Can Home-Based Physical Therapy Benefit Older Adults with Dementia?

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Journal of the American Geriatrics Society Research Summary

Dementia is the leading cause of disability for more than 5 million people aged 65 and older in this country. By 2050, that number is predicted to quadruple. Dementia can cause memory, language and decision-making problems, mood changes, increased irritability, depression, and anxiety.

Dementia also can cause poor coordination as well as balance problems and falls. These difficulties can affect quality of life, reduce caregiver well-being, and increase healthcare costs.

Researchers designed a study to learn more about whether physical therapy (PT) rehabilitation services could improve dementia-associated declines. They published their findings in the Journal of the American Geriatrics Society.

The researchers noted that we understand that physical activity and exercise programs provided by physical therapists can improve balance and reduce fall risk. However, we don’t know whether providing PT in the home could benefit people with dementia. The researchers wanted to learn whether home health PT could help older adults with dementia improve their ability to perform daily functions. These functions include activities like grooming, dressing, bathing, being able to get to and from the toilet (and being able to clean yourself properly after using the bathroom), getting from bed to a chair, walking, eating, being able to plan and prepare light meals, and being able to use the telephone. The researchers also wanted to learn what amount of home-based PT services resulted in the most improvement with these essential tasks.

The researchers examined information provided by the Centers for Medicare and Medicaid Services (CMS), which administers the Medicare program (the federal insurance program for older Americans). The people included in the study were older than 65, had been diagnosed with dementia, and received home health services.

Of the people included in the study, 62 percent received at least one home PT visit. Most people received four visits. Patients who received PT had a higher level of disability and were more likely to:

  • Have started home health after hospitalization or rehabilitation care stays
  • Have severe pain that interfered with movement on a daily basis
  • Have a fall risk

They also were less likely to exhibit symptoms of disruptive behavior.

The researchers said that people who received PT were more likely to experience improvement in their daily functioning. They also said that the more PT people received, the more improvement they experienced, up to about 14 visits.

The researchers suggested that these results highlight the importance of receiving an evaluation by a physical therapist if you or someone you know has been diagnosed with dementia.

This summary is from “The Impact of Home Health Physical Therapy on Medicare Beneficiaries with a Primary Diagnosis of Dementia: A secondary analysis of Medicare data.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Cherie V. LeDoux, PT, DPT; Richard C. Lindrooth, PhD; Katie J. Seidler, PT, DPT, MSCI; Jason R. Falvey, PT, DPT, PhD; and Jennifer E. Stevens-Lapsley, MPT, PhD.

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