Results of a Longitudinal Physical and Cognitive Training of People with Dementia, from Alzheimer Athens

Abstract

Background: Physical and cognitive training programs have shown promise in improving functional and cognitive outcomes in individuals with dementia. However, large-scale, longitudinal evidence remains limited, particularly within real-world clinical settings.
Objective: This study investigates the longitudinal effects of a structured physical and cognitive training program implemented by Alzheimer Athens, focusing on functional and cognitive changes in people with dementia, in a 10-year investigation.

Methods: We analyzed data from 956 patients enrolled in a multi-component intervention program, followed for up to ten-time points. Primary outcomes included the Mini Mental State Examination (MMSE), a verbal fluency task, and the Instrumental Activities of Daily Living (IADL) questionnaire. Mixedeffects models with REML estimation were used to evaluate the impact of time, cognitive status, gender, age, and educational level on outcome measures. Post- hoc comparisons were adjusted using Tukey’s method.

Results: Over time, overall cognition and verbal fluency performance remained stable through the fourth to seventh follow-up, and declined thereafter, similarly to the daily functionality. Results were mostly driven by early-stage demented people. Higher cognitive status and educational level were associated with better performance across measures. Age was a significant predictor, with older individuals generally scoring lower on MMSE and verbal fluency, and having more affected functionality.

Conclusions: Despite disease progression, participation in the routine multimodal care program was associated with relatively stable functional abilities over several follow-up periods and slower decline in some cognitive domains. However, causal effects cannot be inferred from this observational study design. The findings support the integration of multimodal training in dementia care pathways.