Balance, movement confidence, and cognition: Exploring the impacts of a group motion-based technology intervention for people with dementia and mild cognitive impairment

Background: Exercise can impact balance, movement confidence, and cognition among people with dementia and mild cognitive impairment (MCI). However, engaging and accessible ways for this population to exercise are lacking. Motion-based technology, which people with dementia and MCI can learn to use and enjoy using, could be a potential solution. The purpose of this study was to examine the impacts of a group motion-based technology intervention on balance, movement confidence, and cognition among people with dementia and MCI.

Method: Participants with dementia and MCI (n=28; 53.6% female) were recruited from four community-based adult day programs and invited to partake in a 10-week Xbox Kinect bowling intervention. Before and after the intervention, participants completed the Montreal Cognitive Assessment (MoCA) and the Mini Balance Evaluation Systems Test (Mini-BEST) to measure cognition and balance, respectively. Video recordings were taken during the first, middle, and final week of the intervention and coded using video analysis software, to measure movement confidence. Quantitative data from the MoCA, Mini-BEST, and coded video recordings were compared using a series of related-samples Wilcoxon signed rank tests.

Result: At baseline, participants with dementia and MCI were substantially impaired with regards to balance (mean Mini-BEST: 14.58/28), cognition (mean MoCA: 12.86/30), and mobility (57.1% mobility device users). Among the participants who completed the study, there was no significant decline in balance (Z-score=-1.276, p=0.202), movement confidence (Z-score=-0.359, p=0.719), or cognition (Z-score=-0.060, p=0.952), suggesting a potential maintenance effect of the intervention.

Conclusion: Firstly, the findings highlight the prevalence of mobility and balance impairments among people with dementia and MCI, in addition to confirming their cognitive impairment. Secondly, this study also highlights the potential of using motion-based technology to support the function and well-being of people with dementia and MCI. That is, the finding of no significant decline in function among the participants can be considered a positive finding, given the generally progressive nature and trajectory of dementia.