Exercise interventions for older adults with Alzheimer's disease: a systematic review and meta-analysis protocol

Julie M. Faieta*, Hannes Devos, Prasanna Vaduvathiriyan, Michele K. York, Kirk I. Erickson, Mark A. Hirsch, Brian G. Downer, Erwin E.H. van Wegen, Diana C. Wong, Elena Philippou, Ahmed Negm, Pedram Ahmadnezhad, Shilpa Krishnan, Melike Kahya, Pallavi Sood, Patricia C. Heyn

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

BACKGROUND: The growing societal and economic impact of Alzheimer's disease (AD) is further compounded by the present lack of disease-modifying interventions. Non-pharmacological intervention approaches, such as exercise, have the potential to be powerful approaches to improve or mitigate the symptoms of AD without added side effects or financial burden associated with drug therapies. Various forms and regiments of exercise (i.e., strength, aerobic, multicomponent) have been reported in the literature; however, conflicting evidence obscures clear interpretation of the value and impact of exercise as an intervention for older adults with AD. The primary objective of this review will be to evaluate the effects of exercise interventions for older adults with AD. In addition, this review will evaluate the evidence quality and synthesize the exercise training prescriptions for proper clinical practice guidelines and recommendations.

METHODS: This systematic review and meta-analysis will be carried out by an interdisciplinary collective representing clinical and research stakeholders with diverse expertise related to neurodegenerative diseases and rehabilitation medicine. Literature sources will include the following: Embase, PsychINFO, OVID Medline, and Ovid MEDLINE(R) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily. Inclusion criteria are participants with late onset AD and structured exercise interventions with prescribed duration, frequency, and intensity. The primary outcome of this study will center on improved or sustained cognitive functioning. Secondary outcomes will include institutionalization-related outcomes, ability in activities of daily living, mood and emotional well-being, quality of life, morbidity, and mortality. Analysis procedures to include measurement of bias, data synthesis, sensitivity analysis, and assessment of heterogeneity are described in this protocol.

DISCUSSION: This review is anticipated to yield clinically meaningful insight on the specific value of exercise for older adults with AD. Improved understanding of diverse exercise intervention approaches and their specific impact on various health- and function-related outcomes is expected to guide clinicians to more frequently and accurately prescribe meaningful interventions for those affected by AD.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020175016 .

Original languageEnglish
Article number6
JournalSystematic Reviews
Volume10
Issue number1
DOIs
Publication statusPublished - 4 Jan 2021
Externally publishedYes

Funding

MH declares the following interests: MAH, grant funding from Merz Neurosciences, Dutch Brain Foundation, Dutch Parkinson Patient Association. Editorial Board, Parkinsonism and Related Disorders, speaker honoraria from International Association of Parkinsonism and Related Disorders. Non-financial: American Congress of Rehabilitation Medicine—Neurodegenerative Diseases Networking Group. All remaining authors declare that they have no competing interests.

FundersFunder number
Dutch Brain Foundation
Dutch Parkinson Patient Association
Merz Neurosciences
National Institute on AgingK01AG058789

    Keywords

    • Alzheimer’s disease
    • Cognitive function
    • Dementia
    • Exercise
    • Exercise training
    • Mild cognitive impairment
    • Older adults
    • Physical activity

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