Background: Evidence suggests that targeted exercise is important for people living with dementia, especially those living in residential care. The aim of this presentation is to show evidence on the known barriers to and facilitators of adherence to walking group exercise of older people living with dementia in the community.
Methods: We have searched appropriate electronic databases between January 1990 until September 2019, in any language. Additionally, we will search trial registries (clinicaltrial.gov, and WHO ICTRP) for ongoing studies. We included all study designs. Studies were excluded when participants were either healthy older people or people suffering from dementia but living in an institution.
Results: Ten papers met the inclusion criteria. The narrative analysis focused on barriers, facilitators, and adherence. All studies reported on barriers and facilitators. Barriers included: bio-medical reasons (including mental well-being and physical ability); relationship dynamics; and socio-economic reasons and environmental issues. Facilitators included: bio-medical benefits and benefits related to physical ability; staff and group relationship dynamics and social aspects of the walking group; environmental issues and individual tailoring; and participants` perceptions about the walks and the programme. Most studies did not provide data about adherence or attendance; where reported, adherence ranged from 47-89%.
Conclusions: Walking in groups can have positive benefits for those with dementia and their carers. Carers’ willingness to engage, their circumstances, perspectives and previous experiences of exercise seem to play a key role in facilitating adherence, but there is little research that explores these factors. Also, the design, location and organisation of walking groups facilitate adherence. This reflects the need for such activities to be part of a wider ‘programme of care’, tailored to the needs of the individual, flexible and convenient. Knowledgeable and well-trained instructors or healthcare professionals are recommended as group exercise leaders.