BACKGROUND: There is a growing evidence on the benefits of exercise for older people living with dementia in developed countries. However, cultural, health-care systems and environmental differences may impact on the uptake of exercise and outcomes in different regions of the world. OBJECTIVE: This study synthesised the available evidence examining the effectiveness of exercise interventions on improving physical function and reducing behavioural symptoms in community-dwelling older people living with dementia in Asia, and the impact on their informal carers. METHODS: Six databases were searched to November 2021. Randomised controlled trials (RCTs) or quasi-experimental studies evaluating exercise interventions for community-dwelling older people with dementia living in Asia were included. The Cochrane risk-of-bias tool for randomised trials and Downs and Black checklist had been used to assess methodological quality of the studies. Meta-analyses using a fixed effects model assessed the effects of exercise interventions where sufficient data were available. Mean difference (MD) with 95% confidence interval (CI) was used to pool results. RESULTS: Nine studies (five RCTs) were included (Hong Kong-4, China-1, South Korea-2, Taiwan-1, Indonesia-1). Exercise improved dynamic balance (Functional Reach (2 studies, n = 111 people with dementia), MD 2.61, 95% CI (1.55 to 3.67)), but not for the Berg Balance Scale (MD 1.10, 95% CI (-2.88 to 5.07)), Timed Up and Go (MD -3.47, 95% CI (-7.27 to 0.33)) and 5 times sit to stand tests (MD -1.86, 95% CI (-5.27 to 1.54)). Single studies where data could not be pooled showed no effect of exercise on behavioural symptoms or impact on informal carers. CONCLUSIONS: Exercise appeared to have a beneficial effect on improving balance performance among older people with dementia living in Asia, however, this evidence is limited and inconsistent, and should be interpreted with caution. Further high-quality large RCTs are necessary for advancing the evidence base of exercise interventions for this population.

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