Effects of Physical Exercise on Health and Well-Being of Individuals Living With a Dementia in Nursing Homes: A Systematic Review

Abstract

Background Physical exercise interventions have benefits for older individuals and improve the health and well-being of individuals living with a dementia, specifically those living in nursing homes. Purpose Report evidence from randomized controlled trials and cluster randomized control trials that evaluated the effects of physical exercise interventions on individuals living with a dementia in nursing homes. Data sources Web of Science, Scopus, Science Direct, Academic Search Complete, Proquest Central, British Medical Journal Database, PubMed, Cochrane Library, PEDro, Informit, Informa, and Nursing Consult were searched for relevant clinical trials and snowballing of recommended studies. Study selection One reviewer screened articles on inclusion criteria and identified relevant studies. Data extraction Data extraction was performed by 1 reviewer and checked by second and third reviewers. Two authors assessed the methodological quality and risk of bias of the relevant studies. Data synthesis Twelve study populations consisting of individuals living with a dementia in nursing homes were included (n = 901). Different types of physical exercises were undertaken: multimodal (n = 6), walking (n = 5), music and movement (n = 2), and hand exercises (n = 1). The parameters of the interventions varied across the studies. Most of the studies reported significant positive effects of physical exercise on cognition, agitation, mood, mobility, and functional ability for individuals living with dementia in nursing homes. Limitations The main limitations were the heterogeneity of design, small samples, and short interventions. Conclusions There is emerging evidence that physical exercise significantly benefits individuals living with a dementia in nursing homes. Higher quality research is required adopting more rigorous methods, including longer interventions and larger samples to determine optimum parameters of the physical exercise interventions evaluated.

Levels of physical activity and sleep patterns among older people with dementia living in long-term care facilities: A 24-h snapshot

“…LTC facilities may also benefit from the inclusion of more formal physical exercise opportunities within their scheduled activities. A recent systematic review [27] reported that the most significant improvements for LTC residents with dementia occurred when activities involved strength, flexibility, balance, and endurance (typically walking), and were conducted for at least 30-minutes twice a week.…”

Effects of Physical Activity in Nursing Home Residents with Dementia: A Randomized Controlled Trial

“…Possible explanations for the negative results are the small nonrandomized designs [26], or insufficient intensity, frequency (e.g., 15 min per day/6 days per week) [30], or duration of interventions (majority < 6 months) [26,27]. With regard to the second method, exercise training, multiple studies report benefits on physical performance [32][33][34][35][36][37], cognitive functions [12,[38][39][40][41][42][43][44], mood, and behavioral problems [1,2,9,32] in elderly subjects with dementia. Nonetheless, other studies report no benefits of exercise on these outcomes [21,34,35,[43][44][45][46][47][48][49].…”

“…Heterogeneity in type, frequency, and duration of physical activity interventions limits the ability to draw firm conclusions about the optimal training for NH residents with dementia [21,32,43,47]. For instance, some studies report the greatest benefits after multicomponent exercise interventions (e.g., combined strength and aerobic exercises) [32,42], while other studies consider aerobic exercise to be the driving force for improvements in cognition, physical functions, mood, and behavioral problems [1,2,12].…”

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“…Chair dance / exercise and music are a natural combination [32,33]. Exercise can enhance the quality of life, including physical function, in individuals with various neurologic conditions [34,35]. Exercising to music has also been found to enhance levels of brain derived neurotrophic factor (BDNF), a factor critical for synapse development and brain plasticity [36].…”