432 Exercise programmes beneficial for people with dementia

July 08, 2014

PEARLS 432, June 2014, written by Brian R McAvoy

Clinical question
Are exercise programmes effective for people with dementia?

Bottom line
There was promising evidence exercise programmes can have a significant impact in improving ability to perform activities of daily living and, possibly, in improving cognition in people with dementia, although some caution is advised in interpreting these findings. The programmes had no significant effect on challenging behaviours or depression. There was little or no evidence regarding quality of life, mortality, caregiver quality of life and mortality, or costs and use of healthcare services. There was an insufficient number of trials to permit subgroup analyses that would determine which type of exercise (aerobic, strength training, balance), at what frequency and duration, is most beneficial for specific types and severity of dementia.

Caveat
The included trials were highly heterogeneous in terms of subtype and severity of participants' dementia, and type, duration and frequency of exercise. Several authors did not report, or did not describe adequately, the outcome data for each main outcome. High attrition rates, an imbalance of attrition between groups and unknown reasons for attrition and poor adherence (or no description) to the exercise programmes were also potential sources of bias in several of the included trials.

Context
In future, as the population ages, the number of people in our communities suffering with dementia will rise dramatically. This will not only affect the quality of life of people with dementia but also increase the burden on family caregivers, community care and residential care services. Exercise is one lifestyle factor identified as a potential means of reducing or delaying progression of the symptoms of dementia.

Cochrane Systematic Review
Forbes D et al. Exercise programs for people with dementia. Cochrane Reviews, 2013, Issue 12. Art. No.: CD006489.DOI: 10.1002/14651858. CD006489.pub3. This review contains 16 studies involving 937 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.