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The therapeutic effects of exercise training on elderly patients with dementia: a randomized controlled trial [with consumer summary]
Liu I-T, Lee W-J, Lin S-Y, Chang S-T, Kao C-L, Cheng Y-Y
Archives of Physical Medicine and Rehabilitation 2020 May;101(5):762-769
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate whether strength or aerobic training can offer significantly more benefits with regards to the activities of daily living of elderly patients with dementia, as well as to determine the effects of exercise on cognition, depression, and biochemical markers. DESIGN: Single-blind randomized controlled trial SETTING: A nursing home for veterans PARTICIPANTS: A volunteer sample of 80 participants whose scores on the Mini-Mental State Examination were between 15 and 26 were included. Due to cardiopulmonary or orthopedic conditions which prohibit exercise training, along with any cognitive problems that may impede answering the contents of our questionnaires, 11 participants were excluded. During the exercise training period, 8 participants voluntarily dropped out of the study. INTERVENTIONS: The participants were randomly assigned to perform either strength or aerobic training for a total of four weeks. OUTCOME MEASURES: The main outcome measure was the Barthel Index. Other outcome measures included the Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale, plasma monocyte chemotactic protein-1 levels, insulin-like growth factor-1 levels, and serum brain-derived neurotrophic factor levels. RESULTS: After completion of the program, we discovered a significant improvement in the patients' Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in the strength-training group. For the patients who had received aerobic training, their serum brain-derived neurotrophic factor also improved significantly. However, the degree of improvement regarding these outcome measures did not achieve significant statistical difference between the two groups. CONCLUSION: Through our study, an intensive four-week exercise program, whether it be strength or aerobic training, is evidenced to bring significant benefits to elderly patients with dementia, while the serum brain-derived neurotrophic factor was additionally improved through aerobic training.

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