Combination of Exercise and Group Occupational Therapy for Behavioural and Psychological Symptoms of Dementia: A Pilot Randomised Controlled Trial.

Background: The behavioural and psychological symptoms of dementia (BPSD) increase the burden for the caregiver, often leading to difficulties in maintaining home care and triggering psychiatric hospitalisation. Effective management of BPSD plays a critical role in dementia care. This study examined whether the addition of short-term exercise therapy to group occupational therapy (OT) was effective in reducing BPSD.

Methods: This single-blind randomised controlled trial included inpatients aged 60 years or older in a dementia-specialised psychiatric ward. Participants were randomly assigned to either an intervention group (OT plus exercise therapy) or a control group (OT only), with both groups receiving interventions five times per week over a two-week period. The primary outcome was the change in BPSD after 2 weeks.

Results: Seventeen of 18 participants completed the trial. In the full analysis set, there was no significant difference in BPSD between the intervention and control groups. However, in a supplementary per-protocol analysis including 14 participants who completed all interventions, there was a significant improvement in Neuropsychiatric Inventory-Nursing Home version scores for patients in the intervention group.

Conclusions: The addition of short-term exercise therapy to group OT did not result in a significant reduction in BPSD. However, supplementary analysis suggested a potential benefit among participants with high adherence. While these findings suggest that short-term exercise may not immediately enhance the effects of OT, the limited sample size prevents definitive conclusions. This study provides hypothesis-generating insights for future research.

Trail registration: Information Network Clinical Trials Registry (UMIN-CTR): UMIN000038201.