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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

      36,334 Monthly downloads/views I 3.829 Impact Factor I 7.4 CiteScore I 1.83 Source Normalized Impact per Paper (SNIP) I 1.044 Scimago Journal & Country Rank (SJR)

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      Physical activity can improve cognition in patients with Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials

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          Abstract

          Background/objective

          Alzheimer’s disease (AD) is mainly characterized by decline of cognitive functions such as memory and learning, which has a high prevalence and poor drug efficacy in treatment regimes. A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to evaluate the effectiveness of exercise on cognitive function in patients diagnosed with AD.

          Methods

          The bibliographic databases (PubMed, Cochrane Library and Embase, and Web of Science) and four Chinese databases (Wanfang data, CBM, CNKI, and VIP) were searched to identify RCTs published in any language between January 1, 1960, and January 1, 2018. Only peer-reviewed articles and RCTs were included. The collected data were analyzed by Review Manager (5.3).

          Results

          Overall, 869 patients diagnosed with AD were included from 13 RCTs. Patients in the intervention group received pure exercise interventions and a cognitive test. Although there was heterogeneity in intervention methods and cognitive measures among studies, meta-analysis (seven studies) supports positive effects of physical activity on cognitive function of patients with AD (mean difference [MD] =2.53, the 95% CI=0.84 to 4.22, test for overall effect: Z=2.93 [ P=0.003]). Eight studies demonstrated that exercise improves cognitive function for individuals with AD. However, the remaining five studies did not display a beneficial effect of exercise on cognitive function in patients with AD.

          Conclusion

          This meta-analysis and systematic review indicated that exercise intervention might improve the cognitive function of AD or slow down the decline of cognition; however, this relationship was not always true across studies. RCTs with clear intervention criteria, large samples, and long-term follow-up are needed in the future to demonstrate the benefits of exercise for cognitive function in AD patients.

          Most cited references26

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          Loss of recent memory after bilateral hippocampal lesions.

          W SCOVILLE, B Milner (1957)
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            2015 Alzheimer's disease facts and figures.

            (2015)
            This report discusses the public health impact of Alzheimer’s disease (AD), including incidence and prevalence, mortality rates, costs of care and the overall effect on caregivers and society. It also examines the challenges encountered by health care providers when disclosing an AD diagnosis to patients and caregivers. An estimated 5.3 million Americans have AD; 5.1 million are age 65 years, and approximately 200,000 are age <65 years and have younger onset AD. By mid-century, the number of people living with AD in the United States is projected to grow by nearly 10 million, fueled in large part by the aging baby boom generation. Today, someone in the country develops AD every 67 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, resulting in nearly 1 million new cases per year, and the estimated prevalence is expected to range from 11 million to 16 million. In 2013, official death certificates recorded 84,767 deaths from AD, making AD the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years. Between 2000 and 2013, deaths resulting from heart disease, stroke and prostate cancer decreased 14%, 23% and 11%, respectively, whereas deaths from AD increased 71%. The actual number of deaths to which AD contributes (or deaths with AD) is likely much larger than the number of deaths from AD recorded on death certificates. In 2015, an estimated 700,000 Americans age 65 years will die with AD, and many of them will die from complications caused by AD. In 2014, more than 15 million family members and other unpaid caregivers provided an estimated 17.9 billion hours of care to people with AD and other dementias, a contribution valued at more than $217 billion. Average per-person Medicare payments for services to beneficiaries age 65 years with AD and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2015 for health care, long-term care and hospice services for people age 65 years with dementia are expected to be $226 billion. Among people with a diagnosis of AD or another dementia, fewer than half report having been told of the diagnosis by their health care provider. Though the benefits of a prompt, clear and accurate disclosure of an AD diagnosis are recognized by the medical profession, improvements to the disclosure process are needed. These improvements may require stronger support systems for health care providers and their patients.
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              Total daily physical activity and the risk of AD and cognitive decline in older adults.

              A S Buchman, P. Boyle, L Yu … (2012)
              Studies examining the link between objective measures of total daily physical activity and incident Alzheimer disease (AD) are lacking. We tested the hypothesis that an objective measure of total daily physical activity predicts incident AD and cognitive decline. Total daily exercise and nonexercise physical activity was measured continuously for up to 10 days with actigraphy (Actical®; Philips Healthcare, Bend, OR) from 716 older individuals without dementia participating in the Rush Memory and Aging Project, a prospective, observational cohort study. All participants underwent structured annual clinical examination including a battery of 19 cognitive tests. During an average follow-up of about 4 years, 71 subjects developed clinical AD. In a Cox proportional hazards model adjusting for age, sex, and education, total daily physical activity was associated with incident AD (hazard ratio = 0.477; 95% confidence interval 0.273-0.832). The association remained after adjusting for self-report physical, social, and cognitive activities, as well as current level of motor function, depressive symptoms, chronic health conditions, and APOE allele status. In a linear mixed-effect model, the level of total daily physical activity was associated with the rate of global cognitive decline (estimate 0.033, SE 0.012, p = 0.007). A higher level of total daily physical activity is associated with a reduced risk of AD.
              Article 0 comments Cited 238 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Interv Aging
                Journal ID (iso-abbrev): Clin Interv Aging
                Journal ID (publisher-id): Clinical Interventions in Aging
                Title: Clinical Interventions in Aging
                Publisher: Dove Medical Press
                ISSN (Print): 1176-9092
                ISSN (Electronic): 1178-1998
                Publication date Collection: 2018
                Publication date (Electronic): 04 September 2018
                Volume: 13
                Pages: 1593-1603
                Affiliations
                [1 ]Department of Internal Nursing, School of Nursing, Jilin University, Changchun, Jilin, 130020, People’s Republic of China, fli@ 123456jlu.edu.cn
                [2 ]Department of Anesthesiology, The First Hospital of Jilin University, Changchun, Jilin, 130021, People’s Republic of China, xige_yang@ 123456163.com
                Author notes
                Correspondence: Feng Li, Department of Internal Nursing, School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, Jilin, 130020, People’s Republic of China, Tel +86 1 779 008 9009, Fax +86 04 318 561 9580, Email fli@ 123456jlu.edu.cn
                Xige Yang, Department of Anesthesiology, The First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130021, People’s Republic of China, Tel +86 1 375 666 1628, Fax +86 04 318 878 2955, Email xige_yang@ 123456163.com
                [*]

                These authors contributed equally to this work

                Article
                Publisher ID: cia-13-1593
                DOI: 10.2147/CIA.S169565
                PMC ID: 6130261
                PubMed ID: 30233156
                SO-VID: 35f30509-1346-4c5f-9697-babca5e878ed
                Copyright © © 2018 Du et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Subject: Review

                ScienceOpen disciplines: Health & Social care
                Keywords: alzheimer’s disease,exercise,cognitive function,randomized controlled trial
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: alzheimer’s disease, exercise, cognitive function, randomized controlled trial

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