Table 1.
Evidence from included RCTs describing PA interventions.
| Study | Participants | IG (n) |
CG (n) |
Dementia Severity Baseline MMSE |
IG | CG | Length Frequency Duration | PA Modality | PA Intensity | Cognitive Assessment | Follow up | Adherence Rate |
PA Impact on Cognition |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Karssemeijer et al., (2019) [35] | 115/AD, VaD, MD/MMSE score ≥ 17/community-dwelling | IG1: 38 IG2: 38 |
39 | 22.9 Mild dementia |
IG1: cognitive and aerobic bicycle training IG2: Cycling on a stationary bike |
Relaxation and flexibility exercises | 30–50 min, 3× week, 12 weeks | Combined cognitive and PA training Only aerobic training |
Light intensity IG: 41.8% and 43.5% of maximal HR | MMSE; TMT Part B; SCWT; Letter Fluency; Rule Shift Cards Test; WAIS-III (Digit Span); WMS-III (Spatial Span); LLT-R |
12 and 24 weeks | Good adherence (85.4%) | − |
| Huang et al., (2019) [54] | 80/UD/MMSE score not specified/care facility | 40 | 40 | 20.76 Mild dementia |
Tai-Chi exercises | Routine treatments and personalized daily care | 20 min, 3× week, 10 months | Combined PA training | Moderate exercise intensity | MMSE; MoCA; WHO-UCLA-AVLT; TMT | 5 and 10 months | Good Adherence (%NR) |
+*f |
| Lamb et al., (2018) [42] | 494/AD, MD, VaD, UD/MMSE score ≥ 10/community-dwelling | 329 | 165 | 21.8 Mild dementia |
Supervised Gym program: Static cycling, arms and legs strength training Unsupervised prescribed Home program |
Usual Care | 60–90 min, 2× week, 4 months. Plus 60 min, weekly PA at home 150 min each week |
Combined PA training | Vigorous intensity | ADAS- Cog | 12 months | Good adherence (65%) | − |
| Henskens et al., (2018) [37] | 87/AD, VaD, Mixed VaD and AD, UD/ MMSE score < 24/care facility | IG1: 21 IG2: 22 IG3: 22 |
22 | 12.27 Severe dementia |
IG1: ADLs training IG2: Multicomponent PA training: Strength seated upper, lower extremities and torso exercises. Outdoor walking IG3: multicomponent PA and ADLs training |
Care as usual and social activity intervention | 30–45 min, 3× week, 6 months | Combined PA training | Progressive increase intensity | MMSE; SIB-S; GIT (fluency subtest); WAIS (digit Span Task Backward); go-no-go test; FAB (conflicting instructions test) | 3 and 6 months | Poor adherence (%NR) |
− |
| Toots et al., (2017) [38] | 186/AD, VaD, MD; UD/MMSE score ≥ 10/care facility |
93 | 93 | 15.0 Moderate dementia |
Exercise program for limb strength, balance, and mobility | Structured activities (e.g., singing, reading) | 45 min, 5 sessions per two-week period, 4 months | Combined PA training | Vigorous intensity | ADAS- Cog; MMSE; and VF | 4 and 7 months | Good adherence (71.5%) |
− |
| Öhman et al., (2016) [48] | 210/AD/MMSE score not specified/community-dwelling | IG1:70 IG2:70 |
70 | 18.0 Moderate dementia |
IG1: Home-base with physiotherapist supervision IG2: Group-based in a day care centre Both implemented aerobic, balance, strength and dual-tasking training |
Usual community care | 60 min, 2× week, 12 months | Combined cognitive and PA training | NR | CDT; CDR, and MMSE | 3, 6, and 12 months | Good adherence (81%) |
+ * a |
| Kim et al., (2016) [45] | 38/AD/MMSE score ≤ 20/care facility | 19 | 19 | 14.8 Moderate dementia |
Multicomponent intervention + stretching, lower-limb aerobic exercises using TERASUERUGO | Multicomponent intervention: art and social activities | 60 min, 5× week, 6 months | Combined cognitive and PA training | Moderate intensity 40–60% of the maximum HR |
ADAS- Cog, MMSE, and CDT | 6 months | Good adherence (100%) |
− |
| Cancela et al., (2016) [51] | 189/UD //MMSE score not specified/care facility | 73 | 116 | 15.05 Moderate dementia |
Cycling sessions | Recreational activities (e.g., card-playing, craftwork) | 15 min, daily, 15 months | Only aerobic training | Light intensity | MMSE; FOME | 3, 6, 9, 12, and 15 months | Poor adherence (%NR) |
+ |
| Hoffmann et al., (2015) [46] | 200/AD/MMSE score ≥ 19/community-dwelling | 107 | 93 | 24.0 Mild dementia |
Strength training of lower extremities and exercises in ergometer bicycle, cross trainer, and treadmill | Treatment as usual | 60 min, 3× week, 16 weeks | Combined PA training | Moderate to vigorous intensity. 70–80% of maximal HR | SDMT; ADAS-Cog; SCWT; incongruent score; verbal fluency; MMSE | 16 weeks | Good adherence (84%) |
− |
| Bossers et al., (2015) [43] | 109/AD, VaD, MD, UD// MMSE score ≥ 9 and ≤23/Care facility | IG1: 37 IG2: 36 |
36 | 15.6 Mild dementia |
IG1: Two strengthening and two walking sessions per week IG2: Four walking sessions per week |
Social visits | 30 min, 36 individual sessions, 9 weeks | Combined PA training Only aerobic training |
Moderate to vigorous intensity | MMSE; WMS-R; RBMT; SCWT; animals and professions | 9 and 18 weeks | Good adherence (89.2%) |
+ * ae |
| Yang et al., (2015) [39] | 50/AD, VaD/MMSE score ≥ 10 and ≤24 /community-dwelling | 25 | 25 | 20.66 Mild dementia |
Cycling training | Health education | 40 min, 3× week, 3 months | Only aerobic training | Vigorous intensity 70% of maximal HR |
MMSE; ADAS-Cog | 3 months | NR | + |
| Cheng et al., (2014) [36] | 110/AD, VaD, UD/MMSE score ≥ 10 and ≤24/Care facility | IG1:36 IG2: 39 |
35 | 18.8 Moderate dementia |
IG1: Cognitive stimulation-board game Mahjong IG2: 12-Form Yang style Tai-Chi |
Simple handcrafts | 60 min, 3× week, 3 months | Combined PA training | NR | MMSE; Forward and backward digit sequence/digit span; delayed recall Categorical verbal fluency |
3, 6, and 9 months | Good adherence (%NR) |
+ |
| Vreugdenhil, et al., (2012) [50] | 40/AD/MMSE score ≥ 10 and ≤28/community-dwelling | 20 | 20 | 22.0 Mild dementia |
Aerobic walking, strengthening and balance training | Usual treatment | 30 min, 5× week, 4 months | Combined PA training | Moderate intensity | ADAS- Cog, MMSE | 4 months | NR | + |
| Venturelli, et al., (2011) [44] | 21/AD// MMSE score ≥ 5 and ≤15/Care facility | 12 | 11 | 12.5 Severe dementia |
Walking program | Daily organized activities (e.g., bingo, music therapy) | 30 min, 4× week, 24 weeks | Only aerobic training | Moderate intensity | MMSE | 24 weeks | Good adherence (93.4%) |
− |
| Kemoun et al., (2010) [49] | 31/AD/MMSE score ≤ 23 /care facility | 16 | 15 | 12.8 Severe dementia |
Articular mobilization and muscle stimulation trough walking, equilibrium, stamina, and dancing | No PA participation | 60 min, 3× week, 15 weeks | Combined PA training | Moderate intensity 60% and 70% of maximal HR |
French RECF | 15 weeks | NR | + * |
| Steinberg et al., (2009) [47] | 27/AD/MMSE score ≥ 10/community-dwelling | 14 | 13 | 17.7 Moderate dementia |
Home-based program, caregivers instructed during visits on daily walking, strength training of major muscle groups, balance and flexibility | Home safety assessment | 120 min per visit, 3 visits, 12 weeks | Combined PA training | Moderate intensity | MMSE, BNT, HVLT | 6 and 12 weeks | Good adherence (59%) |
+ |
| Eggermont et al., (2009a) [53] | 97/UD/MMSE score ≤ 10 and ≥24/care facility | 51 | 46 | 17.7 Moderate dementia |
Walking program | Received social visits | 30 min, 5× week, 6 weeks | Only aerobic training | Self-selected speed | RBMT (face and picture recognition test); eight words test; digit span from the WMS-R; category fluency and letter fluency | 6 and 12 weeks | NR | − |
| Eggermont et al., (2009b) [52] | 61/UD/MMSE score ≤ 10 and ≥24/care facility | 23 | 24 | 17.7 Moderate dementia | Hand motor activity (finger movements, pinching, handling rubber rings, etc.) | Read aloud program | 30 min, 5× week, 6 weeks | Hand movement training | NR | RBMT; Digit Span from the WMS-R; category fluency; Stop Signal task; and Attention Network Test | 6 and 12 weeks | NR | − |
| Miu et al., (2008) [34] | 85/AD, VaD, MD, UD/MMSE score ≥ 10 and ≤26/community-dwelling | 36 | 49 | 18.9 Moderate dementia |
Treadmill, bicycle, and arm ergometer training | Social visits and discussions on health-related topics | 45–60 min, 2× week, 3 months | Only aerobic training | NR | MMSE and ADAS-Cog | 3-, 6-, 9-, and 12-months post training | Good adherence (%NR) |
− |
| Christofoletti et al., (2008) [40] | 41/AD and MD// MMSE score no specified/care facility | IG1: 12 IG2: 12 |
17 | 14.0 Moderate dementia |
IG1: Interdisciplinary program with strength, balance and cognition training IG2: Physiotherapy session |
No motor intervention | 120 min, 5× week, 6 months 60 min, 3× week, 6 months |
Combined PA training | NR | MMSE and Brief Cognitive Screening Battery | 6 months | NR | − |
| Stevens & Killeen, (2006) [33] | 75/AD, UD/MMSE score ≥ 10 and ≤23/care facility | 24 | CG1: 30 CG2: 21 |
15.0 Moderate dementia |
Gentile aerobic exertion of joints and large muscle groups | CG1: no intervention CG2: Social visits |
30 min, 3× week, 12 weeks | Only aerobic training | Light intensity | MMSE, and CDT | 12 weeks | NR | + |
| Van de Winckel et al., (2004) [41] | 25/AD, VaD/MMSE score ≤ 23/care facility | 15 | 10 | 12.0 Severe dementia |
Training while sitting focus on upper and lower body strengthening, balance, trunk movements, and flexibility | Daily one-to-one conversation with therapist | 30 min, daily, 3 months | Combined PA training | NR | MMSE and ADS-6 | 6 weeks and 3 months | NR | + * |
Intervention Group (IG); Control Group (CG); Alzheimer’s disease (AD); Mixed dementia (MD); Vascular dementia (VaD); Undefined dementia (UD); Not reported (NR); Activities of Daily Living (ADLs); Heart Rate (HR); Mini Mental state Examination (MMSE); Amsterdam Dementia screening test 6 (ADS 6); Clock-Drawing test (CDT); The Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog); The Stroop Colour and Word Test (SCWT); Le Rivermead Behavioural Memory Test (RBMT); Rapid Evaluation of Cognitive Function (French ERCF); The Frontal Assessment Battery (FAB); Wechsler Adult Intelligence Scale (WAIS); Wechsler Memory Scale Revised (WMS-R); Rivermead Behavioural Memory Test (RBMT); Symbol Digit Modalities Test (SDMT); Fuld Object Memory Evaluation (FOME); Verbal Fluency, Clinical Dementia Rating (CDR); Verbal fluency (VF); Severe Impairment Battery-Short From (SIB-S); Groninger Intelligence Test (GIT); Montreal Cognitive Assessment (MoCA); WHO-University of California Los Angeles-Auditory Verbal Learning test (WHO-UCLA-AVLT); Trail Making Test (TMT); Location Learning Test—Revised (LLT-R); Boston Naming Test (BNT); Hopkins Verbal Learning Test (HVLT). Effects on cognition; (+) = improvement; (*) = significant improvement; (−) = No improvement; (a) = improvement in executive functions; (b) = improvement in episodic memory; (c) = improvement in working memory; (d) = Improvement in focus and attention; (e) = improvement in visual memory; (f) = improvement in naming and abstract.