Blog | Wednesday, December 11, 2013

QD: News Every Day--Exercise in elderly with dementia may improve activities of daily living

Exercise programs in people with dementia can have a significant impact in improving ability to perform activities of daily living and possibly in improving cognition, a review of 16 trials concluded.

The review, an update of one in 2008, included 937 participants and tested whether exercise could improve cognition, activities of daily living, behavior, depression, and mortality. Older people diagnosed with dementia were randomized to exercise programs or to control groups (usual care or social contact/activities). Secondary outcomes assessed the roles of family caregivers. Results appeared online Dec. 4 at The Cochrane Library.

Exercise programs might have a significant impact on improving cognitive functioning (8 trials, 329 participants; standardized mean difference (SMD) 0.55; 95% CI, 0.02 to 1.09). However, there was substantial heterogeneity between trials (I2 value, 80%). When researchers re-ran the analysis to exclude one outlying trial that included only participants with moderate or severe dementia, heterogeneity was reduced (I2 value 68%) and the result was no longer significant (7 trials, 308 participants; SMD 0.31; 95% CI, -0.11 to 0.74).

There was a significant effect of exercise programs on the ability of people with dementia to perform activities of daily living, (6 studies, 289 participants; SMD 0.68; 95% CI, 0.08 to 1.27), but with considerable unexplained statistical heterogeneity (I2 value, 77%), leading researchers to caution the interpretation of findings.

The burden experienced by informal caregivers providing care in the home may be reduced when they supervise the participation of the family member with dementia in an exercise program (1 study, 40 participants; mean difference,-15.30, 95% CI -24.73 to -5.87), but there was no significant effect of exercise on challenging behaviors (1 study, 110 participants; mean difference, -0.60; 95% CI, -4.22 to 3.02), or depression (6 studies, 341 participants; mean difference, –0.14; 95% CI, -0.36 to 0.07).

Researchers wrote, “There was promising evidence that exercise programs can significantly improve the cognitive functioning of people with dementia and their ability to perform daily activities, but there was a lot of variation between trial results that we were not able to explain. The studies showed no significant effect of exercise on mood.”