Effects of Physical Activity Training in Patients with Alzheimer’s Dementia: Results of a Pilot RCT Study

Abstract

BackgroundThere is evidence that physical activity (PA) is of cognitive benefit to the ageing brain, but little is known on the effect in patients with Alzheimer’s disease (AD). The present pilot study assessed the effect of a home-based PA training on clinical symptoms, functional abilities, and caregiver burden after 12 and 24 weeks.MethodsIn an RCT thirty patients (aged 72.4±4.3 years) with AD (MMSE: 20.6±6.5 points) and their family caregivers were allocated to a home-based 12-week PA intervention program or the usual care group. The program changed between passive, motor-assisted or active resistive leg training and changes in direction on a movement trainer in order to combine physical and cognitive stimuli.ResultsAnalysis of activities of daily living in the patients (ADCS ADL total score) revealed a significant group × time interaction effect (95% CI of the difference between both groups at T2: 5.01–10.51). The control group experienced decreases in ADL performance at week 12 and 24 whereas patients in the intervention group remained stable. Analyses of executive function and language ability revealed considerable effects for semantic word fluency with a group × time interaction (95% CI of the difference between both groups at T2: 0.18–4.02). Patients in the intervention group improved during the intervention and returned to initial performance at week 12 whereas the controls revealed continuous worsening. Analyses of reaction time, hand-eye quickness and attention revealed improvement only in the intervention group. Caregiver burden remained stable in the intervention group but worsened in the control group.ConclusionsThis study suggests that PA in a home-based setting might be an effective and intrinsically attractive way to promote PA training in AD and modulate caregiver burden. The results demonstrate transfer benefits to ADL, cognitive and physical skill in patients with AD.Trial RegistrationClinicalTrials.gov NCT02196545

Effect of exercise on cognitive function in chronic disease patients: a meta-analysis and systematic review of randomized controlled trials

“…Thirteen studies containing 958 participants examined the effect of exercise on cognitive function in patients with Alzheimer’s disease 24,25,27,28,30,34,43,46,50,52,54–56. We found positive overall random effect of exercise intervention on cognitive function in studies evaluating Alzheimer’s disease patients.…”

“…Five studies containing 261 participants examined the effect of resistance exercise on cognitive function in patients with chronic disease 32,39,41,45,54. Eight studies containing 725 participants examined the effect of combined exercise on cognitive function in patients with chronic disease 34,38,43,47,48,50,52,56. We identified an overall positive random effect for aerobic exercise interventions but not for resistance exercise interventions and combined exercise interventions.…”

“…Eighteen studies containing 1,494 participants examined the effect of high-frequency exercise intervention on cognitive function in patients with chronic disease 26–28,33,35,37–40,42,47–50, 52,54,55,58. Sixteen studies containing 1,547 participants examined the effect of low-frequency exercise intervention on cognitive function in patients with chronic disease 24,25,29–32, 34,36,43–46,51,53,56,57. We identified a positive overall random effect for low-frequency interventions but not for high-frequency interventions.…”

Physical activity correlates in people with mild cognitive impairment: findings from six low- and middle-income countries

“…Understanding the correlates of PA in MCI is important for multiple health reasons, including the enhancement of executive function 21 for the maintenance of personal autonomy 22 and reducing caregiver burden 23 . In addition to the overall lack of information on factors influencing PA participation in people with MCI, very little is known about PA correlates in older people in LMICs in general.…”

Donepezil may reduce the risk of comorbidities in patients with Alzheimer's disease: A large‐scale matched case‐control analysis in Japan

“…People with more comorbidities had more rapid deterioration in cognition and also showed significantly faster decline in daily functioning [15][16][17]. It has been shown that the effect of physical activity and exercise might be effective on cognitive function [18] and thus the decline in daily functioning due to cognitive deterioration could raise physical comorbidities in older subjects. Moreover, people with decline in cognition such as attention and executive function have some difficulties in Controls were matched to each case on sex, age ( 5 years), and AD duration ( 1 year) using risk-set sampling.…”