Review of effects of physical activity on strength, balance, mobility and ADL performance in elderly subjects with dementia.

BACKGROUND/AIMS Elderly individuals with dementia are vulnerable for a decline in physical functioning and basic activities of daily living (BADL) which can lead to a decline in autonomy and participation. This study reviews the effect of physical activity on physical functioning and BADL in elderly subjects with dementia. METHODS A systematic search of the literature was performed. Key words related to the elderly, dementia, exercise interventions and physical outcome measures were used. RESULTS Sixteen studies were included. It was found that physical activity was beneficial in all stages of dementia. Multicomponent interventions (e.g. a combination of endurance, strength and balance) led to larger improvements in gait speed, functional mobility and balance, compared to progressive resistance training alone. BADL and endurance improved but were only assessed in multicomponent interventions. Lower-limb strength improved equally in multicomponent interventions and progressive resistance training. CONCLUSION Multicomponent interventions can improve physical functioning and BADL in elderly subjects regardless of the stage of dementia. The best results were obtained in the interventions with the largest training volume. However, the small number of high-quality studies, and heterogeneity of the participants and interventions prevent us from drawing firm conclusions. Recommendations are given with respect to methodological issues, further research and practical guidelines.