Question: In adults (age >55 years) with dementia in a ward or community setting, how effective is physical activity (including exercise and physiotherapy), compared to any other intervention, in improving patient outcomes (including reducing levels of agitation, reducing risk, reducing the frequency of falls, improving skills of daily living, improving quality of life measures and cognitive functioning)?

Answer:

There is some evidence, from a two systematic reviews and two additional randomised controlled trials, that exercise programmes can improve physical function and activities of daily living in older patients with dementia. There is also some evidence, from two small randomised controlled trials, that exercise may reduce decline, or possibly improve, cognitive function in older patients with Alzheimer's disease. However, both systematic reviews had methodological weaknesses and both the studies included in the systematic review and the separately identified RCTs were generally small and methodologically weak and/or poorly reported.

Larger, high quality studies are needed to confirm the obsereved effects, particularly in relation to the effects of exercise on cognitive function. It is important that specific information about the intervention is well documented (e.g. characteristics of the participants, the intensity, duration and the different components of the exercise intervention), in order to assess the external validity (applicability to various patient groups) of findings, possible confounders and the possible dose-response relationship in.