The nursing home as a possible risk factor for a decrease in physical activity in elderly people with dementia: relation with cognitive function and quality of life.

There is still no cure for dementia. Right now improvement of quality of life
and delay and prevention of further cognitive deterioration, are our best
achievable goals on short term in practice. Currently more than 80 000 people
suffering from dementia live in nursing or care homes in the Netherlands.
Approximately 74% live at home. Both human brain imaging studies and invasive
animal studies suggest that physical activity positively affects cognitive
function through promotion of neuroplasticity, the ability of the human brain
to adapt to dynamic needs through alteration of functional and structural
properties. Elderly have poor levels of physical activity, which is
particularly true for elderly living in an institution or nursing home with an
impoverished environment. It is suggested that the environment is especially
important for people with vulnerable and damaged brains, as seen in dementia.
With this study we would like to investigate the effect of the nursing home
environment on the development of physical activity in the elderly with
dementia, to determine whether the nursing home environment can be considered a
risk factor for a decline in physical activity and to investigate its
relationship with quality of life and cognitive development.

Primary Objective: What is the effect of a transfer from home to a nursing home
environment on the level of physical activity in the elderly with dementia over
time?
Secondary Objective(s): Is there a relationship between a possible change in
the level of physical activity, cognitive function (executive function) and
quality of life in the elderly with dementia who made a transfer from home to
the nursing home?

Prospective cohort study consisting of one group of elderly with dementia,
initially home-dwelling and later institutionalized, for the study duration of
approximately ten months. Study participants will be recruited within centres
and home services of the organisation Kennemerhart (Haarlem).

The assessments and tests have been selected with care, taking into account the
stamina and energy levels of the fragile participants. The test taker(s) will
be alert for symptoms of fatigue, discomfort and/or pain, and may interrupt the
test. Nevertheless, the burden of the participants may lie in performing the
physical strength test and in completing the battery of cognition tests. The
test taker(s) will be alert for symptoms of fatigue, discomfort and/or pain and
may interrupt the test, minimalizing this burden. By taking this measure the
risk associated with participation can be considered negligible.