Exercise programmes beneficial for people with dementia

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.
Review CD#: 
CD006489
PEARLS No: 
432
Date: 
June, 2014
Authored by: 
Brian R McAvoy