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Exercise for cognition and behaviour in dementia

...which cognitive functions are improved, and which patients respond best?

Decline in cognitive function can be categorised as mild cognitive impairment (MCI) or mild, moderate or severe dementia. Decline in cognitive function and behavioural problems are common and inter-related symptoms of dementia.

Exercise improves cognition, but most of the evidence relates to global cognition, which is a summary measure of diverse cognitive functions such as attention, executive function, memory, language and reasoning. These individual cognitive functions decline at different rates throughout the disease progression.

Knowing that exercise improves global cognition is welcome but it is also insufficient. Exercise may help some cognitive functions more than others, so patients and their healthcare professionals should know if exercise improves the specific domains of cognitive function that a patient is having problems with.

In conclusion, exercise appears to be safe in people with MCI and dementia, when under supervision.

There was low quality of evidence to support using non-specific physical exercise to reduce the decline in global cognition in people with MCI or dementia. The quality of evidence improved to moderate when aerobic exercise, particularly at moderate to high intensity, was adopted.

The effect appeared to be more pronounced in those with moderate-grade dementia relative to those at an earlier stage. Total training duration of >24 hours could lead to a greater training effect.

> From: et al., J Physiother 66 (2020) 9-18 . All rights reserved to Australian Physiotherapy Association. Click here for the online summary.

Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!

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