Efficacy of exercise for functional outcomes in older persons with dementia

Abstract

Dementia is a syndrome that is characterized by progressive neurodegeneration and deterioration of cognitive and physical function. Older persons with dementia (PwD) become increasingly dependent upon formal and informal care. There is no cure for dementia. Exercise can help attenuate cognitive and physical declines in PwD. However, the efficacy of exercise for physical and cognitive function in PwD is uncertain. Furthermore, there is insufficient evidence to determine which variables act as moderators and confounders of exercise effects on functional outcomes in PwD. This research was a part of the Deltaplan Dementia. We studied the efficacy of alternating walking and leg-strengthening exercise vs. control activities on physical and cognitive function in PwD. Additionally, we inveestigated whether anticholinergic and sedative drug burden, exercise type, dose-parameters (program duration, session duration, frequency and intensity) and Apolipoprotein e4 (ApoeE4) carriership moderated or confounded exercise effects in PwD. The current findings show the efficacy of alternating walking and leg-strengthening exercise vs. control activities on gait speed. The effects of exercise on gait speed were the strongest after high-intensity exercise. For cognitive function, any type of activity appeared to be beneficial. Exercise programs with short sessions and high frequency predicted stronger effects on cognitive function. The knowledge in this thesis was used to create the Exercise guide for older persons with dementia. This can be found on the website of the Kenniscentrum Sport: https://tools.kenniscentrumsport.nl/bewegen-dementie/tool/bewegen-met-dementie/ .