Evaluation of the Effect of Adherence to a Tai Chi exercise intervention on the Quality of Life of older People with Dementia.

Abstract

The present PhD aimed to assess effect of adherence to a Tai Chi exercise intervention on the Quality of Life (QoL) of community-dwelling older People with Dementia (PWD) and their carers. It was part of an assessor blind, parallel group, randomized controlled trial conducted in the south of England with 83 dyads (person with dementia and informal carer). The intervention group (N = 42) received 20 weeks of Tai Chi classes and home practice along with treatment as usual, and the control group (N = 41) received treatment as usual only. The present PhD partially derived its data from the main trial. It consisted of three sub-studies. Study-I validated a generic QoL scale, The Investigating Choice Experiments for the Preferences of Older People — CAPability index (ICECAP-O), for PWD. It was found to be a valid and reliable QoL measure for PWD (i.e., face validity, feasibility of administration, internal and external reliability, construct validity and confirmatory factor analysis). Study-II evaluated patterns, predictors and factors affecting adherence and causes of non-adherence to Tai Chi intervention among PWD. Dyad’s acute health conditions were found to be the most dominating factor to reduce PWD’s attendance to Tai Chi classes. Study-III analyzed predictors of dyad’s QoL, effect of their QoL on their adherence to the Tai Chi intervention, and the effect of adherence to the Tai Chi intervention on dyad’s QoL. Carer burden was found to be a negative predictor of carers’ QoL. However, adherence to Tai Chi intervention improved the QoL of dyads. The present PhD added valuable knowledge in the realms of psychometric evaluation of PWD’s QoL, predictors of dyads’ QoL and exercise adherence, along with the effects of adherence to an exercise programme on dyad’s QoL. The findings will be useful in future policy formation and intervention designs to improve QoL of PWD and their carers.