Exercise training for managing behavioral and psychological symptoms in people with dementia: a systematic review and meta-analysis

Highlights

 

Exercise training reduces depression levels in people with dementia (PWD).

Exercise tends to reduce global levels of neuropsychiatric symptoms.

Aberrant motor behavior is the neuropsychiatric symptom more positively affected by exercise.

Information about the impact of exercise on antipsychotic use was almost completely inexistent.

 


Abstract

This systematic review and meta-analysis of randomized controlled trials assessed the effects of exercise on behavioral and psychological symptoms of dementia (BPSD, including depression) in people with dementia (PWD). Secondary outcomes for the effects of exercise were mortality and antipsychotic use. Twenty studies were included in this review (n=18 in the meta-analysis). Most studies used a multicomponent exercise training (n=13) as intervention; the control group was often a usual care (n=10) or a socially-active (n=8) group. Exercise did not reduce global levels of BPSD (n=4. Weighted mean difference –3.884; 95% CI –8.969 to 1.201; I2=69.4%). Exercise significantly reduced depression levels in PWD (n=7. Standardized mean difference –0.306; 95% CI –0.571 to –0.041; I2=46.8%); similar patterns were obtained in sensitivity analysis performed among studies with: institutionalized people (p=0.038), multicomponent training (p=0.056), social control group (p=0.08), and low risk of attrition bias (p=0.11). Exploratory analysis showed that the principal BPSD (other than depression) positively affected by exercise was aberrant motor behaviour. Exercise had no effect on mortality. Data on antipsychotics were scarce. In conclusion, exercise reduces depression levels in PWD. Future studies should examine whether exercise reduces the use (and doses) of antipsychotics and other drugs often used to manage BPSD.

Keywords

  • physical activity
  • Alzheimer&apos
  • s disease
  • older adults
  • elderly
  • neuropsychiatric symptoms
  • depression
Corresponding author. Gérontopôle de Toulouse, Institut du Vieillissement, 37 Allées Jules Guesde, F−31000 Toulouse, France. Fax: +33 561 145 640.

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Autor / Fonte:Philipe de Souto Barreto, Laurent Demougeot, Fabien Pillard, Maryse Lapeyre-Mestre, Yves Rolland Ageing Research Reviews 2015 September 11
Link: http://www.sciencedirect.com/science/article/pii/S1568163715300210