Exercise interventions in Alzheimer's disease: A systematic review and meta-analysis of randomized controlled trials
Abstract
AIMS
To assess the potential multi-domain benefits of exercise interventions on patients with Alzheimer's disease (AD), as well as to determine the specific effects of different exercise modalities (aerobic, strength, or combined training).
METHODS
A systematic search was conducted in PubMed and Web of Science until March 2021 for randomized controlled trials assessing the effect of exercise interventions (compared with no exercise) on patients with AD. Outcomes included cognitive function (mini-mental state examination [MMSE] test), physical function (e.g., 6-minute walking test [6MWT]), functional independence (Barthel index), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). A random-effects meta-analysis was conducted.
RESULTS
28 studies (total n=1,337 participants, average age 79-90 years) were included in the systematic review, of which 21 could be meta-analyzed. Although considerable heterogeneity was found, exercise interventions induced several significant benefits, including in Barthel index (n=147 patients, mean difference [MD]=8.36 points, 95% confidence interval [CI]=0.63-16.09), 6MWT (n=369, MD=84 meters, 95% CI=44-133)), and NPI (n=263, MD=-4.4 points, 95% CI=-8.42--0.38). Benefits were also found in the MMSE test, albeit significance was only reached for aerobic exercise (n=187, MD=2.31 points, 95% CI 0.45-4.27).
CONCLUSIONS
Exercise interventions appear to exert multi-domain benefits in patients with AD.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,337 participants or records.
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