OBJECTIVES: To assess the effect of exercise training on the cognitive function of older adults living with different types of dementia, as well as potential moderators of exercise efficacy. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Cochrane Central, PsycINFO, Embase, Medline and CINAHL. ELIGIBILITY CRITERIA: Peer-reviewed, randomised controlled trials, in English (1990-present), which examined the effects of exercise training on the cognitive function of older adults living with dementia. STUDY APPRAISAL AND SYNTHESIS: Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0 and Physiotherapy Evidence Database Scale). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test. RESULTS: Twenty-eight studies (n = 2,158) were included in the qualitative review and 25 in the meta-analysis. For all-cause dementia, a small effect of exercise training on cognitive function was observed (g = 0.19; 95% CI 0.05 to 0.33; p = 0.009). Type of dementia and exercise training characteristics did not moderate the effects of exercise training on cognitive function (p > 0.05). Adherence to the intervention moderated the cognitive outcome effect size such that greater mean adherence was associated with greater cognitive outcome effect sizes (b = 0.02; SE 0.01; p = 0.005). CONCLUSION: Exercise training showed small benefits for the cognitive function of older adults living with all-cause dementia. More research and standardised reporting of exercise training characteristics can strengthen the evidence for what works best for which types of dementia. PROSPERO REGISTRATION NUMBER: CRD42020198716.
Reproduced with permission from the BMJ Publishing Group.

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