A randomised controlled trial comparing the effectiveness of Tai Chi alongside usual care with usual care alone on the postural balance of community-dwelling people with dementia

Study ID: 32303
Short Title: The TACIT Trial: TAi ChI for people with demenTia (version 1.0)
Organisation: Solent NHS Trust
Location: Solent NHS Trust
Condition: Dementia
Main Specialty: Dementias
Expected End Date: 31/05/2018
Postcode: PO3 6AD
Contact Name: Solent Research
Contact Email: research@solent.nhs.uk
Active: Yes

Inclusion Criteria

PWD must satisfy all of the following criteria to be enrolled in the study: - Aged 65 or above - Living at home - Have a diagnosis of a dementia - Able to do standing Tai Chi (e.g. not be wheelchair bound) - Willing to attend weekly Tai Chi classes - Willing to attend a focus group (intervention pilot phase only) Informal carers must satisfy all of the following criteria: - Able to commit to supporting the PWD by participating in data collection throughout the study and in the intervention components if allocated to the intervention group (minimum of 2 times per week in-person, but ideally more) - Able to do standing Tai Chi (e.g. not be wheelchair bound) - Willing to attend weekly Tai Chi classes - Willing to attend a focus group (intervention pilot phase only).

Exclusion Criteria

PWD: - Living in a care home - In receipt of palliative care - Do not have a diagnosis of dementia - Indicate that they have: Severe dementia OR A Lewy body dementia or dementia with Parkinson’s disease OR Severe sensory impairment - Are already currently practising (on average once a week or more) or have been practising within the past six months (on average once a week or more) Tai Chi or similar exercise (Qigong, yoga, or Pilates) - Are currently under the care of or have been referred to a falls clinic for assessment, or are currently attending a balance exercise programme (e.g. Otago classes) - Lack mental capacity to provide informed consent Carers: - Indicate that they have severe sensory impairment a - Lack mental capacity to provide informed consent.

Study summary:

Amongst people aged over 65, people with dementia (PWD) are much more likely to fall, and be injured, than those without dementia. Being injured from falling over is the main reason why older people attend the hospital A&E department. PWD often experience longer hospital stays following a fall, and may become confused which can be stressful for the carer; and a considerable cost to the NHS. There is evidence that exercise programmes help to prevent falling. Can a Tai Chi exercise programme prevent falls among PWD living at home? We will investigate whether practising Tai Chi over several months improves ability to balance (because standing balance is a good indicator of how likely someone is to fall). People with mild to moderate dementia who live at home are eligible to take part with their regular care-giver as a ‘pair’. The PWD must be aged 65 years or older and both must be willing and able to do standing Tai Chi. At baseline, the researcher will visit the pair at home to assess the participants’ balance, memory skills, and general well-being. Pairs will be randomly assigned to either Tai Chi and usual care (intervention) or usual care only (control). Pairs in the intervention group will practice Tai Chi together in a weekly group class held locally, and at home, and will complete a diary of how much time was spent doing Tai Chi over six months. All participants will complete diaries showing how often they fell and whether falls caused an injury. The baseline assessment will be repeated at six months. A researcher will collect feedback from the pair to see whether the intervention could be (further) tailored to the need of PWD and carers. The change in ability to balance over six months will be compared between PWD in each group.

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