Physical Leisure Activities and their Role in Preventing Dementia: A Systematic Review.
BACKGROUND
Identifying protective factors or effective prevention strategies for dementia would result in considerable benefits by prolonging quality of life and reducing social burden. Current data suggests that participation in physical leisure activities may lower the risk of dementia by improving cognitive reserves.


OBJECTIVE
The objective of this review was to determine the best available evidence in relation to physical leisure activities in preventing dementia among older adults.


METHODS
Types of studies Randomised controlled trials (RCTs) and other experimental designs were considered for inclusion into the review. In the absence of clinical trials, other study designs such as cohort, case controlled and cross-sectional were considered. Only articles published in the English language were included with no publication date restriction.Types of participants Participants of interest were adults aged 60 and older with or without a clinical diagnosis of dementia, living in the community or residential care setting.Types of intervention This review considered studies that evaluated the effectiveness of any physical leisure activity in the prevention of dementia. Physical activities included gardening, playing sports, exercises, sightseeing and any other activities that required active movement of the body.Types of outcome measures The review considered studies that indicated the presence or absence of dementia as determined by cognitive function tests, mental examination scores, DSM classification (Diagnostic and Statistical Manual of Mental Disorders), and other valid dementia diagnostic tools.


METHODS
A search for published and unpublished literature in the English language was conducted using all major electronic databases. There was no publication date restriction. A three-step search strategy was developed using MeSH terminology and keywords to ensure that all material relevant to the review was captured.
The methodological quality of included studies was assessed by two reviewers, who appraised each study independently, using standardised Joanna Briggs Institute (JBI) critical appraisal tools.


METHODS
Data was extracted from the studies that were identified as meeting the criteria for methodological quality using the standard JBI data extraction tools. Due to the heterogeneity of populations and interventions, results are presented in narrative form.


RESULTS
Seventeen longitudinal studies were included in the review. Studies were grouped by stage of adult life participation when interventions were undertaken i.e. early-middle adulthood and late life. The evidence regarding the relationship between participation in physical activities during midlife and later life and the prevention of dementia was equivocal. The majority of studies showed limited benefits in engaging in physical activities and results indicated that some activities might be more beneficial than others.


CONCLUSIONS
IMPLICATIONS FOR RESEARCH.
1. The National Evidence-Based Aged Care Unit (NEBACU): A Collaborating Centre of the Joanna Briggs Institute, Adelaide, Australia 2. The Joanna Briggs Institute, Adelaide, Australia.
Cindy
C
Stern
Rie
R
Konno