Exercise interventions ameliorate neuropsychiatric symptoms in dementia: A meta-analysis

Objectives: This meta-analysis was aimed at systematically synthesizing the effects of exercise interventions on neuropsychiatric symptoms in individuals with dementia. The possible moderators that may influence inter-vention effects were also examined.Methods: We searched seven databases (PubMed, Web of Science, SCOPUS, SportDiscus, Ebsco, China National Knowledge Infrastructure, and Wanfang) for randomized clinical trials. The pooled effect sizes were computed by the standardized mean difference (SMD) from post-intervention scores using random-effects models. Potential moderators were also explored by performing subgroup analyses and meta-regression. The risk of bias for included studies was evaluated by the Cochrane Risk of Bias 2.0 Tool.Results: A total of 22 effect sizes from 17 studies (n = 1344) fulfilled the inclusion criteria. The results indicated that exercise interventions had a small but significant effect on neuropsychiatric symptoms in dementia (SMD =-0.27, 95% CI [-0.40,-0.14], p < 0.001). Subgroup analyses showed that intervention frequency and disease severity moderated the effects. Specifically, interventions with medium-frequency (3 times/week) had a positive effect on neuropsychiatric symptoms (SMD =-0.5, 95% CI [-0.65,-0.34], p < 0.001), but not with low -frequency (1-2 times/week) (SMD =-0.07, 95% CI [-0.22, 0.08], p = 0.38) or high-frequency (4-7 times/ week) (SMD =-0.11, 95% CI [-0.36, 0.14], p = 0.38). Interventions had a beneficial effect on neuropsychiatric symptoms in people with mild dementia (SMD =-0.48, 95% CI [-0.71,-0.26], p < 0.001), and moderate dementia (SMD =-0.21, 95%CI [-0.37, 0.05], p < 0.05), but not severe dementia (SMD =-0.01, 95% CI [-0.33, 0.3], p = 0.94). Conclusions: Exercise interventions effectively improve neuropsychiatric symptoms in mild and moderate de-mentia patients. Interventions occurring three times per week were associated with significant effects. Our findings provide evidence that exercise interventions may be an accessible and effective means for improving dementia patients' neuropsychiatric symptoms.