Physical inactivity could be considered as a potential risk factor for dementia and mild cognitive impairment (MCI). Despite several systematic reviews and meta-analyses regarding the impact of physical activity and exercise for the prevention and the management of dementia and MCI are present, no guidelines are currently available. With this project involving nine international scientific societies (including the European Academy of Neurology) and stakeholders, we summarized the current literature about physical activity and exercise in people without dementia and MCI, in MCI, and in dementia. Overall, in people without any evidence of dementia or MCI, physical activity may be considered for the primary prevention of dementia, AD, or vascular dementia, even if the certainty of the evidence was very low; in participants without dementia or MCI, exercise may be no better than health education for the primary prevention of dementia and MCI. However, since only one intervention study could be included, the analysis may have been underpowered for this outcome. In MCI, there is continued uncertainty about the role of physical activity and exercise in slowing the conversion to dementia: these cautious findings are based on the fact that the studies included were highly heterogeneous in terms of interventions proposed, small sample size, and that several of the studies included had changes in cognitive tests as outcomes and not the transition to dementia. Finally, in people with moderate dementia, physical activity/exercise could be considered for maintaining cognition; in people with moderate dementia, exercise could be considered for stabilizing disability compared to usual care. In this latter population, exercise seems to be good for improving some neuropsychiatric symptoms (in particular depression) and the risk/number of falls.
Considering together, despite the limitations of the literature, our guidelines agreed to support physical activity and exercise in our guidelines after taking into account their overall beneficial effect on our target population's global health, including physical and psychological health.
Key Points:
- Physical inactivity is a strong risk factor for dementia and MCI.
- With this international guidelines, we summarized the current literature about physical activity and exercise in people without dementia and MCI, in MCI, and in dementia.
- In people without any evidence of dementia or MCI, physical activity may be considered for the primary prevention of dementia, AD, or vascular dementia.
- In MCI, there is continued uncertainty about the role of physical activity and exercise in slowing the conversion to dementia.
- In dementia, physical activity/exercise could be considered for maintaining cognition and stabilizing disability.
References:
- Veronese, N., Soysal, P., Demurtas, J. et al. Physical activity and exercise for the prevention and management of mild cognitive impairment and dementia: a collaborative international guideline. Eur Geriatr Med (2023). doi.org/10.1007/s41999-023-00858-y
Co-authors:
Kristian Steen Frederiksen, University of Copenhagen Svetlana Tomic, Osijek University Hospital Centre
Publish on behalf of the Scientific Panel Dementia and Cognitive Disorders