Exercise interventions in Alzheimer’s disease: A systematic review and meta-analysis of randomized controlled trials

López-Ortiz, Susana; Valenzuela, Pedro L.; Seisdedos, María M.; Morales, Javier S.; Vega, Tomás; Castillo‐García, Adrián; Nisticò, Robert; Mercuri, Nicola Biagio; Lista, Simone; Lucı́a, Alejandro; Santos‐Lozano, Alejandro

doi:10.1016/j.arr.2021.101479

Cited by 66 publications

(49 citation statements)

References 73 publications

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“…Similarly, Demurtas and colleagues could not be certain that PA improved cognition in dementia patients [16]. To support this point, a recent meta-analysis study including 11 studies showed no significant improvements in a Mini-Mental State Examination (MMSE) test [17].…”

Section: Introductionmentioning

confidence: 99%

“…Although many systematic review studies have examined the effects of exercise on cognition and physical performance in adults with AD, they have commonly shown inconclusive results due to inconsistent inclusion criteria, considerable heterogeneity (I 2 ≈ 80%) across studies, a small number of included studies, and different types of dementia populations (e.g., Lewy body dementia and vascular dementia) [16,17,27]. They have considered the limitations of previous studies and the fact that a growing body of new RCT studies published in Chinese and English language is investigating the effect of exercise on cognition and ADL in populations with AD.…”

Section: Introductionmentioning

confidence: 99%

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Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhou

Chen

Zhang

et al. 2022

IJERPH

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Objective: The purpose of this meta-analysis was to examine the effects of physical activity (PA) on cognition and activities of daily living in adults with Alzheimer’s Disease (AD). Methods: Six electronic databases (MEDLINE, CINAHL, PsycArticles, SPORTDiscus, EMBASE and CNKI) were used to search for potential studies from inception until October 2021. Randomized controlled trials (RCTs) investigating the effect of physical activity (PA) on cognition and activities of daily living in AD patients compared to a control condition were included. The effect sizes were synthesized using a random effects model with a 95% confidence interval (CI). Results: Sixteen articles including 945 participants (aged 70 to 88 years, 34.6% male) met the inclusion criteria. The pooled effect sizes demonstrated that PA intervention was associated with significant improvements in global cognition (Standard Mean Difference (SMD) = 0.41, 95% CI [0.24, 0.58], p < 0.01) and activities of daily living (SMD = 0.56, 95% CI [0.32, 0.79], p < 0.01) in AD patients. Subgroup analyses suggested that PA for 3–4 times per week for 30–45 min for more than 12 weeks had a relatively strong effect on improving global cognition in AD patients. The sensitivity analysis showed robust results. Conclusions: The findings from the current meta-analysis suggested that AD patients can improve their global cognition and Activities of Daily Living (ADL) through engaging in aerobic and mixed exercise (aerobic and anaerobic exercise).

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhou

Chen

Zhang

et al. 2022

IJERPH

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“…Several reviews have been published on the effects of physical exercise on the cognitive performance of older adults with AD ( 19 , 34 – 37 ). Some reviews concluded that the intervention was beneficial for global cognitive impairment ( 19 , 35 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of Physical Exercise on Cognitive Function of Alzheimer's Disease Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trial

et al. 2022

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This review aims to systematically review the effects of physical exercise on the cognitive performance of patients with Alzheimer's disease (AD) and its mechanisms of action. Databases such as Web of Science, PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched until December 2021. A randomized controlled trial (RCT) to assess the effect of an exercise intervention (compared with no exercise) on patients with AD. The measures included cognitive function [Mini-Mental State Examination (MMSE), Alzheimer's Disease assessment scale-cognitive (ADAS-Cog), Montreal cognitive assessment scale (MoCA) and Executive Function (EF)]. The methodological quality of the included literature was assessed using the Physiotherapy Evidence Database (PEDro) scale. Twenty-two studies (n = 1647, mean age: 77.1 ± 6.3 years) were included in the systematic review, sixteen of which were included in the meta-analysis. A systematic review and meta-analysis revealed that physical exercise positively affects cognitive performance in older patients with AD. However, the positive effects of the intervention should be interpreted with caution considering the differences in methodological quality, type, frequency, and duration of exercise in the included studies. Future studies should consider the design rigor and specification of RCT protocols.

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“…Physical exercise cannot be neglected as an effective intervention. Several meta-analyses pointed out its multi-domain beneficial effects on cognition in older people and patients with AD ( Gavelin et al, 2021 ; López-Ortiz et al, 2021 ). The gut microbiome–targeted therapies are extremely popular and have achieved a breakthrough in recent years, which include fecal microbiota transplantation (FMT), antibiotics, prebiotics, probiotics, synbiotics, and other products that can modify the intestinal microbial ecosystem.…”

Section: Conclusion and Future Directionmentioning

confidence: 99%

Overnutrition Induced Cognitive Impairment: Insulin Resistance, Gut-Brain Axis, and Neuroinflammation

et al. 2022

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Overnutrition-related obesity has become a worldwide epidemic, and its prevalence is expected to steadily rise in the future. It is widely recognized that obesity exerts negative impacts on metabolic disorders such as type 2 diabetes mellitus (T2DM) and cardiovascular diseases. However, relatively fewer reports exist on the impairment of brain structure and function, in the form of memory and executive dysfunction, as well as neurogenerative diseases. Emerging evidence indicates that besides obesity, overnutrition diets independently induce cognitive impairments via multiple mechanisms. In this study, we reviewed the clinical and preclinical literature about the detrimental effects of obesity or high-nutrition diets on cognitive performance and cerebral structure. We mainly focused on the role of brain insulin resistance (IR), microbiota-gut-brain axis, and neuroinflammation. We concluded that before the onset of obesity, short-term exposure to high-nutrition diets already blunted central responses to insulin, altered gut microbiome composition, and activated inflammatory mediators. Overnutrition is linked with the changes in protein expression in brain insulin signaling, leading to pathological features in the brain. Microbiome alteration, bacterial endotoxin release, and gut barrier hyperpermeability also occur to trigger mental and neuronal diseases. In addition, obesity or high-nutrition diets cause chronic and low-grade systematic inflammation, which eventually spreads from the peripheral tissue to the central nervous system (CNS). Altogether, a large number of unknown but potential routes interact and contribute to obesity or diet-induced cognitive impairment. The challenge for future research is to identify effective interventions involving dietary shifts and personalized therapy targeting the underlying mechanisms to prevent and improve cognition deficits.

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Exercise interventions in Alzheimer’s disease: A systematic review and meta-analysis of randomized controlled trials

Cited by 66 publications

References 73 publications

Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Physical Activity Improves Cognition and Activities of Daily Living in Adults with Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Physical Exercise on Cognitive Function of Alzheimer's Disease Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trial

Overnutrition Induced Cognitive Impairment: Insulin Resistance, Gut-Brain Axis, and Neuroinflammation

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