Promoting independence in Lewy body dementia through exercise: the PRIDE study

Area of Science:

• Neurology
• Geriatrics
• Rehabilitation Medicine

Background:

• Lewy body dementia (LBD) is an aggressive dementia characterized by rapid progression, fluctuating symptoms, and functional decline.
• Non-pharmacological interventions, including high-intensity exercise, show promise in other neurological conditions but are understudied in LBD.

Purpose of the Study:

• To assess the feasibility and preliminary efficacy of a progressive, high-intensity exercise program in individuals with LBD.
• To evaluate the impact of exercise on functional independence, a key outcome measure in LBD.
• To explore clinical characteristics associated with functional independence and potential treatment targets in LBD.

Main Methods:

• The Promoting Independence in Lewy Body Dementia through Exercise (PRIDE) trial was a non-randomized, crossover pilot study.
• Participants underwent an 8-week wait-list period followed by an 8-week supervised, clinic-based exercise intervention.
• The intervention included progressive resistance training, balance, and functional exercises, 3 days/week.

Main Results:

• Nine participants (4 DLB, 5 PDD) completed baseline; six completed the exercise intervention.
• Functional independence at baseline correlated with physical function, balance, cognition, and quality of life.
• Participants showed clinically meaningful improvements in functional independence, cognition, physical function, and strength after the exercise intervention.
• The exercise program was well-tolerated with high adherence (>80%) and minimal adverse events.

Conclusions:

• The PRIDE trial is the first exercise intervention study specifically for individuals with LBD.
• Progressive, high-intensity exercise appears feasible, safe, and potentially efficacious for improving outcomes in LBD.
• Findings support the design of larger randomized controlled trials to further investigate exercise as a therapeutic strategy for LBD.