Physical exercise is effective for neuropsychiatric symptoms in Alzheimer's disease: a systematic review

Abstract

Background: Neuropsychiatric symptoms are disorders frequently seen in Alzheimer's disease. These symptoms contribute to reduction of brain reserve capacity and, in addition, they present unfavorable implications, such as: poor prognosis for the disease, increased functional decline, increased burden on the caregiver and institutionalization. This scenario makes neuropsychiatric symptoms one of the biggest problems in Alzheimer's disease, and gives rise to a need for treatments focused on improving these symptoms. Sow progress in drug trials has led to interest in exploring non-pharmacological measures for improving the neuropsychiatric symptoms of Alzheimer's disease, such as physical exercise. Objective: To ascertain the effect of exercise on the neuropsychiatric symptoms of Alzheimer's disease and its implications. Methods: This was a systematic review of effective longitudinal research, conducted by searching for articles in the PubMed, Web of Science, CINAHL and Scopus electronic databases, from 2009 to 2019. Studies in which the sample consisted of elderly people aged 65 years old or over with a diagnosis of Alzheimer's disease were included. Initially 334 articles were identified. After exclusions, 21 articles remained to be read in full. From these, five articles fitted the eligibility criteria, and a further two articles were added through manual searches in the references of the articles found. Results: Out of the seven articles analyzed in this review, five studies revealed that physical exercise had a positive effect on the neuropsychiatric symptoms of Alzheimer's disease. Conclusion: This systematic review indicated that physical exercise is a favorable non-pharmacological means for attenuating the neuropsychiatric symptoms of elderly people with Alzheimer's disease, with special attention to aerobic exercises.

Physical Exercise as a Nonpharmacological Intervention for the Treatment of Neuropsychiatric Symptoms in Persons With Dementia

“…The findings of this study are in accordance with those of previous systematic reviews and meta-analyses that have shown that physical exercise interventions have a beneficial effect on NPS 7,9,11 and significantly limit the symptoms of depression 9,11,12 in patients with dementia. Contrary results with regard to NPS arose in the study by Barreto et al, 12 who concluded that physical exercise does not significantly reduce the overall level of behavioral and psychological symptoms in this group.…”

“…7,9 More recently, it was suggested that exercise, particularly aerobic exercise, constitutes a beneficial nonpharmacological approach for mitigating NPS in patients with Alzheimer disease. 11 Conversely, Barreto et al 12 showed that exercise does not significantly limit behavioral and psychological symptoms in this particular population group. However, depression and aberrant motor behavior, and to a lesser extent apathy, agitation, and eating disorders, seem to have been positively affected by exercise (the latter 3 symptoms showed no significant effect).…”

“…Specifically, physical exercise has been shown to have beneficial effect on NPS in patients with dementia 7,9. More recently, it was suggested that exercise, particularly aerobic exercise, constitutes a beneficial nonpharmacological approach for mitigating NPS in patients with Alzheimer disease 11. Conversely, Barreto et al12 showed that exercise does not significantly limit behavioral and psychological symptoms in this particular population group.…”

Atividades físicas e a boa alimentação: uma relação estreita com o tratamento e a prevenção da doença de Alzheimer

“…A partir de pesquisas, foi possível compreender quais são as principais consequências dessa atividade em relação à neurofisiologia. Dessa forma, o exercício possibilita um aumento do volume do hipocampo, o que contribui para um maior funcionamento cognitivo, além de auxiliar no desenvolvimento da memória e do aprendizado (Du et al, 2018;Cass, 2017;Mendonça et al, 2021;Brasil et al, 2019). Outrossim, alguns hormônios favorecem o processo cognitivo, ao permitir um maior armazenamento da memória e aprendizagem, como catecolaminas, vasopressinas e o fator neurotrófico derivado do cérebro (BDNF), que está relacionado com a plasticidade neural (Du et al, 2018;Brasil et al, 2019).…”

A Systematic Study into the Effects of Long-Term Multicomponent Training on the Cognitive Abilities of Older Adults with Neurodegenerative Disorders

“…Brain function in some conditions is directly compromised, affecting neuromotor areas related to large muscle groups [20]. Non-pharmacological interventions, such as physical exercise alone or multifactorial programmes, have attenuated cognitive decline and improved behavioural disorders in patients [21]. The multicomponent exercise program (MEP) that involves stretching-balance, aerobic conditioning, neuromotor stimulation, or a combination of the two [22], may be related to this process and has been shown to improve various cognitive processes, including memory, reasoning speed, and problem-solving skills [23,24].…”