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Intervention Review

Physical activity programs for persons with dementia

  1. Dorothy Forbes1,*,
  2. Sean Forbes2,
  3. Debra G Morgan3,
  4. Maureen Markle-Reid4,
  5. Jennifer Wood5,
  6. Ivan Culum5

Editorial Group: Cochrane Dementia and Cognitive Improvement Group

Published Online: 16 JUL 2008

Assessed as up-to-date: 23 JAN 2008

DOI: 10.1002/14651858.CD006489.pub2

How to Cite

Forbes D, Forbes S, Morgan DG, Markle-Reid M, Wood J, Culum I. Physical activity programs for persons with dementia. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD006489. DOI: 10.1002/14651858.CD006489.pub2.

Author Information

  1. 1

    University of Western Ontario, H33 Health Sciences Addition, School of Nursing, London, Ontario, Canada

  2. 2

    Michigan State University, Department of Physiology, East Lansing, MI, USA

  3. 3

    University of Saskatchewan, Institute for Rural, Agricultural & Environmental Health, Saskatchewan, Canada

  4. 4

    McMaster University, School of Nursing, Ontario, ON, Canada

  5. 5

    University of Western Ontario, Health and Rehabilitation Sciences, Elborn College, London, Ontario, Canada

*Dorothy Forbes, H33 Health Sciences Addition, School of Nursing, University of Western Ontario, London, Ontario, N6A 5C1, Canada. dforbes6@uwo.ca.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 16 JUL 2008

SEARCH

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

There is some evidence that physical activity delays the onset of dementia in healthy older adults and slows down cognitive decline to prevent the onset of cognitive disability. Studies using animal models suggest that physical activity has the potential to attenuate the pathophysiology of dementia. 'Physical activity' refers to 'usual care plus physical activity'.

Objectives

Primary: do physical activity programs maintain or improve cognition, function, behaviour, depression, and mortality compared to usual care in older persons with dementia?

Secondary: do physical activity programs have an indirect positive impact on family caregivers' health, quality of life, and mortality compared to family caregivers of older persons with dementia who received usual care alone? Do physical activity programs reduce the use of health care services (e.g., visits to the emergency department) compared to usual care in older persons with dementia and their family caregiver?

Search methods

The trials were identified from searches of the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group, The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS on 9 September 2007 using the search terms: exercise OR "physical activity" OR cycling OR swim* OR gym* OR walk* OR danc* OR yoga OR "tai chi".

Selection criteria

All relevant, randomized controlled trials in which physical activity programs were compared with usual care for the effect on managing or improving cognition, function, behaviour, depression, and mortality in people with dementia of any type and degree of severity. Secondary outcomes related to the family caregiver(s) included quality of life, mortality, and use of health care services were intended to be examined.

Data collection and analysis

Two reviewers independently assessed the retrieved articles for relevance and methodological quality, and extracted data from the selected trials.  These were pooled were appropriate.

Main results

Four trials met the inclusion criteria. However, only two trials were included in the analyses because the required data from the other two trials were not made available. Only one meta-analysis was conducted. The results from this review suggest that there is insufficient evidence of the effectiveness of physical activity programs in managing or improving cognition, function, behaviour, depression, and mortality in people with dementia. Few trials have examined these important outcomes. In addition, family caregiver outcomes and use of health care services were not reported in any of the included trials.

Authors' conclusions

There is insufficient evidence to be able to say whether or not physical activity programs are beneficial for people with dementia.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

There is insufficient evidence to determine the effectiveness of physical activity programs in managing or improving cognition, function, behaviour, depression, and mortality in people with dementia

Few trials examined these important outcomes. In addition, family caregiver outcomes and use of health care services were not reported in any of the included studies. There is some evidence that physical activity delays the onset of dementia in healthy older adults and slows down cognitive decline to prevent the onset of cognitive disability. Studies using animal models suggest that physical activity has the potential to attenuate the pathophysiology of dementia. Four trials met the inclusion criteria. However, only two trials were included in the analyses because the required data from the other two trials were not made available. Further well-designed research is required.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

運動方案用於失智症患者

一些證據顯示運動延緩健康年長成年人失智症的發生,並且減緩認知的退化造成的失能。使用動物進行的研究顯示運動可能減弱失智症的病理生理(現象)。"運動"意指"一般照護方式加上運動"

目標

主要目標:針對年長失智症者,以運動方案與一般照護比較,運動方案是否有助於保持或改善了認知、功能、行為、抑鬱、及死亡率? 次要目標:運動方案對家中照護者的健康、生活的品質及死亡率的影響與較年長患有失智症而僅接受一般照護者比較時有正面的影響嗎? 與僅接受一般照護者及其家庭照護者相比較,運動方案減少了健康照護服務的用量(例如:送到急救部門)嗎?

搜尋策略

於2007年9月9日使用 exercise OR "physical activity" OR cycling OR swim* gym* OR walk* OR danc* OR yoga OR "tai chi"關鍵字搜尋 Specialized Register of the Cochrane Dementia and Cognitive Improvement Group、The Cochrane Library、MEDLINE、EMBASE、 PsycINFO、CINAHL 以及LILACS以找出所需試驗。

選擇標準

針對失智患者(不限種類及嚴重程度),比較採用運動方案與一般照顧方式,對於認知、功能、行為、憂鬱以及死亡的改善情形的重要的隨機對照試驗。 次要結果與家照顧者有關,包含生活品質、死亡、以及健康照護服務的使用都使我們所欲分析的。

資料收集與分析

兩位回顧作者獨立評估所找到的文章的攸關度以及研究方法品質,並且摘錄所挑出的文章的數據。如果合適則進行匯總。

主要結論

4個試驗符合納入的標準。然而因其他兩項試驗所取得的資料無法被利用,所以僅兩項試驗被納入分析,並且僅進行一項統合分析。由本文獻回顧的結果顯示運動方案在管理或改善失智症人們認知、功能、行為、沮喪以及死亡率上的功效證據不足。幾乎沒有試驗詳細檢查這些重要的結果。此外,在納入的研究中,並沒有報導家庭照護者的結果及健康照護服務的使用。

作者結論

沒有足夠的證據能說是否運動對於失智症患者有效益。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

沒有足夠的證據確認運動方案對於處置或改善失智患者認知、功能、行為、抑鬱及死亡方面有效果:幾乎沒有試驗詳細檢查這些重要的結果。 此外,沒有研究報告有關家庭照護者的結果及健康照護服務的使用。有一些證據證明運動延緩了健康較年長成年人的失智症之起始,且延緩了認知衰退所造成的失能。 使用動物的研究顯示運動可能減弱失智症的病理生理(影響)。4項試驗符合納入的標準。然而,因為由其他兩試驗中所要求獲得的資料無法予以利用,所以僅兩項試驗納入分析。 需要進一步設計良好的研究。