resulting from a better vascularization of the brain. However, physical exercise requires precautions related to the conditions inherent to normal and pedagogical ageing. It is possible to perform adapted physical activity resulting from the coordination of sports and health professionals, knowledgeable of the needs and idiosyncrasies of the elderly, with cognitive decline or dementia.

Keywords: Cognitive decline, Dementia, Elderly, Physical exercise.

---

^* Corresponding author Jaime Ribeiro: School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; E-mail: [email protected]

INTRODUCTION

This chapter summarizes the effects of physiological and pathological ageing and their cognitive implications. In the most exacerbated cases, we can observe the onset of dementia, which, despite the different aetiologies and possible evolutions, inevitably leads to deterioration of cognitive skills and, consequently, to lesser autonomy, greater dependence on caregivers and loss of quality of life.

In this way, in a multidisciplinary approach that combines Occupational Therapy and Physical Education professionals, it is important to list a set of scientific evidence that describes the benefits of exercise and physical activity in minimizing cognitive deterioration due to ageing. It also aims to submit a proposal for an exercise and physical activity program that helps seniors and their formal and informal caregivers.

Research in the area of exercise and ageing has a relatively short but very active history. There has been a major development in the research of ageing in the last two decades. Among other findings, the researchers provided evidence of potential low-cost alternative therapies for the treatment and prevention of disease and the potential to improve the quality of life, health, and overall vitality of the elderly.

The discussion about ageing-associated cognitive impairment and especially dementia is justified. In this context, we highlight Stone (2011), who stated that it is extremely rare to find an elderly person who does not have cognitive impairment. In this sense, this chapter discusses the benefits of physical activity in the ageing of the individual, in particular on one of the most frequent associated disorders - cognitive compromise.

Sustained by the scientific evidence, we want to contextualize and propose a program of exercise and physical activity as a non-pharmacological intervention for the prevention and reduction of progression of cognitive decline in individuals of advanced age.

Population ageing is a worldwide reality and in particular, in the European context where there is already an ageing index of 123.9, meaning that for every 100 young people, there are 123.9 elderly people (PORDATA, 2016).

The increase in human longevity has been a constant trend worldwide in recent decades. Improved socioeconomic conditions and nutritional resources, together with the prevention and treatment of important pathologies such as infectious, metabolic, vascular and cardiac diseases, have contributed to an increase in longevity from 60 to 80 years old during the 20th century in Western countries (Démonet & Celsis, 2012). However, this dramatic increase in life expectancy was not accompanied by a proportional increase in quality of life for the elderly. On the contrary, generally, the increase of the life expectancy intensifies the risk of disease, deficiency, dementia and advanced ageing before the death. In the particular aspect of dementia, Santana, Farinha, Freitas, Rodrigues and Carvalho (2015) mentioned that the incidence and prevalence of dementia increase with age, doubling every five years after the sixth decade of life. They added that the estimated number of Portuguese over 60 years old and with dementia was 160287, which corresponds to 5.91% of this population. Knowing that Alzheimer's Disease represents 50-70% of the cases, there will be between 80144 and 112201 patients (Santana, Farinha, Freitas, Rodrigues & Carvalho, 2015). Kravitz, E., Schmeidler, J., & Beeri, M. S. (1990) disclosed that in the 85-year age group, more than half will have dementia and that the annual incidence rate doubles every 5 years. In 2010, Corrada, Brookmeyer, Paganini-Hill, Berlau, and Kawas already argued that the incidence of all causes of dementia is very high in people aged 90 years and older and continues to increase exponentially with age in both men and women. In this context arises the need to fight the effects of cognitive impairment and, in its more severe variant, dementia, trying to minimize its effects and delay its setting in so that individuals can live longer, but also with greater autonomy and quality of life. One of the most widely used therapies, along with vitamin supplements, used as the first line of defence against the detection of mild cognitive impairment and against the onset of dementia, is the practice of physical exercise.

However, the elderly population, because of ageing, needs special attention when delineating a program of exercise and physical activity.

Ageing - brief contextualization

The current section provides a brief context for the reader to contact with the conjuncture of ageing, observing the demography and the main physiological changes, in particular, the repercussions on the brain, and the care to be taken when exercising and performing physical activity. It seeks to justify the need for the exploration of the present subject-matter in the context of contemporary society.

Sociodemography

Population ageing is a worldwide concern. There is a growing increase in the elderly population due to two main aspects: the increase in life span and the decrease in the birth rate. Human life expectancy has been increasing rapidly. Due to better health and hygiene, healthier lifestyles, enough food and better medical care, as well as the reduction of infant mortality, we can now expect to live much longer than our ancestors and in just a few generations (Brown, 2015). In this context, it is verifie...

Table of contents

• Welcome
• Table of Content
• Title
• BENTHAM SCIENCE PUBLISHERS LTD.
• FOREWORD
• PREFACE
• List of Contributors
• Exercise and Physical Activity - Contributions to Intervention in People with Dementia
• Disorders of Consciousness
• Promoting Autonomous Language Learning in People with Special Needs: Universal Design for Learning in the Project En-Abilities
• The Daily Life´s Routines of Children with Disabilities
• Sensory Integration and the Child with Autism Spectrum Disorders
• Combined Interventions on Diabetes
• Celiac Disease and Modern Society
• Animal-Assisted Therapy and Developmental Disorders
• Physical Activity Practice Determinants for People with Motor Disabilities: Inequities in Access and Physical Activity Engagement
• Psychosocial Correlates of the Physical Activity of Children and Adolescents with Intellectual Disability or Motor Impairment