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Table 3 Summary of reviews examining the effects of exercise interventions on symptoms associated with Alzheimer’s disease and related dementias

From: Formulation of evidence-based messages to promote the use of physical activity to prevent and manage Alzheimer’s disease

Review Quality score # Studies in reviewa Type Characteristics Outcomes
Participants Design Interventions Physical Psycho-logical ADL and quality of life
Blankevoort et al., 2010b [26] 9 16 NR/MA Elderly (mean age >70 years) with dementia 10 RCT, 6 case series Various structured exercise programs Physical Function:
↑ Gait Speed, fast (k = 2) ES = 0.14; ↑ Gait speed, normal (k = 6) ES = 0.29; ↑ Endurance (k = 5) ES = 1.08;
↑ Lower extremity strength (k = 7) ES = 0.85
↑ Functional mobility (k = 6) ES = 0.28
Balance and Falls:
↑ Balance (k = 5) ES = 1.76
  ↑ ADL (k = 4)
d = 0.68
Boote et al., 2006 [27] 8 1 NR Mod-severe AD RCT Group exercise Physical Function:
<>Functional ability (0/1),
↑ Physical Therapy Assessment (1/1)
Balance and Falls:
↑ Balance (1/1)
  
Brett et al., 2015 [12] 9 12 SR Dementia living in nursing home RCT Any PA Physical Function:
↑ Mobility (3/5)
Balance and Falls:
↑ Balance (1/2)
Cognition:
↑ Cognition (5/7);
Affect:
↑ Mood (3/4);
↓ Agitation (1/1)
↑ ADL (3/5)
Burton et al., 2015 [28] 11 4 SR/MA Dementia living in the community 3 RCT and 1 quasi-experi-mental Strength, balance and mobility exercises Balance and Falls:
↓ Falls (k = 2) MD = -1.06*;
<>Fall risk (k = 2) MD = -0.1;
<>Balance (k = 2) MD = 0.51
  
Cooper et al., 2012 [13] 10 1 NR Dementia RCT Comprehensive exercise program    <>QOL (1/1)
de Souto Barreto et al., 2015 [14] 8 20 SR/MA Dementia RCT Any exercise   Affect:
↓ Depression (k = 7) SMD= -0.31*
Behaviours:
<>Behaviours (k = 4) MD= -3.88
 
Farina et al., 2014 [15] 10 3 MA AD RCT Any exercise (min. 4 weeks)   Cognition:
↑ Global cognition (k = 3) SMD = 0.75*
 
Forbes et al, 2013 [16] 11 16 CR Older adults (>65 years old) with dementia RCT Any exercise   Cognition:
↑ Global cognition (k = 8) SMD = 0.55*
Behaviours:
<>Challenging behaviours (k = 1) SMD=-0.60
Affect:
<> Depression (k = 5) SMD = -0.14
↑ ADL (k = 6)
SMD = 0.68*
Forbes et al, 2015 [17] 11 17 CR Older adults (>65 years old) with dementia RCT Any exercise   Cognition:
<>Global cognition (k = 9) SMD = 0.43; [excluding moderate-severe dementia (k = 8) SMD = 0.21]
Affect:
<> Depression (k = 5) SMD = -0.14
Behaviours:
<>Challenging behaviours (k = 1) MD= -0.60
↑ ADL (k = 6)
SMD = 0.68*
Groot et al., 2016 [52] 9 18 MA All dementia except those that affect motor system (e.g., Huntington’s, Parkinson’s) RCT Any physical activity   Cognition:
↑ Cognition
(k = 16) SMD = 0.42*
↑ ADL (k = 4)
SMD = 1.18*
Hermans et al., 2007 [18] 9 0 CR Dementia living in domestic setting RCT Walking and exercise therapy   Behaviours:
No studies of wandering met inclusion criteria
 
Heyn et al., 2004 [19] 10 30 MA Older adults (≥65 years) with cognitive impairment (MMSE <26) RCT Any exercise Physical Fitness:
↑ Health-related physical fitness (k = 40) ES = 0.69*; ↑ Cardiovascular (k = 18) ES = 0.62*; ↑ Strength (k = 17) ES = 0.75*; ↑ Flexibility (k = 4) ES = 0.91*
Physical Function:
↑ Functional performance (k = 20) ES = 0.59*
Cognition:
↑ Cognition (k = 12) ES = 0.57*
Behaviour:
↑ Behaviour (k = 13) ES = 0.54*
 
Jensen and Padilla, 2011 [29] 6 6 NR Dementia Mixed Exercise and motor-based interventions for falls prevention (2 group-based; 4 individual) Balance and Falls:
↓ Fall risk (3/4) ↑ Balance (1/1)
  
Littbrand et al., 2011 [20] 9 10; results from 6 low quality studies not reported NR Dementia RCT Walking and combined exercise Physical Function:
↑ Walking performance (2/2); <> Mobility (0/2)
Balance and Falls:
<> Balance (0/1)
  ↑ ADL (1/1)
O’Connor et al., 2009 [21] 8 1 NR Dementia RCT, RM Any PA or exercise   Affect:
↑ Positive affect, (1/2);
↓ Negative affect, (1/2)
 
Pitkala et al., 2013 [30] 8 20 NR Dementia RCT Any PA Physical Function:
↑ Physical function (16/20); ↑ Mobility or ↓ functional limitations (8/9 moderate-to-high quality studies)
  
Rao et al., 2014 [22] 5 6 SR Ambulatory older adults (>65 years) with AD RCT with sample size >15 Aerobic, strength, and balanced or any combination of the three Physical Function:
Functional ability (k = 6) ES = 0.53*
  ↑ ADL (k = 6) ES = 0.80*
Thuné-Boyle et al., 2012 [23] 6 16 RCIA Dementia Exercise inter-vention studies (6) and reviews (10) Any exercise   Affect:
↓ Agitation (4/4);
↓ Depression (4/8);
Behavior:
↓ Wandering (1/2);
↑ Night time sleep (3/5)
 
Yu, 2011 [24] 6 12 NR AD Experi-mental or quasi-experi-mental Aerobic exercise (alone or combination; >2weeks) Physical Fitness:
↑ 6 min walk (1/1);
↑ Strength (1/1);
Physical Performance
↑ Physical performance (4/5)
Cognition:
↑ Global cognition,
MMSE (4/4)
Affect:
↑ Mood (4/6)
↓ ADL
limitations
(2/2)
Yu et al., 2006 [25] 8 18 NR AD Any Aerobic exercise   Cognition:
↑ Global cognition (2/2)
 
  1. Note: AD Alzheimer’s disease, ADL activities of daily living, CR Cochrane review, MA meta analysis, NR narrative review, PA physical activity, QOL quality of life, RCT randomized controlled trial, RCIA rapid critical interpretive approach, SMD standard mean difference, MD mean difference, ES effect size; k number of studies
  2. Values in parentheses indicate the number of studies or effect sizes in a review that addressed that outcome (denominator) and the number that indicated significant improvements (numerator)
  3. *Significant effect size, p < .05
  4. aFor meta-analyses, ‘# of studies’ refers to the number of unique studies included in the reported meta-analyses
  5. bBlankevoort et al. did not report the statistical significance of effect sizes nor did they report confidence intervals