Adherence to exercise interventions in older people with mild cognitive impairment and dementia: A systematic review and meta-analysis

Di Lorito, Claudio; Bosco, Alessandro; Booth, Vicky; Goldberg, Sarah; Harwood, Rowan H.; Van der Wardt, Veronika

Abstract

Adherence to physical exercise is associated with multiple benefits in people with mild cognitive impairment (MCI) and dementia. Given the gap in research, this systematic literature review aimed to determine in the context of exercise intervention studies for people with MCI and dementia: 1. How adherence is defined, monitored and recorded; 2. Adherence rates; 3. Attrition, compliance and adverse events and 4. Intervention characteristics associated with adherence. Embase, Medline, PsychInfo, SPORTDiscus, AMED, CINAHL and the International Bibliography of Social Sciences were searched in November 2018. The data were analyzed through descriptive and correlation/inferential statistics. Forty-one studies were included, 34 involving participants with dementia (n = 2149) and seven participants with MCI (n = 970). Half of the studies operationally defined adherence. Mean adherence rate was 70% [CI, 69–73%]. Adherence was significantly associated with endurance/resistance training, and interventions not including walking. The review found a lack of consistency around reporting of adherence and of key variables mediating adherence, including compliance, attrition and adverse events. Further research using more reliable measures is needed to confirm whether a correlation exists between length of interventions and adherence in participants with MCI and dementia and to identify the factors or strategies that mediate adherence in this population. Relevant implications for practice include a consideration in the development of new interventions of elements associated with higher adherence in this review, such as endurance/resistance training, and the provision of exercise in group formats.

Citation

Di Lorito, C., Bosco, A., Booth, V., Goldberg, S., Harwood, R. H., & Van der Wardt, V. (2020). Adherence to exercise interventions in older people with mild cognitive impairment and dementia: A systematic review and meta-analysis. Preventive Medicine Reports, 19, Article 101139. https://doi.org/10.1016/j.pmedr.2020.101139

• Journal Article Type: Article
• Acceptance Date: May 26, 2020
• Online Publication Date: Jun 1, 2020
• Publication Date: 2020-09
• Deposit Date: Jul 1, 2020
• Publicly Available Date: Jul 1, 2020
• Journal: Preventive Medicine Reports
• Print ISSN: 2211-3355
• Electronic ISSN: 2211-3355
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 19
• Article Number: 101139
• DOI: https://doi.org/10.1016/j.pmedr.2020.101139
• Keywords: Public Health, Environmental and Occupational Health; Health Informatics
• Public URL: https://nottingham-repository.worktribe.com/output/4597651
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2211335520300991?via%3Dihub