Perspectives of People with Mild to Moderate Cognitive Impairment and Their Caregivers about Physical Activity and Exercise for Fall Prevention: A Qualitative Study

Abstract

Older adults with cognitive impairment are at high risk of experiencing falls. Although no specific fall prevention guidelines presently exist for this population, exercise programmes to prevent falls are recommended. Limited literature exploring what older adults with mild to moderate cognitive impairment think about or how they make sense of the need for such programmes exists. This study explored the perspectives of older adults with mild to moderate cognitive impairment and their caregivers about exercise and physical activity in the context of fall prevention. Underpinned by Interpretive Phenomenological Analysis, qualitative semi-structured interviews were undertaken with nine community-dwelling adults (>65 years) with mild to moderate cognitive impairment and their caregivers (N = 6). Three themes of acceptance, denial, and accommodation were identified. The fluctuating concept of ‘self’ appeared to influence individual decisions to exercise or be physically active and what sort of physical activity to undertake more than any practical barriers. We suggest that healthcare professionals emphasise the concept of personhood, listening to and reinforcing biographic narratives of older adults living with cognitive impairment to foster a sense of autonomy, and shared decision-making while emphasising fall prevention activities that older adults with cognitive impairment might like to engage with.

Keywords

• cognitive impairment
• older adults
• falls prevention
• physical activity
• exercise
• caregiver perceptions