Effectiveness of exercise interventions for adults over 65 with moderate-to-severe dementia in community settings: a systematic review
Key summary points
To review the literature on the effectiveness of exercise interventions for people with moderate-to-severe dementia in community settings.
The literature was of low quality, but suggested exercise programmes may improve physical function of people with moderate-to-severe dementia. There was no evidence that exercise programmes improve mood.
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.
To conduct a systematic review of the literature to evaluate the effectiveness of exercise interventions for people with moderate-to-severe dementia in community settings.
Eight electronic databases (MEDLINE, Embase, CINAHL, AMED, PsycINFO, PEDro, The Cochrane Library and BNI) were searched from inception to July 2018. Snowball searching identified additional articles not identified initially. Articles were included if they: reported randomised or quasi-randomised controlled trials comparing exercise with usual care or no treatment; and involved people over 65 with moderate-to-severe dementia in community settings. Outcome measures of interest were strength, endurance, mobility, mood and quality of life. Titles and abstracts of all studies were screened by one reviewer. Two reviewers independently screened full text articles for all eligible studies, extracted data and assessed quality and risk of bias.
Eight studies with 819 participants were included. Interventions were variable in terms of content, duration and frequency. There was some evidence exercise programmes may improve physical function of people with moderate-to-severe dementia, with significant effects seen for gait speed and endurance, and a trend towards improvement in strength. There was little evidence to suggest exercise programmes improve mood. Most studies were of low quality.
Exercise was associated with improvements in gait speed and endurance for older people with moderate-to-severe dementia living in the community, but the quality of evidence was low. There was no conclusive evidence regarding effect on strength or mood. Findings are limited by the quality of the available evidence.
KeywordsDementia Aged Exercise Systematic review
All authors wrote the protocol for the review, contributed to the analysis and wrote the manuscript. AL and KR conducted the review and led the analysis.
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 2.WHO (2017) Global action plan on the public health response to dementia 2017–2025. World Health Organisation, GenevaGoogle Scholar
- 5.P.A.G.A.C (2018) Physical Activity Guidelines Advisory Committee Scientific Report. In: Services DoHaH (ed). WashingtonGoogle Scholar
- 6.Forbes D, Forbes SC, Blake CM, Thiessen EJ, Forbes S (2015) Exercise programs for people with dementia. Cochrane Database Syst Rev 4:Cd006489Google Scholar
- 13.Long A, Robinson K. Systematic review of effectiveness of exercise over usual care for adults over 65 with moderate to severe dementia in community settings: A Protocol York: NIHR; 2018 [updated 15/10/18. Available from: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018096194
- 14.Higgins JPT, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration. www.handbook.cochrane.org
- 21.Meng-Chun C, Kuei-Min C, Chu-Lin C, Ya-Hui C, Yin-Yin C, Hsin-Ting H (2016) Elastic band exercises improved activities of daily living and functional fitness of wheelchair-bound older adults with cognitive impairment. A cluster randomized controlled trial. Am J Phys Med Rehabil 95(11):789–799CrossRefGoogle Scholar