A Cochrane review [Abstract] 1 included17 RCTs with a total of 1067 patients with dementia. Only two trials included participants living at home. The administration of the exercise programs ranged considerably regarding time, intensity and type of exercise. There was no clear evidence of benefit from exercise on cognitive functioning. The estimated SMD between exercise and control groups was 0.43 (95% CI -0.05 to 0.92, p= 0.08; 9 studies, n=409). There was a significant effect of exercise programs on the ability of people with dementia to perform activities of daily living (SMD 0.68, 95% CI 0.08 to 1.27; 6 studies, n=289). The burden experienced by informal caregivers providing care in the home may be reduced when they supervise the participation of the family member with dementia in an exercise program (MD -15.30, 95% CI -24.73 to -5.87; one study, n=40), but there was no significant effect of exercise on neuropsychiatric symptoms (MD -0.60, 95% CI -4.22 to 3.02; 1 study, n=110), or depression (SMD -0.14, 95% CI -0.36 to 0.07; 5 studies, n=341) . Quality of life, mortality and healthcare costs could not be examined because of the lack of data.
Comment: The quality of the evidence is downgraded by inconsistency (heterogeneity in patients and interventions) and indirectness of evidence (differences in studied patients).
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