![]() Thus, less is known about the significance of exercise intensity. In addition, a systematic review from 2019 dealing with exercise doses in people with cognitive impairment reports on superiority of short but more frequent exercise sessions (Sanders, Hortobágyi, La Bastide-van Gemert, Van der Zee, & Van Heuvelen, 2019). compared to resistance training) and higher volumes (at least 45 min for 6 months) (Erickson et al., 2019). Indeed, some but not all studies demonstrate higher effect sizes for endurance training (e.g. Nevertheless, to date, only limited data exist about the most effective exercise dose (e.g. Thus, increasing PA and implementing exercise have been identified as protective factors as well as treatment strategies (Forbes, Forbes, Blake, Thiessen, & Forbes, 2015 Lam et al., 2018 Pitkälä, Savikko, Poysti, Strandberg, & Laakkonen, 2013). Furthermore, a recent review reports on moderate evidence for exercise training interventions (structured programs) in improving cognitive function in people with dementia (Erickson et al., 2019). ![]() There is a huge body of evidence suggesting that a higher amount of physical activity (PA) is associated with a reduced risk of cognitive impairments throughout the life span and that PA counteracts brain atrophy, one of the main features of Alzheimer’s disease (Colcombe et al., 2006 Erickson et al., 2011 Erickson, Weinstein, & Lopez, 2012 Intlekofer & Cotman, 2013 Kirk-Sanchez & McGough, 2014 McGurran, Glenn, Madero, & Bott, 2019 Pini et al., 2016). ![]() Hence, the aim of existing therapies is to maintain general functions, facilitate independency, and to ensure quality of life (QoL) (Hildreth & Church, 2015 Hugo & Ganguli, 2014). There is currently no disease-modifying therapy available for any of the neurodegenerative types of dementia. Gait and balance disturbances increase the risk of falls (Kato-Narita, Nitrini, & Radanovic, 2011) and are related to reduced lower-limb muscle strength (Muehlbauer, Gollhofer, & Granacher, 2015), habitual physical activity (Morie et al., 2010), and the ability to perform activities of daily living (ADLs) independently (Wennie Huang, Perera, VanSwearingen, & Studenski, 2010). Aside from cognitive decline, dementia is also associated with impaired motor function and difficulties in social and occupational functioning. Dementia is a syndrome which pathoetiologically affects the brain and is characterized by a progressive deterioration in intellect including memory, learning, orientation, language, comprehension and judgment (Hugo & Ganguli, 2014). In 2012, the World Health Organization (WHO) declared dementia a public health priority, highlighting the high global prevalence and economic impact (World Health Organization & Alzheimer’s Disease International, 2012). Due to demographic transition and increasing societal ageing, the financial burden of this disease will continuously grow in the coming years. The prevalence of dementia doubles every 5 years after the age of 65 (Fiest et al., 2016) meaning that more than two thirds of all affected individuals have already reached the age of 80. Further well-designed studies are needed to identify the best exercise type for different types and stages of dementia.ĭementia is one of the most common mental and neurological disorders affecting nearly 50 million people worldwide (Prince et al., 2015). There is only limited evidence for an intensity-related dose–response relationship. The qualitative analyses yielded sporadic beneficial results (mobility, psychological well-being and apathetic behaviour) in favour of HIT. No differences were found in cognitive function, depressive symptoms and QoL. Compared to seated control activities, strength and balance HIT resulted in statistically significant but small positive effects on balance performance (MD = 2.31, 95% CI = 0.44–4.17, p = 0.02 I 2 = 73%) and on the abilities to independently perform ADLs (SMD = 0.28, 95% CI = 0.12–0.44, p = 0.0006 I 2 = 0%). ![]() There was an overall good study quality (mean PEDro score = 7.6 ± 0.7). Nine studies from three large-scale research projects which were based on the high-intensity functional exercise (HIFE) program incorporating strength, balance and mobility exercises of the lower limbs, including 456 participants (85.5 ± 7.0 years), were considered. We calculated mean difference (MD) or standardized MD (SMD) and the 95% confidence interval (CI), and assessed heterogeneity using I 2 statistic. A systematic literature search for randomized controlled trials was performed until July 2019. The aim of this systematic review was to investigate the effects of high-intensity exercise training (HIT) programs on cognitive and mental health, physical performance, activities of daily living (ADLs) and quality of life (QoL) in people with dementia. Dementia is a syndrome characterized by a progressive deterioration of cognitive and physical functions.
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