Regular exercise can help people with
dementia think a little more clearly, and care for themselves a bit more, a new
"If the person with dementia is living
at home, there are usually exercise programmes offered at community day programs
for persons with dementia.
would encourage family caregivers to connect with these programmes and/or home
care to learn about the available resources in their community," said
Dorothy Forbes, an associate professor at the Faculty of Nursing, University of
Alberta in Edmonton, who led the study.
For patients with dementia who can no
longer live at home, "Most residential settings should be offering
exercise programmes for their residents," Dr Zaldy Tan, a dementia expert
who was not involved in the new study, told Reuters Health. "If not,
family caregivers may wish to advocate for these."
"People are considered to have
dementia if their mental function is bad enough to interfere with daily
activities. Alzheimer's disease is the most common cause, accounting for about
60% to 80% of cases. The next most common cause of dementia is stroke.
A burden on families and caregivers
Dementia leads to poorer quality of life
for patients, and it also puts a burden on families and caregivers – as Forbes,
who led the study, knows all too well.
"For over 20 years I worked as a
community health nurse where health promotion was my focus and in home care
where I attempted to support and provide the needed resources with many family caregivers
and persons with dementia in rural and inner city homes," Forbes told
Reuters Health in an e-mail.
"My mother also had dementia and died
in an acute care setting where the health care providers did not understand how
to care for her dementia symptoms."
"These experiences made me realise how
difficult it was to care for someone with dementia at home and in other care
settings, especially with little knowledge about what was helpful in managing
the symptoms and available resources," Forbes said.
"There is strong evidence regarding
the benefits of exercise on older adults, but we did not know if there were
benefits for persons diagnosed with dementia," she explained.
In 2006, therefore, when "there was
little research conducted in this area," Forbes and her colleagues pooled
the data from four studies of the role of exercise for patients with dementia.
A great deal of interest
Their new study, published online by the
Cochrane Library, is an update of that earlier effort."This updated review
includes 16 trials," Forbes said.
"We plan to do another update in six
months as additional trials have already come to our attention. There is now a
great deal of interest in this area of research.
"The 16 trials altogether involved
nearly a thousand elderly adults with dementia. Each trial tested the effects
of exercise programmes on such outcomes as thinking skills, activities of daily
living, challenging behaviour, and depression.
All 16 trials were so-called "randomised,
controlled studies", which means the research teams used the most
dependable methods. Even so, the studies utilised different types and duration
of exercise programmes, and the participants were in different stages of
dementia, so the results were not uniform.
Improved cognitive function
Still, despite the differing nature of the
studies, Forbes and her team found that on average, exercise improved cognitive
functioning and the ability to perform activities of daily living.
"Exercise is not only beneficial for
older adults (in general) but also for persons with dementia in delaying memory
problems and prolonging their ability to care for themselves (i.e., activities
of daily living such as dressing, bathing)," Forbes said.
Exercise didn't have an effect on
depression or mood, however, and there wasn't enough evidence to draw firm
conclusions about its effects on other outcomes."I think it's really
important topic," Tan, who is the medical director of the Alzheimer's and
Dementia Care Programme at the University of California, Los Angeles, told
A practical side
"The challenge here is, as the authors
pointed out, that these studies they reviewed were quite heterogeneous,"
"But with that said," he added,
"it's promising that even with quite different interventions and studies,
they found that it appears to be beneficial for cognition and also activities
of daily living."
Tan sees a practical side to exercise
that goes beyond its impact on measurable cognitive skills. "I think
exercise is one intervention that's going to turn out to be good for other
things like, for example, reducing one's risk for falls," he said.
"Falling is one thing that is a big
problem for people with dementia." Tan expects to see more research in the
future, including studies of how exercise programmes might affect the children
and caregivers of people with dementia.