title: Exercise training for managing behavioral and psychological symptoms in people with dementia: A systematic review and meta-analysis.
abstract: This systematic review and meta-analysis of randomized controlled trials assessed the effects of exercise on behavioral and psychological symptoms of dementia (BPSD, including depression) in people with dementia (PWD). Secondary outcomes for the effects of exercise were mortality and antipsychotic use. Twenty studies were included in this review (n=18 in the meta-analysis). Most studies used a multicomponent exercise training (n=13) as intervention; the control group was often a usual care (n=10) or a socially-active (n=8) group. Exercise did not reduce global levels of BPSD (n=4. Weighted mean difference -3.884; 95% CI -8.969-1.201; I(2)=69.4%). Exercise significantly reduced depression levels in PWD (n=7). Standardized mean difference -0.306; 95% CI -0.571 to -0.041; I(2)=46.8%); similar patterns were obtained in sensitivity analysis performed among studies with: institutionalized people (p=0.038), multicomponent training (p=0.056), social control group (p=0.08), and low risk of attrition bias (p=0.11). Exploratory analysis showed that the principal BPSD (other than depression) positively affected by exercise was aberrant motor behavior. Exercise had no effect on mortality. Data on antipsychotics were scarce. In conclusion, exercise reduces depression levels in PWD. Future studies should examine whether exercise reduces the use (and doses) of antipsychotics and other drugs often used to manage BPSD.
authors.affiliation: Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; CNRS UMR 7268 Biocultural Anthropology, Law, Ethics and Health, Aix-Marseille University, Marseille, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France. Electronic address: philipebarreto81@yahoo.com.br.
authors.forename: Philipe de Souto
authors.initials: Pde S
authors.lastname: Barreto
authors.affiliation: Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Demougeot
authors.affiliation: Department of Respiratory Function Exploration and Sports Medicine, Larrey Hospital, Toulouse, France.
authors.forename: Fabien
authors.initials: F
authors.lastname: Pillard
authors.affiliation: UMR INSERM 1027, University of Toulouse III, Toulouse, France; Department of Clinical Pharmacology, Toulouse University Hospital, 37 Allees Jules Guesde, F-31000 Toulouse, France.
authors.forename: Maryse
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.affiliation: Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Rolland
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D003704:Dementia / Q000401:mortality / Q000523:psychology / Q000628:therapy; D003863:Depression / Q000209:etiology / Q000628:therapy; D015444:Exercise / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic
keywords: Alzheimer’s disease; Depression; Elderly; Neuropsychiatric symptoms; Older adults; Physical activity