Physical Activity Interventions in Preventing Cognitive Decline and Alzheimer-Type Dementia: A Systematic Review
Abstract
Background: The prevalence of cognitive impairment and dementia is expected to increase dramatically as the population ages, creating burdens on families and health care systems. Purpose: To assess the effectiveness of physical activity interventions in slowing cognitive decline and delaying the onset of cognitive impairment and dementia in adults without diagnosed cognitive impairments. Data Sources: Several electronic databases from January 2009 to July 2017 and bibliographies of systematic reviews. Study Selection: Trials published in English that lasted 6 months or longer, enrolled adults without clinically diagnosed cognitive impairments, and compared cognitive and dementia outcomes between physical activity interventions and inactive controls. Data Extraction: Extraction by 1 reviewer and confirmed by a second; dual-reviewer assessment of risk of bias; consensus determination of strength of evidence. Data Synthesis: Of 32 eligible trials, 16 with low to moderate risk of bias compared a physical activity intervention with an inactive control. Most trials had 6-month follow-up; a few had 1- or 2-year follow-up. Evidence was insufficient to draw conclusions about the effectiveness of aerobic training, resistance training, or tai chi for improving cognition. Low-strength evidence showed that multicomponent physical activity interventions had no effect on cognitive function. Low-strength evidence showed that a multidomain intervention comprising physical activity, diet, and cognitive training improved several cognitive outcomes. Evidence regarding effects on dementia prevention was insufficient for all physical activity interventions. Limitation: Heterogeneous interventions and cognitive test measures, small and underpowered studies, and inability to assess the clinical significance of cognitive test outcomes. Conclusion: Evidence that short-term, single-component physical activity interventions promote cognitive function and prevent cognitive decline or dementia in older adults is largely insufficient. A multidomain intervention showed a delay in cognitive decline (low-strength evidence). Primary Funding Source: Agency for Healthcare Research and Quality.
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One systematic review published after the PAGAC search concluded there was insufficient evidence that physical activity could be used for dementia prevention.
“One additional SR published after the PAGAC search was completed examined the effects of PA interventions (of any type) lasting at least 6 months on delaying cognitive impairment in currently undiagnosed individuals (44). The authors concluded that there was insufficient evidence that PA could be used for dementia prevention.”
From Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines (2019) · cites this paper as [44]
Evidence on the protecting role of short-term, single-component physical activity interventions is largely insufficient.
“Conversely, the evidence on the protecting role of short-term, single-component physical activity interventions seems to be largely insufficient (32).”
From The Multidisciplinary Approach to Alzheimer’s Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment (2018) · cites this paper as [32]
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- Authors
- Brasure, M., Desai, P., Davila, H., Nelson, V. A., Calvert, C., Jutkowitz, E., Butler, M., Fink, H. A., Ratner, E., Hemmy, L. S., McCarten, J. R., Barclay, T. R., & Kane, R. L.
- Affiliations
- University of Minnesota (US)
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2018-01-02
- Volume
- 168
- Issue
- 1
- Pages
- 30-38
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2779580162
- Cited by
- 280
- References
- 49
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 23 · 2023: 36 · 2022: 44 · 2021: 58 · 2020: 34 · 2019: 32 · 2018: 19 · 2017: 2
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Annals of Internal Medicine
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- physical activity interventions, cognitive decline, dementia prevention, Alzheimer's disease, cognitive impairment, aerobic exercise, resistance training, Tai Chi, multicomponent intervention, multidomain intervention, older adults, cognitive function
- MeSH terms
- Aged, Alzheimer Disease, Humans, Middle Aged, Exercise, Cognitive Dysfunction
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