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

Blankevoort et al., 2010^b [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)