Exercise programs for people with dementia
Dementia is a serious loss of global cognitive ability, beyond what might be expected from normal aging, and is most commonly diagnosed among people over 65. It is becoming increasingly common as the population ages worldwide, and the number of people suffering with dementia is expected to rise dramatically. This will not only affect the quality of life of people with dementia but also increase the burden on family caregivers, community care, and residential care services.
Many studies have examined the influence of exercise on healthy older people, looking for impacts in areas such as cognitive speed, memory function, and auditory and visual attention. There are several potential mechanisms that link exercise programs to cognitive function, including improved vascular function, which are associated in the maintenance of cerebral perfusion - i.e. balance between the supply and demand of nutrients to the brain. As a result, exercise is one lifestyle factor that has been identified as a potential means of reducing or delaying progression of the symptoms of dementia.
A team of Cochrane researchers based in Canada and the US first set out in 2008 to answer the question of whether exercise programs for older people with dementia improve cognition, activities of daily living, challenging behaviour, depression, and mortality outcomes. As a secondary question, the researchers also hoped to find evidence about whether exercise programs would benefit those providing care to people with dementia.
In this update of the original review, the research team has examined 16 trials randomising more than 900 patients. Twelve of these have been included and analysed for the first time, significantly increasing the data available for consideration. The authors found promising evidence that exercise programs can significantly improve cognitive functioning of people with dementia and their ability to perform daily activities, but no significant effect of exercise on mood, including challenging behaviours and depression.
“Healthcare providers who work with people with dementia and their caregivers should feel confident in promoting exercise among this population”, said Dorothy Forbes, lead author of the Cochrane Review team. “Further research would support development of best practice guidelines, and help to understand what level and intensity of exercise is beneficial for which types of dementia.”