Methods of physical exercise for older adults with Alzheimer's and the factors that hinder its practice: a systematic review

Abstract

Objective To assess the impact of participation in physical exercise programs among older adults with Alzheimer's disease (AD) and the factors that compromise its practice. Method This study constitutes a systematic review conducted across the databases of the United States National Library of Medicine (PubMed), Web of Science, Scopus, Scientific Electronic Library Online (SciELO), LILACS, and Embase, starting from 2014. The PRISMA – 2020 guidelines were employed, alongside bias risk analysis supported by the Cochrane (RoB2) tool. Results Eleven studies were included for qualitative analysis. The impairment of episodic memory leads to a decline in AD and involves a complexity of cognitive processes encompassing multiple aspects of the neural system. Conclusion Depression, anxiety, and difficulty in comprehension are the primary factors that compromise the participation of older adults with Alzheimer's in exercises aimed at physical stimulation, and they are the main predictors hindering perceptual-motor development. Protocols involving combined exercises appear to better promote executive function in patients with AD. Awareness of physical exercise is fundamental from the outset of treatments, with the suggestion to prioritize improvements in attention for older adults with AD. The particularities of the relationship between activities of daily living and the functional capacity of Alzheimer's patients still represent a gap to be explored, as well as the prescription of specific exercises that consider both the level of attention and the stage of the disease.