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Effectiveness of exercise interventions for adults over 65 with moderate-to-severe dementia in community settings: a systematic review

  • Annabelle LongEmail author
  • Katie Robinson
  • Sarah Goldberg
  • Adam L. Gordon
Review

Key summary points

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 programmes may improve physical function of people with moderate-to-severe dementia. There was no evidence that exercise programmes 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.

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

Keywords

Dementia Aged Exercise Systematic review 

Notes

Author contributions

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.

Funding

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.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

None.

Supplementary material

41999_2019_236_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 kb)

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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  1. 1.Division of Rehabilitation and Ageing, School of Medicine, B109, Medical School, Queen’s Medical CentreUniversity of NottinghamNottinghamUK
  2. 2.Research and InnovationNottingham University Hospitals NHS TrustNottinghamUK
  3. 3.East Midlands Collaboration for Leadership in Applied Health Research and Care (EM-CLAHRC)NottinghamUK
  4. 4.School of Health SciencesUniversity of NottinghamNottinghamUK
  5. 5.Division of Medical Sciences and Graduate Entry MedicineUniversity of NottinghamDerbyUK
  6. 6.University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK

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