Exercise Interventions Involving Minimal Equipment for Community-Dwelling Adults With Dementia: A Systematic Review and Meta-analysis

Abstract

Objective: Although exercise is an appealing nonpharmacological intervention for patients with dementia, the use of specialized equipment or facility in some interventions limits its translation into community settings. However, the effectiveness of minimal equipment exercise programs is unclear. We aimed to synthesize the effects of exercise interventions involving minimal equipment in community-dwelling adults with dementia.

Design: A systematic review and meta-analysis.

Settings and participants: Randomized controlled trials enrolling community-dwelling adults diagnosed with dementia, examining the effects of exercise interventions involving minimal equipment.

Methods: A systematic literature search was conducted in MEDLINE, EMBASE, CENTRAL, CINAHL, and PsycINFO databases for studies published from inception to September 2024. A meta-analysis was performed to synthesize the effects on 6 outcome domains including cognitive function, physical performance, ability to perform activities of daily living (ADLs), behavioral and psychological symptoms (BPSD), quality of life, and caregivers' burden. The methodological quality of studies was assessed using Cochrane's RoB 2, and the certainty of evidence was evaluated using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. The study protocol was prospectively registered in PROSPERO (CRD42023428573).

Results: Twenty-six studies (1843 participants) were included. Despite high heterogeneity between studies, modest significant improvements were found in cognitive function [standardized mean difference (SMD) = 0.56; 95% CI, 0.06-1.06; low certainty], physical performance (SMD = 0.51; 95% CI, 0.13-0.89; low certainty), ADLs (SMD = 0.39; 95% CI, 0.08-0.71; low certainty), BPSD (SMD = -0.39; 95% CI, -1.24 to 0.46; very low certainty), QoL (SMD = 0.22; 95% CI, 0.01-0.43; low certainty), and caregivers' burden (SMD = -0.12; 95% CI, -0.69 to 0.46; very low certainty).

Conclusions and implications: Our findings suggest that exercise interventions involving minimal equipment show promising benefits in various outcome domains among community-dwelling adults with dementia. However, given the low certainty of evidence, more studies of higher quality are needed to confirm these findings.

Keywords: Physical activity; aging; dementia; exercise; meta-analysis; systematic review.