Effect of physical activity on cognitive domains in dementia and mild cognitive impairment: overview of systematic reviews and meta-analyses

Venegas-Sanabria, Luis Carlos; Martínez‐Vizcaíno, Vicente; Cavero‐Redondo, Iván; Chavarro-Carvajal, Diego Andrés; Cano-Gutiérrez, Carlos; Álvarez‐Bueno, Celia

doi:10.1080/13607863.2020.1839862

Cited by 30 publications

(32 citation statements)

References 43 publications

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“…Our findings are in line with previous research but are arguably more robust as the meta‐analysis was limited to only RCTs, 14,15,20,21,24,25 pre‐ and post‐treatment measures have been taken into account using Morris' recommendations 29 and the cognitive measures were meta‐analysed using the same scales rather than pooling different instruments. There was a significant impact of baseline MMSE scores for people with MCI, whereby those whose MMSE scores were low experienced more benefit from practising physical activity.…”

Section: Discussionsupporting

confidence: 89%

“…Results from the large Dementia and Physical Activity (DAPA) randomised controlled trial reported no benefits of physical activity on any cognitive domain 18 ; whilst other studies have suggested small to moderate positive effects on cognitive functions. 19 Previous meta-analyses examining the effect of physical activity on people with AD and MCI, [20][21][22][23][24][25][26] have shown that exercise compared to a control arm has beneficial effects, but it is not clear how this compares to pharmacological treatments. A recent meta-analysis examining the impact of both exercise and medications in AD and MCI revealed that medications have a small impact on cognition primarily in AD, whilst physical activity was shown to improve cognition in both clinical groups.…”

Section: Introductionmentioning

confidence: 99%

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A meta‐analysis of randomised controlled trials of physical activity in people with Alzheimer's disease and mild cognitive impairment with a comparison to donepezil

Pisani

Mueller

Huntley

et al. 2021

Int J Geriat Psychiatry

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Objectives Physical exercise may benefit people with Alzheimer's disease (AD) and mild cognitive impairment (MCI). However, randomised controlled trials (RCTs) of exercise have shown conflicting findings and it is unclear if positive outcomes are comparable to a commonly used cholinesterase inhibitor, donepezil. Methods Embase, Medline, PsycINFO, PsycARTICLES, SCOPUS were searched for RCTs of physical activity compared to a control condition, and donepezil compared to placebo in people with AD and MCI. Effect sizes were calculated from pre‐ and post‐MMSE and ADAS‐Cog scores and pooled using a random effects meta‐analysis. Results Ninteen RCTs were included in the exercise meta‐analysis (AD, N = 524; MCI, N = 1269). Physical exercise improved MMSE scores in AD (Hedges' g = 0.46) and MCI groups (g = 0.63). For the MCI group, exercise appeared to have a stronger effect for those with lower MMSE scores at baseline (p = 0.022). 18 RCTs were included in the donepezil meta‐analysis (AD, N = 2984, MCI, N = 1559). In people with AD, donepezil improved cognition (MMSE g = 0.23; ADAS‐Cog, g = −0.17) but there was no evidence of improved cognition in MCI. Conclusions Physical exercise improved cognition in both AD and MCI groups. Where comparisons were possible, the effect size for physical exercise was generally comparable to donepezil. These results strengthen the evidence base for exercise as an effective intervention in AD and MCI, and future clinical trials should examine exercise type, intensity and frequency, in addition to cholinesterase inhibitors to determine the most effective interventions for AD and MCI.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

A meta‐analysis of randomised controlled trials of physical activity in people with Alzheimer's disease and mild cognitive impairment with a comparison to donepezil

Pisani

Mueller

Huntley

et al. 2021

Int J Geriat Psychiatry

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“…Although the relationship between this type of exercise and cognitive functions is unclear, the effectiveness of physical exercise in reducing frailty and improving cognition, emotions, and social networks has been reported among frail older adults [ 16 ], using multicomponent exercise and including aerobic exercise. This fact makes difficult to isolate the effect of the multicomponent exercise intervention approach, whose evidence on cognition remains inconclusive [ 36 ], as well as the most suitable combination of components, duration and dose [ 37 ]. Nevertheless and considering that physical activity is part of the intervention of the vast majority of conditions that affect older people, the inclusion of an individualized physical exercise in the management of the older patients should be part of the daily clinical practice [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of multicomponent exercise in cognitive impairment: a systematic review and meta-analysis

et al. 2022

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Background Multicomponent physical exercise is the most recommended type of physical intervention in older adults. Experimental data suggest the relevance of the muscle-brain axis and the relationship between muscle contraction and release of brain-derived neurotrophic factor, however, the impact of this relationship on cognition remains unclear, especially in people with diagnosis of cognitive impairment. This study assesses the effect of multicomponent physical exercise on global cognition in people with mild cognitive impairment or dementia. Methods Randomized controlled trials published until January 2021 were searched across three electronic databases (PubMed, Scopus, and Cochrane Database). Data about exercises included in the multicomponent intervention (endurance, strength, balance, or flexibility), the inclusion of aerobic exercise, and the change in global cognition were extracted. The effect size was represented as a standardized mean difference. Risk of bias was assessed by the RoB2 tool. Results A total of 8 studies were included. The overall effect size suggested an effect of multicomponent exercise on global cognition. However, the subgroup analysis showed an effect only when aerobic exercise was included in the intervention. No effect when mild cognitive impairment and dementia were assessed separately was found. Conclusion This study suggests that multicomponent physical exercise could have an effect on global cognition in people with mild cognitive impairment or dementia only when aerobic exercise is included in the intervention. Our results support the inclusion of structured physical exercise programs in the management of people with cognitive impairment.

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Section: Discussionmentioning

confidence: 99%

Effect of multicomponent exercise in cognitive impairment: A systematic review and meta-analysis

Cavero‐Redondo

Venegas-Sanabria

Martínez‐Vizcaíno

et al. 2022

Preprint

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Background: Multicomponent physical exercise is the most recommended type of physical intervention in older adults, however, this effect on cognition is unclear. This study assesses the effect of multicomponent physical exercise on global cognition in people with mild cognitive impairment or dementia.Methods: Randomized controlled trials published until January 2021 were searched across three electronic databases (PubMed, Scopus, and Cochrane Database). Data about exercises included in the multicomponent intervention (endurance, strength, balance, or flexibility), the inclusion of aerobic exercise, and the change in global cognition were extracted. The effect size was represented as a standardized mean difference. Risk of bias was assessed by the RoB2 tool. Results: A total of 8 studies were included. The overall effect size suggested an effect of multicomponent exercise on global cognition. However, the subgroup analysis showed an effect only when aerobic exercise was included in the intervention. No effect when mild cognitive impairment and dementia were assessed separately was found.Conclusion: This study suggests that multicomponent physical exercise could have an effect on global cognition in people with mild cognitive impairment or dementia only when aerobic exercise is included in the intervention. Our results support the inclusion of structured physical exercise programs in the management of people with cognitive impairment.

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Effect of physical activity on cognitive domains in dementia and mild cognitive impairment: overview of systematic reviews and meta-analyses

Cited by 30 publications

References 43 publications

A meta‐analysis of randomised controlled trials of physical activity in people with Alzheimer's disease and mild cognitive impairment with a comparison to donepezil

A meta‐analysis of randomised controlled trials of physical activity in people with Alzheimer's disease and mild cognitive impairment with a comparison to donepezil

Effect of multicomponent exercise in cognitive impairment: a systematic review and meta-analysis

Effect of multicomponent exercise in cognitive impairment: A systematic review and meta-analysis

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