The effects of balance exercises versus strengthening exercises on gait and cognitive parameters in geriatric individuals with early-stage dementia

The aim of this study was to examine and compare the effects of balance exercises versus strengthening exercises on gait parameters, balance, and cognitive outcomes in geriatric individuals with early-stage dementia. A total of 32 geriatric individuals diagnosed with early-stage dementia were included in the study. Participants were randomly assigned into two groups and followed for a period of 8 weeks. The first group received strengthening exercises, while the second group received balance exercises, both administered twice a week. After recording the demographic and clinical characteristics of all participants, gait was assessed using Spatiotemporal Gait Parameters and the Timed Up and Go (TUG) Test; balance was evaluated with the Berg Balance Scale (BBS); cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) and the Dynamic Lowenstein Occupational Therapy Cognitive Assessment Geriatric Version (DLOTCA-G); muscle strength was measured using the Activforce-2 digital dynamometer; and quality of life was evaluated with the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). According to the assessment results, both groups demonstrated statistically significant improvements in BBS scores, step length, and TUG test scores (p<0.05). However, improvements in double step length and step width were statistically significant only in Group I and not in Group II. The difference between the two groups was not statistically significant, indicating similar improvements in balance and gait parameters. Regarding cognitive outcomes, both groups showed significant improvements in overall cognitive performance and sub-parameters (p<0.05). In the comparison between groups, Group I exhibited statistically significant improvements in the MoCA Visuospatial/Executive subdomain and the DLOTCA-G Visual-Motor Organization subdomain, while Group II showed a statistically significant improvement in the DLOTCA-G Awareness subdomain (p<0.05). In terms of muscle strength, both groups demonstrated statistically significant improvements, with no significant difference observed between them. According to the WHOQOL-OLD assessment, no statistically significant change was found in Group I after the intervention (p>0.05). In contrast, Group II showed a statistically significant improvement in the overall WHOQOL-OLD score and in the "Past, Present, and Future Activities" subdomain (p<0.05), although the difference between the two groups was not statistically significant. In conclusion, both strengthening and balance exercises had positive effects on balance, gait, and cognitive parameters in geriatric individuals with early-stage dementia. Strengthening exercises appeared to be more effective in improving visuospatial/executive functions and visual-motor organization, whereas balance exercises were more effective in enhancing awareness. In all other outcome measures, both interventions demonstrated similar effects.