A 12-Week Step Training Intervention for Older Adults with Mild Dementia: A Feasibility and Preliminary Efficacy Study

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Wayne LS Chan1; Jae QJ Liu1; Michael K Yeung2; Sam CC Chan1; Stephen Lord3; Jasmine Menant3; Daina Sturnieks4; Vincent CT Mok5

1.Department of Rehabilitation Sciences, The Hong Kong Polytechnic University 2.Department of Psychology, The Education University of Hong Kong 3.Neuroscience Research Australia, University of New South Wales 4.School of Medical Sciences, University of Ne

Scientific Research

SP - Falls

Falls

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Abstract

Introduction

Reduced stepping performance is a key modifiable risk factor for falls in older adults with dementia. While step training is effective in healthy older populations, its feasibility and efficacy have not been established for individuals with dementia. This study aimed to evaluate the feasibility and potential effects of a step training program in a preliminary sample of community-dwelling older adults with mild dementia.

Methods

In this pre-post intervention study, 31 older adults with mild dementia participated in a structured step training program (2 times per week, 30-min sessions). Participants were instructed to stand on a nonslip plastic mat and repeatedly step onto targets designated by an exercise instructor throughout each session. We primarily assessed feasibility through retention rates, adherence, and safety monitoring. Secondary objectives were to evaluate changes in clinical outcomes from baseline to 12 weeks, including measures of stepping performance and other physical, cognitive, and psychological outcomes.

Results

Twenty-seven participants (mean age = 78.9 ± 7.1 years; 54% female; mean MoCA = 14.0 ± 2.6) completed the study, yielding a retention rate of 87%. The mean adherence rate to the training sessions was 83%. No adverse events were recorded. Participants showed significant improvements in the Berg Balance Scale (p = .006), the Choice Stepping Reaction Time Test (p = .011), the Maximum Step Length Test (p < .001), the 30-second Sit-to-stand Test (p = .002), and the Geriatric Depression Scale (p = .006). All effects were of medium to large magnitude (Cohen’s d = 0.53-0.78).

Conclusions

This preliminary investigation demonstrates that a structured step training program is a safe, feasible, and potentially effective intervention in older adults with mild dementia. These promising results warrant a larger randomized controlled trial to confirm efficacy and evaluate the program's impact on fall rates.