Objectives To assess the effect of exercise training on the cognitive function of older adults living with different types of dementia, as well as potential moderators of exercise efficacy. Design Systematic review and meta-analysis. Data sources Cochrane Central, PsycINFO, Embase, Medline and CINAHL. Eligibility criteria Peer-reviewed, randomised controlled trials, in English (1990–present), which examined the effects of exercise training on the cognitive function of older adults living with dementia. Study appraisal and synthesis Risk of bias and study quality were assessed (Cochrane Risk of Bias Tool 2.0 and Physiotherapy Evidence Database Scale). We performed random-effects models using robust variance estimation and tested moderators using the approximate Hotelling-Zhang test. Results Twenty-eight studies (n=2158) were included in the qualitative review and 25 in the meta-analysis. For all-cause dementia, a small effect of exercise training on cognitive function was observed ( g =0.19; 95% CI 0.05 to 0.33; p=0.009). Type of dementia and exercise training characteristics did not moderate the effects of exercise training on cognitive function (p>0.05). Adherence to the intervention moderated the cognitive outcome effect size such that greater mean adherence was associated with greater cognitive outcome effect sizes ( b =0.02; SE =0.01; p=0.005). Conclusion Exercise training showed small benefits for the cognitive function of older adults living with all-cause dementia. More research and standardised reporting of exercise training characteristics can strengthen the evidence for what works best for which types of dementia. PROSPERO registration number CRD42020198716.

中文翻译：

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运动训练对不同类型痴呆老年人认知功能的影响：系统评价和荟萃分析

目的 评估运动训练对患有不同类型痴呆的老年人认知功能的影响，以及运动效果的潜在调节因素。设计系统回顾和荟萃分析。数据来源 Cochrane Central、PsycINFO、Embase、Medline 和 CINAHL。资格标准 同行评议的随机对照试验，英文版（1990 年至今），检查了运动训练对老年痴呆症患者认知功能的影响。研究评估和综合评估偏倚风险和研究质量（Cochrane 偏倚风险工具 2.0 和物理治疗证据数据库量表）。我们使用稳健的方差估计执行随机效应模型，并使用近似 Hotelling-Zhang 检验测试调节器。结果 28 项研究（n=2158）被纳入定性评价，25 项纳入荟萃分析。对于全因痴呆，观察到运动训练对认知功能的影响很小（g = 0.19；95% CI 0.05 至 0.33；p=0.009）。痴呆症的类型和运动训练特征并未调节运动训练对认知功能的影响（p>0.05）。对干预的依从性缓和了认知结果效应大小，因此平均依从性越高，认知结果效应越大（b = 0.02；SE = 0.01；p = 0.005）。结论 运动训练对患有全因痴呆的老年人的认知功能显示出小的益处。对运动训练特征进行更多研究和标准化报告可以加强证据，证明哪种方法最适合哪种类型的痴呆症。PROSPERO 注册号 CRD42020198716。