Jacopo Demurtas1, Daniel Schoene2, Gabriel Torbahn3, Alessandra Marengoni4, Giulia Grande5, Liye Zou6, Mirko Petrovic7, Stefania Maggi8, Matteo Cesari9, Sarah Lamb10, Pinar Soysal11, Wolfgang Kemmler12, Cornel Sieber3, Christoph Mueller13, Susan D Shenkin14, Lukas Schwingshackl15, Lee Smith16, Nicola Veronese17. 1. Primary Care Department Azienda USL Toscana Sud Est, Grosseto, Italy; Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. 2. Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany; Department of Geriatric Rehabilitation, Robert-Bosch Hospital, Stuttgart, Germany. 3. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany. 4. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. 5. Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 6. Exercise and Mental Health Laboratory, Shenzhen University, Shenzhen, China. 7. Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium. 8. National Research Council, Neuroscience Institute - Aging Branch, Padova, Italy. 9. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. 10. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford University, Oxford, United Kingdom. 11. Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, Istanbul, Turkey. 12. Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Nuremberg, Germany. 13. King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK. 14. Geriatric Medicine, Usher Institute, University of Edinburgh, Edinburgh, UK. 15. Faculty of Medicine, Institute for Evidence in Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany. 16. The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University, Cambridge, UK. 17. Unità Locale Socio Sanitaria 3 "Serenissima", Primary care Department, Venice, Italy; Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy. Electronic address: ilmannato@gmail.com.
Abstract
OBJECTIVES: The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia. DESIGN: Umbrella review of systematic reviews (SR), with or without meta-analyses (MAs), of randomized controlled trials (RCTs) and observational studies. SETTINGS AND PARTICIPANTS: People with MCI or dementia, confirmed through validated assessment measures. Any form of physical activity/exercise was included. As controls, we included participants not following any prespecified physical activity/exercise intervention or following the same standard protocol with the intervention group. METHODS: The protocol was registered in PROSPERO (CDR 164197). Major databases were searched until December 31, 2019. The certainty of evidence of statistically significant outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. SRs' findings, without a formal MA, were reported descriptively. RESULTS: Among 1160 articles initially evaluated, 27 SRs (all of RCTs, 9 without MA) for a total of 28,205 participants with MCI/dementia were included. In patients with MCI, mind-body intervention (standardized mean difference [SMD] = 0.36; 95% confidence intervals [CI] 0.20-0.52; low certainty) and mixed physical activity interventions (SMD = 0.30; 95% CI 0.11-0.49; moderate certainty) had a small effect on global cognition, whereas resistance training (SMD = 0.80; 95% CI 0.29-1.31; very low certainty) had a large effect on global cognition. In people affected by dementia, physical activity/exercise was effective in improving global cognition in Alzheimer disease (SMD = 1.10; 95% CI 0.65-1.64; very low certainty) and in all types of dementia (SMD = 0.48; 95% CI 0.22-0.74; low certainty). Finally, physical activity/exercise improved noncognitive outcomes in people with dementia including falls, and neuropsychiatric symptoms. CONCLUSIONS AND IMPLICATIONS: Supported by very low-to-moderate certainty of evidence, physical activity/exercise has a positive effect on several cognitive and noncognitive outcomes in people with MCI and dementia, but RCTs, with low risk of bias/confounding, are still needed to confirm these relationships.
OBJECTIVES: The aim of this umbrella review was to determine the effect of physical activity/exercise on improving cognitive and noncognitive outcomes in people with MCI (mild cognitive impairment) and dementia. DESIGN: Umbrella review of systematic reviews (SR), with or without meta-analyses (MAs), of randomized controlled trials (RCTs) and observational studies. SETTINGS AND PARTICIPANTS: People with MCI or dementia, confirmed through validated assessment measures. Any form of physical activity/exercise was included. As controls, we included participants not following any prespecified physical activity/exercise intervention or following the same standard protocol with the intervention group. METHODS: The protocol was registered in PROSPERO (CDR 164197). Major databases were searched until December 31, 2019. The certainty of evidence of statistically significant outcomes was evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. SRs' findings, without a formal MA, were reported descriptively. RESULTS: Among 1160 articles initially evaluated, 27 SRs (all of RCTs, 9 without MA) for a total of 28,205 participants with MCI/dementia were included. In patients with MCI, mind-body intervention (standardized mean difference [SMD] = 0.36; 95% confidence intervals [CI] 0.20-0.52; low certainty) and mixed physical activity interventions (SMD = 0.30; 95% CI 0.11-0.49; moderate certainty) had a small effect on global cognition, whereas resistance training (SMD = 0.80; 95% CI 0.29-1.31; very low certainty) had a large effect on global cognition. In people affected by dementia, physical activity/exercise was effective in improving global cognition in Alzheimer disease (SMD = 1.10; 95% CI 0.65-1.64; very low certainty) and in all types of dementia (SMD = 0.48; 95% CI 0.22-0.74; low certainty). Finally, physical activity/exercise improved noncognitive outcomes in people with dementia including falls, and neuropsychiatric symptoms. CONCLUSIONS AND IMPLICATIONS: Supported by very low-to-moderate certainty of evidence, physical activity/exercise has a positive effect on several cognitive and noncognitive outcomes in people with MCI and dementia, but RCTs, with low risk of bias/confounding, are still needed to confirm these relationships.
Authors: Giovanni Fiorilli; Andrea Buonsenso; Marco Centorbi; Giuseppe Calcagno; Enzo Iuliano; Antonella Angiolillo; Santina Ciccotelli; Alessandra di Cagno; Alfonso Di Costanzo Journal: Nutrients Date: 2022-06-17 Impact factor: 6.706
Authors: Shengwen Zhou; Sitong Chen; Xiaolei Liu; Yanjie Zhang; Mengxian Zhao; Wenjiao Li Journal: Int J Environ Res Public Health Date: 2022-01-22 Impact factor: 3.390