Applicability and Effects of Physical Exercise on Physical and Cognitive Functions and Activities of Daily Living Among People With Dementia

Abstract

: Among older people with Alzheimer disease in residential care facilities, combined functional weight-bearing exercise seems applicable for use regarding attendance and adverse events, and there is some evidence that exercise improves walking performance and reduces the decline in activities of daily living. Furthermore, there is some evidence that walking exercise performed individually reduces decline in walking performance, but adverse events need to be evaluated. Among older people with various types of dementia disorders who are staying in a hospital, there is some evidence that combined functional and nonfunctional exercise over 2 wks has no effect on mobility. It seems important that the interventions last for at least a few months and that the exercises are task-specific and are intended to challenge the individual's physical capacity. Among older people with unspecified dementia disorders in residential care facilities, there is some evidence that walking exercise performed at a self-selected speed has no effect on cognitive functions. Whether physical exercise can improve cognitive functions among people with dementia remains unclear because studies evaluating this have either been of low methodologic quality or used an intervention of presumably insufficient intensity. There is a need for more studies of high methodologic quality, especially among people with dementia disorders other than Alzheimer disease.

Treadmill training as an augmentation treatment for Alzheimer?s disease: a pilot randomized controlled study

“…However, according to Forbes et al 14 there is insufficient evidence to determine the effectiveness of physical activity programs in managing or improving cognition. In a recent systematic review, Littbrand et al 9 concluded that low methodological quality and/or an intervention of insufficient intensity can be responsible for the exercise has no effect on cognitive functions among people with dementias. These effects are dependent, however, on the intensity and frequency of exercise.…”

“…Whereas studies which used walking as a type of aerobic intervention in patients with dementia did not provide the same results 8,12,13 . In recent years, several systematic reviews have observed positive effects of physical exercise on people with dementia 3,9 . However, according to Forbes et al 14 there is insufficient evidence to determine the effectiveness of physical activity programs in managing or improving cognition.…”

“…Higher fitness levels in early AD patients were associated with preserved brain volume (less brain atrophy) independent of age 5 . Several studies have shown that physical training programs may have a role in the improvement of ADL, quality of life, depressive symptoms, and motor and cognitive function in patients with AD 3,4,[6][7][8][9][10][11] . However, some methodological questions may affect the application of the training protocols.…”

Measuring physical function in people with dementia: a psychometric investigation

“…While several recent systematic reviews on the effectiveness of exercise for cognitively impaired older adults exist (Burge, Kuhne, Berchtold, Maupetit, & von Gunten, 2012;Hauer et al, 2006;Heyn et al, 2004;Littbrand et al, 2011;Pitkala, Savikko, Poysti, Strandberg, & Laakkonen, 2013;Suttanon et al, 2011;Van Uffelen, Chin A Paw, Hopman-Rock, & Van Mechelen, 2008), all had their limitations. Only four of these reviews were specific to a dementia diagnosis, two of these only examined the effect on activities of daily living (ADLs) (Burge et al, 2012), with this considered a too narrow scope of physical function in this population and one was not specific on physical exercise (Littbrand et al, 2011;Suttanon et al, 2011). One recent systematic review (Pitkala et al, 2013) examined the effects of exercise interventions on mobility and physical function in people with dementia.…”

“…Exercise undertaken regularly can have pronounced physical and functional benefits for adults with dementia (Ahlskog et al, 2011;Littbrand, Stenvall, & Rosendahl, 2011). To understand these benefits, we are reliant on the sound psychometric properties of the measures utilised to assess functional and physical capacity.…”