Effects of Exercise on Cognitive Function in Older People with Dementia: A Randomized Controlled Trial

Annika Toots, Håkan Littbrand, Gustaf Boström, Carl Hörnsten, Henrik Holmberg, Lillemor Lundin-Olsson, Nina Lindelöf, Peter Nordström, Yngve Gustafson, Erik Rosendahl, Annika Toots, Håkan Littbrand, Gustaf Boström, Carl Hörnsten, Henrik Holmberg, Lillemor Lundin-Olsson, Nina Lindelöf, Peter Nordström, Yngve Gustafson, Erik Rosendahl

Abstract

Background: Although physical exercise has been suggested to influence cognitive function, previous exercise studies show inconsistent results in people with dementia.

Objectives: To investigate effects of exercise on cognitive function in people with dementia.

Method: The Umeå Dementia and Exercise (UMDEX) study, a cluster-randomized controlled trial, was set in 16 nursing homes in Umeå, Sweden. One hundred-and-forty-one women and 45 men with dementia; mean age of 85 y and mean Mini-Mental State Examination (MMSE) score of 15, were randomized to a High-Intensity Functional Exercise program or a seated attention control activity. Blinded assessors measured global cognitive function using the MMSE and the Alzheimer's disease Assessment Scale - Cognitive subscale (ADAS-Cog), and executive function using Verbal fluency (VF) at baseline and 4 months (directly after intervention completion), and MMSE and VF at 7 months.

Results: Linear mixed models showed no between-group effects in mean difference from baseline (95% confidence intervals, CI) at 4 months in MMSE (-0.27; 95% CI -1.4 to 0.87, p = 0.644), ADAS-Cog (-1.04, 95% CI -4 to 1.92, p = 0.491), or VF (-0.53, 95% CI -1.42 to 0.35, p = 0.241) or at 7 months in MMSE (-1.15, 95% CI -2.32 to 0.03, p = 0.056) or VF (-0.18, 95% CI -1.09 to 0.74, p = 0.707).

Conclusion: A 4-month, high-intensity functional exercise program had no superior effects on global cognition or executive function in people with dementia living in nursing homes when compared with an attention control activity.

Keywords: Cognition; dementia; exercise; residential facilities.

Figures

Fig.1
Fig.1
Flow of participants through the study. ADLs, Activities of Daily Living; MMSE, Mini-Mental State Examination.
Fig.2
Fig.2
Between-group differences from baseline in Mini-Mental State Examination (MMSE) and Verbal fluency (VF). Values are least square mean change from baseline, with 95% confidence intervals, from linear mixed-effects models adjusted for age, sex, and antidepressant use.

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