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Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial
Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, Kukull WA, LaCroix AZ et al.. JAMA, 2003-10-01
Topic: Amyloid, tau and blood-test diagnosis
Context Exercise training for patients with Alzheimer disease combined with teaching caregivers how to manage behavioral problems may help decrease the frailty and behavioral impairment that are often prevalent in patients with Alzheimer disease. Objective To determine whether a home-based exercise program combined with caregiver training in behavioral management techniques would reduce functional dependence and delay institutionalization among patients with Alzheimer disease. Design, setting, and patients Randomized controlled trial of 153 community-dwelling patients meeting National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer Disease and Related Disorders Association criteria for Alzheimer disease, conducted between June 1994 and April 1999. Interventions Patient-caregiver dyads were randomly assigned to the combined exercise and caregiver training program, Reducing Disability in Alzheimer Disease (RDAD), or to routine medical care (RMC). The RDAD program was conducted in the patients' home over 3 months. Main outcome measures Physical health and function (36-item Short-Form Health Survey's [SF-36] physical functioning and physical role functioning subscales and Sickness Impact Profile's Mobility subscale), and affective status (Hamilton Depression Rating Scale and Cornell Depression Scale for Depression in Dementia). Results At 3 months, in comparison with the routine care patients, more patients in the RDAD group exercised at least 60 min/wk (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.25-6.39; P =.01) and had fewer days of restricted activity (OR, 3.10; 95% CI, 1.08-8.95; P Conclusion Exercise training combined with teaching caregivers behavioral management techniques improved physical health and depression in patients with Alzheimer disease.
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APA 7th
Teri, L., Gibbons, L. E., McCurry, S. M., Logsdon, R. G., Buchner, D. M., Barlow, W. E., et al. (2003). Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA. https://doi.org/10.1001/jama.290.15.2015
Vancouver
Teri L, Gibbons LE, McCurry SM, Logsdon RG, Buchner DM, Barlow WE, et al. Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. JAMA. 2003. doi:10.1001/jama.290.15.2015. PMID: 14559955.
BibTeX
@article{teri2003-14559955,
author = {Teri, L. and Gibbons, L. E. and McCurry, S. M. and Logsdon, R. G. and Buchner, D. M. and Barlow, W. E. and Kukull, W. A. and LaCroix, A. Z. and others},
title = {{Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial}},
journal = {JAMA},
year = {2003},
doi = {10.1001/jama.290.15.2015},
pmid = {14559955},
url = {https://doi.org/10.1001/jama.290.15.2015}
}
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Key findings
- Results At 3 months, in comparison with the routine care patients, more patients in the RDAD group exercised at least 60 min/wk (odds ratio [OR], 2.82; 95% confidence interval [CI], 1.25-6.39; P =.01) and had fewer days of restricted activity (OR, 3.10; 95% CI, 1.08-8.95; P<.001).
Why it matters
In this randomized trial, 153 people with Alzheimer disease living at home took part with their caregivers. Pairs received either a 3-month home programme that combined exercise with training caregivers to manage behaviour problems, or routine medical care. At 3 months, more people in the programme exercised at least 60 minutes a week (OR 2.82) and had fewer days of restricted activity (OR 3.10). The authors concluded that the combined programme "improved physical health and depression". The stored summary is cut before the depression and physical-function figures and reports no result on delaying nursing-home placement, so those effects cannot be checked here.
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Study details
- Study designrandomized controlled trial
- Evidence strengthHigh
How this study scored 75/100
Published in a top-tier journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 6 / 7 | Cited 773 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 30.9 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 4 / 6 | Cited 17.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 41 other studies in this library |
| Still being cited | 2 / 4 | Cited 32 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Eric B. Larson: h-index 105 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 14559955) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 75 / 100 | — |
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