P488: The effects of cognitive and exercise interventions for people with mild cognitive impairment and dementia on carers: a systematic review (original) (raw)
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European Geriatric Medicine, 2019
Aim: To review the literature on the effectiveness of exercise interventions for people with moderate to severe dementia in community settings Findings: The literature was of low quality but suggested exercise programs may improve physical function of people with moderate to severe dementia. There was no evidence that exercise programs improve mood. Message: More research is needed to improve the quality of the evidence to better understand the effectiveness of exercise programmes in community-dwelling older people with moderate to severe dementia.
2019
As the population ages, the number of people suffering from dementia will rise significantly. Current estimates of total societal cost of dementia exceed $8 billion dollars (US). Epidemiological studies have shown that increased lifetime engagement in exercise reduces cognitive decline and the incidence of dementia in normal older adults. While existing research suggests that lifelong exercise may be preferable, the adoption of exercise at any age and stage of dementia-onset to delay or reverse cognitive decline is worthwhile given the prevalence of sedentary lifestyle, and the increasing proportion of older adults and dementia incidence. Recently, trials have started to explore the impact of exercise on cognitive symptoms in individuals diagnosed with dementia. These studies are reporting promising findings, which call for further meta-analytical review. The primary objective of this meta-analysis is to examine the effects of exercise interventions on cognitive function compared to...
Exercise for dementia and Mild Cognitive Impairment: methodological considerations
European Journal of Human Movement, 2018
The exponential worldwide increase in the number of older adults is causing a parallel rise in the number of cases of neurodegenerative diseases, such as mild cognitive impairment (MCI) and dementia. Exercise is a promising strategy for improving physical and cognitive function in healthy older adults, reducing the risk of developing MCI and dementia, and improving physical and cognitive function as well as decreasing neuropsychiatric symptoms in people with MCI and dementia. However, there are still some inconsistencies in the literature, especially in regards to the cognitive benefits, and there are currently no guidelines for prescribing exercise for older adults with cognitive impairment. In this article, a narrative review on the benefits of exercise for people with MCI and dementia was conducted, establishing some preliminary guidelines for prescribing exercise efficiently and safely in this population.
European Geriatric Medicine
Background Physical activity and exercise have been suggested as effective interventions for the prevention and management of mild cognitive impairment (MCI) and dementia, but there are no international guidelines. Objectives To create a set of evidence- and expert consensus-based prevention and management recommendations regarding physical activity (any bodily movement produced by skeletal muscles that results in energy expenditure) and exercise (a subset of physical activity that is planned, structured, repetitive), applicable to a range of individuals from healthy older adults to those with MCI/dementia. Methods Guideline content was developed with input from several scientific and lay representatives’ societies. A systematic search across multidisciplinary databases was carried out until October 2021. Recommendations for prevention and management were developed according to the GRADE and complemented by consensus statements from the expert panels. Recommendations Physical activi...
Background: The aim of this study was to examine the benefits of exercise on the neurocognitive performance of individuals with dementia. Methods: We conducted a systematic search of PubMed, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Central Register of Controlled Trials (1966–2014) using the concepts of dementia, cognitive impairment, cognitive function, and exercise. Results: Fourteen randomized controlled trials were included, providing data from 1056 individuals. We found that exercise provided significant improvements in the following assessments: mini mental state examination, mean difference (MD) 1.17 (95% confidence interval [CI] 0.75–1.59, P < 0.00001); Alzheimer’s Disease Assessment Scale, MD −1.41 (95% CI −2.48–−0.34, P = 0.01); Clinical Dementia Rating scale, MD −0.37 (95% CI −0.57–−0.16, P = 0.0004); similarities subscale of Wechsler Adult Intelligence Scale Revised, MD 2.21 (95% CI 0.75–3.67, P = 0.003); arithmetic subscale of Wec...
Health technology assessment (Winchester, England), 2018
Approximately 670,000 people in the UK have dementia. Previous literature suggests that physical exercise could slow dementia symptom progression. To estimate the clinical effectiveness and cost-effectiveness of a bespoke exercise programme, in addition to usual care, on the cognitive impairment (primary outcome), function and health-related quality of life (HRQoL) of people with mild to moderate dementia (MMD) and carer burden and HRQoL. Intervention development, systematic review, multicentred, randomised controlled trial (RCT) with a parallel economic evaluation and qualitative study. 15 English regions. People with MMD living in the community. A 4-month moderate- to high-intensity, structured exercise programme designed specifically for people with MMD, with support to continue unsupervised physical activity thereafter. Exercises were individually prescribed and progressed, and participants were supervised in groups. The comparator was usual practice. The primary outcome was the...
Alzheimer's Research & Therapy
Background The prevalence of dementia is expected to increase dramatically. Due to a lack of pharmacological treatment options for people with dementia, non-pharmacological treatments such as exercise programs have been recommended to improve cognition, activities of daily living, and neuropsychiatric symptoms. However, inconsistent results have been reported across different trials, mainly because of the high heterogeneity of exercise modalities. Thus, this systematic review aims to answer the questions whether exercise programs improve cognition, activities of daily living as well as neuropsychiatric symptoms in community-dwelling people with dementia. Methods Eight databases were searched for articles published between 2016 and 2021 (ALOIS, CENTRAL, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, Web of Science). Randomized controlled trials evaluating the effects of any type of physical activity on cognition, activities of daily living, or neuropsychiatric symptoms in community-dwell...
Evidence-Based Exercise Recommendations for Older Adults With Cognitive Impairments
Innovation in Aging, 2020
Since the publishing of our meta-analysis evaluating the effects of randomized exercise trials on cognitive function of Older Adults with Cognitive Impairments (OAwCIs) (Heyn et al 2004), several meta-analysis reviews were published addressing similar question. We currently appraised this evidence and preliminary synthesis of twelve, well-designed meta-analysis reports resulted in 193 RCTs and 15,614 participants over the age of 65 years old diagnosed with MCI or Alzheimer’s disease (AD). Exercise prescription paradigms averaged 156 minutes per week for 20-week. The combined cognitive function outcome mean effect size was medium; 0.67 (0.06-1.34 95% CI). Grounded in this unique umbrella study results, sustained and prolonged exercise training might provide an effective intervention for the maintenance or enhancement of cognitive function for MCI and AD. This comprehensive meta-analysis umbrella offers valuable and strong exercise recommendations for OAwCIs. This study results will b...