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Meta-Analysis
. 2018 Sep 4:13:1593-1603.
doi: 10.2147/CIA.S169565. eCollection 2018.

Physical activity can improve cognition in patients with Alzheimer's disease: a systematic review and meta-analysis of randomized controlled trials

Zhen Du  1 , Yuewei Li  1 , Jinwei Li  1 , Changli Zhou  1 , Feng Li  1 , Xige Yang  2
Affiliations
Meta-Analysis

Physical activity can improve cognition in patients with Alzheimer's disease: a systematic review and meta-analysis of randomized controlled trials

Zhen Du et al. Clin Interv Aging. .

Abstract

Background/objective: Alzheimer's disease (AD) is mainly characterized by decline of cognitive functions such as memory and learning, which has a high prevalence and poor drug efficacy in treatment regimes. A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to evaluate the effectiveness of exercise on cognitive function in patients diagnosed with AD.

Methods: The bibliographic databases (PubMed, Cochrane Library and Embase, and Web of Science) and four Chinese databases (Wanfang data, CBM, CNKI, and VIP) were searched to identify RCTs published in any language between January 1, 1960, and January 1, 2018. Only peer-reviewed articles and RCTs were included. The collected data were analyzed by Review Manager (5.3).

Results: Overall, 869 patients diagnosed with AD were included from 13 RCTs. Patients in the intervention group received pure exercise interventions and a cognitive test. Although there was heterogeneity in intervention methods and cognitive measures among studies, meta-analysis (seven studies) supports positive effects of physical activity on cognitive function of patients with AD (mean difference [MD] =2.53, the 95% CI=0.84 to 4.22, test for overall effect: Z=2.93 [P=0.003]). Eight studies demonstrated that exercise improves cognitive function for individuals with AD. However, the remaining five studies did not display a beneficial effect of exercise on cognitive function in patients with AD.

Conclusion: This meta-analysis and systematic review indicated that exercise intervention might improve the cognitive function of AD or slow down the decline of cognition; however, this relationship was not always true across studies. RCTs with clear intervention criteria, large samples, and long-term follow-up are needed in the future to demonstrate the benefits of exercise for cognitive function in AD patients.

Keywords: Alzheimer’s disease; cognitive function; exercise; randomized controlled trial.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flow diagram of the study identification process.
Figure 2
Figure 2
Risk of bias summary: review authors’ judgments about each risk of bias item for each included study.
Figure 3
Figure 3
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.
Figure 4
Figure 4
A forest plot shows the results of a meta-analysis of six RCTs measuring MMSEoutcome for individuals with AD. Note: Exercise intervention had a positive effect on MMSEresults. Abbreviations: AD, Alzheimer’s disease; MMSE, Mini-Mental State Examination; RCT, randomized controlled trial.
Figure 5
Figure 5
A funnel plot of the meta-analysis of six studies. Notes: SE indicates the accuracy of the estimated value of the treatment effect, and the smaller the SE, the more accurate it is. The MD measures the treatment effect size. Abbreviations: MD, mean difference; SE, standard error.
See this image and copyright information in PMC

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