Tackling Dementia: A Systematic Review of Interventions Based on Physical Activity.

Background and purpose: Dementia prevalence is expected to increase dramatically with population aging. As a nonpharmacological therapy, physical activity is an appealing alternative to tackling aging and dementia. However, contradictions were found in previous studies. The aim of this systematic review is to gather the latest evidence of the effects of physical activity interventions on cognition and noncognitive functions of older people with dementia.

Methods: PubMed, Cochrane, and Web of Science databases were searched to identify relevant studies. We followed the PRISMA guidelines to identify randomized controlled trials that reported original findings of physical activity interventions on older people with dementia (≥65 years of age). These studies were published in English between January 1, 2009 and November 9, 2019.

Results: In total, 16 trials with 2085 participants were included in the review. Compared to baseline, cognitive function improved significantly in 2 studies, deteriorated in 3 studies, and remained stable in 11 studies. In the exercise relative to the control group, 5 studies showed no significant differences, 2 studies showed significantly greater deterioration in cognition, and 9 studies showed significantly greater improvement in cognition. However, most studies (n = 13.81%) had notable limitations (eg, with a high risk of bias, limited follow-up time, or unexplained high heterogeneity in their findings). Fourteen studies reported a positive impact on one or more areas of physical function, mobility, activities of daily living, depression levels, and behavioral/psychological symptoms of dementia.

Conclusions: Physical activity interventions have a positive impact on physical function, mobility, and activities of daily living. However, the available evidence is insufficient to support the conclusion that physical activity improves cognitive function of older people with dementia.