The effect of physical activity on cognitive function in patients with dementia: A meta-analysis of randomized control trials |
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| Institution: | 1. Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, The Netherlands;2. Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands;3. Department of Clinical Neuropsychology, VU University, Amsterdam, The Netherlands;4. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands;1. Department of Clinical Biochemistry, Section for Molecular Genetics, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark;2. Faculty of Health and Medical Sciences, University of Copenhagen, Denmark;1. Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité – Universitätsmedizin Berlin, Germany;2. Department of Neuropsychiatry, Charité – Universitätsmedizin Berlin, Germany;3. Berlin School of Public Health, Charité – Universitätsmedizin Berlin, Germany;4. Psychologische Hochschule Berlin, Germany;5. Cluster of Excellence, NeuroCure, German Center for Neurodegenerative Diseases and BIH, Berlin, Germany;6. Social and Preventive Medicine, University of Potsdam, Potsdam, Germany;1. Musculoskeletal Rehabilitation Research Unit and Institute of Sports Medicine, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark;2. Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark;3. Department of Psychology, University of Copenhagen, Copenhagen, Denmark;4. Dementia Clinic, Aalborg University Hospital, Aalborg, Denmark;5. Dementia Clinic, Aarhus University Hospital, Aarhus N, Denmark;6. Dementia Clinic, Odense University Hospital, Odense, Denmark;7. Department of Geriatrics, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark;8. Department of Geriatrics, Slagelse Hospital, Slagelse, Denmark;9. Zeland University Hospital, Department of Neurology, Regional Dementia Research Centre, Roskilde, Denmark;10. Memory Clinic, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark;11. Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;1. Department of Health Sciences, Public University of Navarre, Pamplona, Spain;2. Division of Geriatric Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain;1. Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;2. School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China;3. Department of Nursing, Tianjin Hospital, Tianjin 300211, China |
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| Abstract: | Non-pharmacological therapies, such as physical activity interventions, are an appealing alternative or add-on to current pharmacological treatment of cognitive symptoms in patients with dementia. In this meta-analysis, we investigated the effect of physical activity interventions on cognitive function in dementia patients, by synthesizing data from 802 patients included in 18 randomized control trials that applied a physical activity intervention with cognitive function as an outcome measure. Post-intervention standardized mean difference (SMD) scores were computed for each study, and combined into pooled effect sizes using random effects meta-analysis. The primary analysis yielded a positive overall effect of physical activity interventions on cognitive function (SMD95% confidence interval] = 0.420.23;0.62], p < .01). Secondary analyses revealed that physical activity interventions were equally beneficial in patients with Alzheimer's disease (AD, SMD = 0.380.09;0.66], p < .01) and in patients with AD or a non-AD dementia diagnosis (SMD = 0.470.14;0.80], p < .01). Combined (i.e. aerobic and non-aerobic) exercise interventions (SMD = 0.590.32;0.86], p < .01) and aerobic-only exercise interventions (SMD = 0.410.05;0.76], p < .05) had a positive effect on cognition, while this association was absent for non-aerobic exercise interventions (SMD = -0.10−0.38;0.19], p = .51). Finally, we found that interventions offered at both high frequency (SMD = 0.330.03;0.63], p < .05) and at low frequency (SMD = 0.640.39;0.89], p < .01) had a positive effect on cognitive function. This meta-analysis suggests that physical activity interventions positively influence cognitive function in patients with dementia. This beneficial effect was independent of the clinical diagnosis and the frequency of the intervention, and was driven by interventions that included aerobic exercise. |
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| Keywords: | Dementia Physical Activity Exercise Cognition Meta-analysis |
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