Veterans are admitted to Veterans Health Administration (VA) Nursing Homes (NH) because impairments in their ability to perform activities of daily living (ADL) overwhelm their support system (family and friends) in the community. The etiologies of this impairment are, in part, due to chronic disease, deconditioning, and immobility. Yet, after admission, NH residents frequently have decreased levels of daily activity compared with their pre-admission activity. Our preliminary observations suggest that dependent, frail residents improve in function in response to exercise in a NH setting. No previous study of exercise in NH residents has included measures of body composition, the impact of exercise on cost of care, or has compared an exercise group with a non-exercise group that receives a comparable level of staff attention and positive reinforcement. The results will be relevant to care in nursing homes within and outside the VA to improve the health and care of residents. By comparing an exercise group with a non-exercise group that receives a comparable level of staff attention and positive reinforcement, we will determine whether changes in function normally associated with low intensity exercise are due to exercise or to other factors.

We are conducting a blinded, prospective, randomized, controlled, clinical investigation at a VA nursing home, comparing the effect of four months of low intensity exercise activity with the effect of music and art activity on: 1) muscle mass, assessed by DEXA scan; 2) physical function, assessed by timed performance tests, strength, category of care and independence in ADL; and 3) the cost of NH care, assessed by measuring the cost of providing care within the NH minus the cost of providing the intervention. The study setting is a VA nursing home, resident participants are new admissions and are 65 years or older. All participants must be able to follow a one step command and be able to participate in group activity. Participants with a Mini Mental Status Exam (MMSE) of less than 24/30 must have consent of an authorized representative. Screening of candidates is completed on all admissions.

Ages Eligible for Study:  65 Years and above,  Genders Eligible for Study:  Both

Criteria

• Must be able to follow a one step command and be able to participate in group activity
• Participants with a Mini Mental Status Exam (MMSE) of less than 24/30 must have consent of an authorized representative
• Nursing Home resident