Aerobic and strength training exercise programme for cognitive impairment in people with mild to moderate dementia: the DAPA RCT

Lamb, Sarah E; Mistry, Dipesh; Alleyne, Sharisse; Atherton, Nicky; Brown, Deborah; Copsey, Bethan; Dosanjh, Sukhdeep; Finnegan, Susanne; Fordham, Beth; Griffiths, Frances; Hennings, Susie; Khan, Iftekhar; Khan, Kamran; Lall, Ranjit; Lyle, Samantha; Nichols, Vivien; Petrou, Stavros; Zeh, Peter; Sheehan, Bart

doi:10.3310/hta22280

Cited by 41 publications

(61 citation statements)

References 141 publications

(240 reference statements)

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“…Effects of the intervention analyzed in each study were measured through different outcome variables according to the type of analysis, type of intervention, pathology of the participants and the objectives of the study. Consequently, QALY was measured in all the studies conducting cost-utility analysis [ 13 , 14 , 17 , 18 , 20 , 21 , 22 , 27 , 28 , 31 , 32 , 34 , 39 , 40 , 41 , 42 , 43 , 46 , 49 , 50 , 51 , 54 ]. Other health outcomes were used including HRQL [ 14 , 27 , 28 , 31 ], daily life activities [ 22 , 52 ] or pain [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

Economic Evaluation in Neurological Physiotherapy: A Systematic Review

2021

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This systematic review was carried out to compile and assess original studies that included economic evaluations of neurological physiotherapy interventions. A thorough search of PubMED, Cochrane and Embase was developed using keywords such as health economics, neurological physiotherapy and cost analysis, and studies published during the last six-year term were selected. A total of 3124 studies were analyzed, and 43 were eligible for inclusion. Among the studies analyzed, 48.8% were interventions for stroke patients, and 13.9% were focused on Parkinson’s disease. In terms of the countries involved, 46.5% of the studies included were developed in the UK, and 13.9% were from the USA. The economic analysis most frequently used was cost-utility, implemented in 22 of the studies. A cost-effectiveness analysis was also developed in nine of those studies. The distribution of studies including an economic evaluation in this discipline showed a clear geographic dominance in terms of the pathology. A clear upward trend was noted in the economic evaluation of interventions developed in neurological physiotherapy. However, these studies should be promoted for their use in evidence-based clinical practice and decision-making.

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Section: Resultsmentioning

confidence: 99%

Economic Evaluation in Neurological Physiotherapy: A Systematic Review

2021

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“…However, this is likely to be due to the inclusion of more intensive support by trained physiotherapists and exercise assistants than other programmes as well as several other cost components such as equipment and use of site in our calculation of the cost of the intervention. Although patients became physically fitter due to exercise [ 21 ], these benefits did not translate into improvements in mobility and functional activities that may have required demonstrating improved motor re-learning or cognitive outcomes. It is possible that carers are reluctant to encourage dementia sufferers to re-establish functional activities through fear of injury, although this remains to be elucidated through further research.…”

Section: Discussionmentioning

confidence: 99%

“…A total of 375 participants were required to detect a difference of 2.45 ADAS-Cog points (standardised effect of 0.31) in the ADAS-Cog (80% power, 5% type I error). Further details of the trial are reported elsewhere [ 21 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

Does Structured Exercise Improve Cognitive Impairment in People with Mild to Moderate Dementia? A Cost-Effectiveness Analysis from a Confirmatory Randomised Controlled Trial: The Dementia and Physical Activity (DAPA) Trial

Khan

Petrou

Khan

et al. 2018

PharmacoEconomics Open

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“…that a 4 month structured, moderate to high intensity aerobic exercise did not influence cognition, quality of life, or caregiver burden. 10 According to recent systematic reviews, the impact of physical exercise on AD is inconclusive, due to lack of large sample sizes, methodological disparities across studies and lack of prospective designs. 11,12 Moreover, studies on preclinical AD population remain relatively scarce.…”

Section: Effects Of Moderate Intensity Exercise On the Cortical Thickmentioning

confidence: 99%

Effects of Moderate Intensity Exercise on the Cortical Thickness and Subcortical Volumes of Preclinical Alzheimer’s Disease Patients: A Pilot Study

Wang

Kim

et al. 2020

Psychiatry Investig

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Objective We aimed to explore the impact of moderate intensity exercise on the cortical thickness and subcortical volumes of preclinical Alzheimer’s disease (AD) patients.Methods Sixty-three preclinical AD patients with magnetic resonance imaging (MRI) and 18-florbetaben positron emission tomography (PET) data were enrolled in the study. Information on demographic characteristics, cognitive battery scores, self-reported exercise habits were attained. Structural magnetic resonance images were analyzed and processed using Freesurfer v6.0.Results Compared to Exercise group, Non-Exercise group demonstrated reduced cortical thickness in left parstriangularis, rostral middle frontal, entorhinal, superior frontal, lingual, superior parietal, lateral occipital, inferior parietal gyrus, temporal pole, precuneus, insula, fusiform gyrus, right precuneus, superiorparietal, lateral orbitofrontal, rostral middle frontal, medial orbitofrontal, superior frontal, lingual, middle temporal gyrus, insula, supramarginal, parahippocampal, paracentral gyrus. Volumes of right thalamus, caudate, putamen, pallidum, hippocampus, amygdala were also reduced in Non-Exercise group.Conclusion Moderate intensity exercise affects cortical and subcortical structures in preclinical AD patients. Thus, physical exercise has a potential to be an effective intervention to prevent future cognitive decline in those at high risk of AD.

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Aerobic and strength training exercise programme for cognitive impairment in people with mild to moderate dementia: the DAPA RCT

Cited by 41 publications

References 141 publications

Economic Evaluation in Neurological Physiotherapy: A Systematic Review

Economic Evaluation in Neurological Physiotherapy: A Systematic Review

Does Structured Exercise Improve Cognitive Impairment in People with Mild to Moderate Dementia? A Cost-Effectiveness Analysis from a Confirmatory Randomised Controlled Trial: The Dementia and Physical Activity (DAPA) Trial

Effects of Moderate Intensity Exercise on the Cortical Thickness and Subcortical Volumes of Preclinical Alzheimer’s Disease Patients: A Pilot Study

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